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  4. The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies
 
research article

The risk of COVID-19 death is much greater and age dependent with type I IFN autoantibodies

Manry, Jeremy
•
Bastard, Paul
•
Gervais, Adrian
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May 24, 2022
Proceedings Of The National Academy Of Sciences Of The United States Of America (PNAS)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection fatality rate (IFR) doubles with every 5 y of age from childhood onward. Circulating autoantibodies neutralizing IFN-alpha, IFN-omega, and/or IFN-beta are found in similar to 20% of deceased patients across age groups, and in similar to 1% of individuals aged <70 y and in >4% of those >70 y old in the general population. With a sample of 1,261 unvaccinated deceased patients and 34,159 individuals of the general population sampled before the pandemic, we estimated both IFR and relative risk of death (RRD) across age groups for individuals carrying autoantibodies neutralizing type I IFNs, relative to noncarriers. The RRD associated with any combination of autoantibodies was higher in subjects under 70 y old. For autoantibodies neutralizing IFN-alpha 2 or IFN-omega, the RRDs were 17.0 (95% CI: 11.7 to 24.7) and 5.8 (4.5 to 7.4) for individuals <70 y and >= 70 y old, respectively, whereas, for autoantibodies neutralizing both molecules, the RRDs were 188.3 (44.8 to 774.4) and 7.2 (5.0 to 10.3), respectively. In contrast, IFRs increased with age, ranging from 0.17% (0.12 to 0.31) for individuals <40 y old to 26.7% (20.3 to 35.2) for those >= 80 y old for autoantibodies neutralizing IFN-alpha 2 or IFN-omega, and from 0.84% (0.31 to 8.28) to 40.5% (27.82 to 61.20) for autoantibodies neutralizing both. Autoantibodies against type I IFNs increase IFRs, and are associated with high RRDs, especially when neutralizing both IFN-alpha 2 and IFN-omega. Remarkably, IFRs increase with age, whereas RRDs decrease with age. Autoimmunity to type I IFNs is a strong and common predictor of COVID-19 death.

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Type
research article
DOI
10.1073/pnas.2200413119
Web of Science ID

WOS:000841027100010

Author(s)
Manry, Jeremy
Bastard, Paul
Gervais, Adrian
Le Voyer, Tom
Rosain, Jeremie
Philippot, Quentin
Michailidis, Eleftherios
Hoffmann, Hans-Heinrich
Eto, Shohei
Garcia-Prat, Marina
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Date Issued

2022-05-24

Publisher

National Academy of Sciences

Published in
Proceedings Of The National Academy Of Sciences Of The United States Of America (PNAS)
Volume

119

Issue

21

Article Number

e2200413119

Subjects

Multidisciplinary Sciences

•

Science & Technology - Other Topics

•

covid-19

•

type i ifns

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autoantibodies

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relative risk

•

infection fatality rate

•

chronic mucocutaneous candidiasis

•

disease

•

infection

•

immunity

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
UPFELLAY  
Available on Infoscience
September 12, 2022
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/190769
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