Persistent Autoimmune Activation and Proinflammatory State in Post-Coronavirus Disease 2019 Syndrome

Yeny Acosta-Ampudia, Diana M Monsalve, Manuel Rojas, Yhojan Rodríguez, Elizabeth Zapata, Carolina Ramírez-Santana, Juan-Manuel Anaya

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76 Scopus citations


BACKGROUND: The immunopathological pathways enabling post-COVID syndrome (PCS) development are not entirely known. We underwent a longitudinal analysis of patients with COVID-19 who developed PCS aiming to evaluate the autoimmune and immunological status associated with this condition.

METHODS: Thirty-three patients were included for longitudinal clinical and autoantibody analyses of whom 12 patients were assessed for cytokines and lymphocyte populations. Patients were followed during 7-11 months after acute COVID-19. Autoimmune profile and immunological status were evaluated mainly by enzyme-linked-immunosorbent assays and flow cytometry.

RESULTS: Latent autoimmunity and overt autoimmunity persisted over time. A proinflammatory state was observed in patients with PCS characterized by upregulated IFN-α, TNF-α, G-CSF, IL-17A, IL-6, IL-1β, and IL-13, whereas IP-10 was decreased. In addition, PCS was characterized by increased levels of Th9, CD8+ effector T cells, naive B cells, and CD4+ effector memory T cells. Total levels of IgG S1-SARS-CoV-2 antibodies remained elevated over time.

DISCUSSION: The clinical manifestations of PCS are associated with the persistence of a proinflammatory, and effector phenotype induced by SARS-CoV-2 infection. This long-term persistent immune activation may contribute to the development of latent and overt autoimmunity. Results suggest the need to evaluate the role of immunomodulation in the treatment of PCS.

Translated title of the contributionActivación autoinmune persistente y estado proinflamatorio en el síndrome poscoronavirus 2019
Original languageEnglish (US)
Pages (from-to)2155-2162
Number of pages8
JournalJournal of Infectious Diseases
Issue number12
StatePublished - Jun 15 2022

All Science Journal Classification (ASJC) codes

  • Immunology


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