Auto-antibodies neutralizing type I interferons in ~10% of Moroccan patients with life-threatening COVID-19.

INTRODUCTION

Autoantibodies neutralizing type I interferon (AAN-I-IFN) have been found in at least 10-15% of critical COVID-19 pneumonia cases in various studies across North and Latin America, Oceania, Europe, and Asia. We sought to analyze the prevalence of AAN-I-IFN and describe the demographic, clinical, and laboratory characteristics in a Moroccan cohort of patients with life-threatening COVID-19.

METHODS

We performed a cross-sectional and multicenter study of patients hospitalized in different university hospitals and clinical centers in Casablanca between November 2020 and December 2021.

RESULTS

Our cohort included 195 patients with proven SARS-CoV-2 infection, 164 (84.1%) of whom developed severe or critical COVID-19 disease requiring hospitalization, and 31 (15.9%) patients developed mild or moderate disease. Patients with moderate or mild COVID-19 did not exhibit detectable levels of AAN-I-IFNs. Among the 20 patients with AAN-I-IFN, most were men (n=16, 80%), and age ranged from 19 to 101 years. 13 (65%) patients with severe COVID-19 and 7 (35%) with critical COVID-19 had AAN-I-IFNs. Twelve patients (60%) had autoantibodies (auto-Abs) neutralizing both high and low concentrations of IFN-α2 and/or IFN-ω, five (25%) had auto-Abs neutralizing only low concentrations of IFN-α2 or IFN-ω, two (10%) had auto-Abs neutralizing IFN-β (1ng/mL) only, and one (5%) had auto-Abs neutralizing high and low concentrations of IFN-α2 and IFN-ω, as well as IFN-β at 1ng/mL, but none neutralized IFN-β at 10 ng/mL.

CONCLUSION

Overall, AAN-I-IFNs were detected in 20/195 (10.3%) of Moroccan patients with life-threatening COVID-19 and in 20/164 (12.2%) patients with severe or critical disease, whereas none were detected in patients with mild or moderate COVID-19.