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DOI 10.1073/pnas.2518581123

Медицинская библиотека · Proceedings of the National Academy of Sciences of the United States of America · 2026

High risk of hypoxemic COVID-19 pneumonia in myasthenia gravis patients with type I IFN autoantibodies.

Gervais Adrian, Marchal Astrid, Maillard Alexis, Le Voyer Tom, Rosain Jérémie, Philippot Quentin, Bizien Lucy, Peel Jessica, Cederholm Axel, Migaud Mélanie, Pons Sylvie, Saker Kahina, Laforet Pascal, Aubart Mélodie, Gitiaux Cyril, Biggs Catherine M, Lopez Rafael Leon, Souvannanorath Sarah, Tard Céline, Pakleza Aleksandra Nadaj, Grapperon Aude-Marie, Heming Nicholas, Annane Djillali, Verschueren Annie, Attarian Shahram, Bigaut Kévin, Hankiewicz Karolina, Kouton Ludivine, Villar-Quiles Rocio-Nur, Cauquil Cécile, Fleury Marie-Céline, Rocher Emilie, Nicolas Guillaume, de Paula Estephan Eduardo, da Penha Ananias Morita Maria, Zanoteli Edmar, Saied Zakaria, Rachdi Amine, Rim Amouri, Belal Samir, Ben Sassi Samia, Hübers Annemarie, Faure Emmanuel, Desguerre Isabelle, Basse Clémence, Girard Nicolas, Béziat Vivien, Pan-Hammarström Qiang, Hammarström Lennart, Bodansky Aaron, Parent Audrey V, Anderson Mark S, DeRisi Joseph L, Demeret Sophie, Truffault Frédérique, Fort Romain, Ader Florence, Wallet Florent, Trouillet-Assant Sophie, Abel Laurent, Molina Thierry, Alyanakian Marie-Alexandra, Le Panse Rozen, Solé Guilhem, Cobat Aurélie, Landegren Nils, Casanova Jean-Laurent, Puel Anne, Bastard Paul, Jouanguy Emmanuelle

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Аннотация

Patients with myasthenia gravis (MG) may produce autoantibodies neutralizing type I interferons (AAN-I-IFN), which underlie severe viral diseases, including critical COVID-19 pneumonia, in patients without MG. We studied an international cohort of 85 unvaccinated SARS-CoV-2-infected MG patients not given antiviral treatment. Hypoxemic pneumonia occurred in 48 of these patients, including 22 (45.8%) with AAN-I-IFN, which neutralized both IFN-α2 and IFN-ω in 14 (29.2%) patients. Six (16.2%) of the remaining 37 patients had AAN-I-IFN, neutralizing both IFN-α2 and IFN-ω in three patients. The risk of hypoxemic pneumonia was greater in MG patients with AAN-I-IFN neutralizing 10 ng/mL of both IFN-α2 and IFN-ω (odds ratio and 95% confidence interval (OR [95% CI]): 12.7 [2.1 to 78.9], P = 0.0010) or IFN-α2 at any dose (OR [95% CI]: 4.7 [1.5 to 15.0], P = 0.0054) than in those without such autoantibodies. The risk of producing AAN-I-IFN was much higher in MG patients than in the general population (OR [95% CI]: 28.9 [10.8 to 77.7], P = 4.9 × 10-27). Thymoma was found in 14 patients and increased the risk of AAN-I-IFN (64% versus 27%, (OR [95% CI]: 5.6 [1.6 to 19.4], P = 0.0050) and hypoxemic pneumonia (9.2 [1.9 to 44.2]; P = 0.0019). Thymoma is, thus, associated with a higher risk of producing AAN-I-IFN, which are, in turn, associated with a higher risk of developing life-threatening COVID-19 pneumonia in patients with MG.

Для цитирования: Gervais Adrian, Marchal Astrid, Maillard Alexis, Le Voyer Tom, Rosain Jérémie, Philippot Quentin, Bizien Lucy, Peel Jessica, Cederholm Axel, Migaud Mélanie, Pons Sylvie, Saker Kahina, Laforet Pascal, Aubart Mélodie, Gitiaux Cyril, Biggs Catherine M, Lopez Rafael Leon, Souvannanorath Sarah, Tard Céline, Pakleza Aleksandra Nadaj, Grapperon Aude-Marie, Heming Nicholas, Annane Djillali, Verschueren Annie, Attarian Shahram, Bigaut Kévin, Hankiewicz Karolina, Kouton Ludivine, Villar-Quiles Rocio-Nur, Cauquil Cécile, Fleury Marie-Céline, Rocher Emilie, Nicolas Guillaume, de Paula Estephan Eduardo, da Penha Ananias Morita Maria, Zanoteli Edmar, Saied Zakaria, Rachdi Amine, Rim Amouri, Belal Samir, Ben Sassi Samia, Hübers Annemarie, Faure Emmanuel, Desguerre Isabelle, Basse Clémence, Girard Nicolas, Béziat Vivien, Pan-Hammarström Qiang, Hammarström Lennart, Bodansky Aaron, Parent Audrey V, Anderson Mark S, DeRisi Joseph L, Demeret Sophie, Truffault Frédérique, Fort Romain, Ader Florence, Wallet Florent, Trouillet-Assant Sophie, Abel Laurent, Molina Thierry, Alyanakian Marie-Alexandra, Le Panse Rozen, Solé Guilhem, Cobat Aurélie, Landegren Nils, Casanova Jean-Laurent, Puel Anne, Bastard Paul, Jouanguy Emmanuelle. High risk of hypoxemic COVID-19 pneumonia in myasthenia gravis patients with type I IFN autoantibodies.. Proceedings of the National Academy of Sciences of the United States of America. 2026. DOI: 10.1073/pnas.2518581123.

Предметные рубрики MeSH

HumansAutoantibodiesMyasthenia GravisFemaleMaleInterferon Type ICOVID-19Middle AgedSARS-CoV-2AgedHypoxiaAdultInterferon-alphaPandemicsRisk Factors
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