Coronavirus disease 2019 (COVID-19) has similarities to systemic autoimmune conditions, including an association with increased incidence of autoantibodies, including those directed toward cytokines. However, reports to date lack longitudinal assessments and have inadequate controls (i.e., comparison to different severities within COVID-19 or to healthy individuals). Moreover, previous studies reported the emergence of autoantibodies in severe respiratory and infectious disease.
We performed an observational cohort study in which we prospectively enrolled adults with suspected COVID-19-associated acute respiratory failure on admission to the intensive care unit (ICU). Patients were classified based on SARS-CoV-2 testing by polymerase chain reaction (PCR). The primary clinical outcome was death in ICU within 3 months; secondary outcomes included in-hospital death and disease severity. Anti-nuclear antibodies (ANA), antigen-specific autoantibodies (sp-AAB), myositis-related autoantibodies and anti-cytokine autoantibodies (aC-AAB) were measured longitudinally. Patients did not receive any COVID-19-specific therapies since recruitment occurred before any were considered standard of care.