Abstract：
OBJECTIVE: Autoantibodies and autoimmune diseases after SARS-CoV-2 infection are widely reported. Given evolving variants, milder infections, and increasing population vaccination, we hypothesized that SARS-CoV-2 infection earlier in the pandemic would be associated with more autoimmune connective tissue disease (CTD) symptoms and immunologic abnormalities.
METHODS: Patients ≥18 years old with COVID-19 3/1/2020-8/15/2022 completed the CTD Screening Questionnaire and were tested for 27 autoimmune serologies, SARS-CoV-2 serologies, cell-bound complement activation products (CB-CAPs), and T and B lymphocyte immunophenotypes by flow cytometry. We assessed relationships between symptoms, serologies, and immunophenotypes in earlier (3/1/2020-1/31/2021) vs. later (2/1/2021-8/15/2022) periods, with different predominating SARS-CoV-2 viruses.
RESULTS: 57 subjects had earlier and 23 had later pandemic COVID-19. 35 % of earlier vs. 17 % of later pandemic patients had CTD symptoms (p 0.18). More patients were antinuclear antibody (ANA) positive (44 % vs. 13 %, p 0.01) and had lupus anticoagulant (11 % vs. 4 %, p 0.67). After adjustment for age, race, and sex, earlier (vs. later) COVID-19 was associated with increased ANA positivity (OR 4.60, 95%CI 1.17, 18.15). No subjects had positive CB-CAPs. T and B cell immunophenotypes and SARS-CoV-2 serologies did not differ by group. In heatmap analyses, higher autoantibody variety was seen among those with infection in the early pandemic.
CONCLUSIONS: In this sample, having COVID-19 infection in the earlier (pre-2/1/2021) vs. later pandemic was associated with more CTD symptoms, ANA positivity, and autoantibody reactivities. Earlier SARS-CoV-2 variants circulating in a less vaccinated population with less natural immunity may have been more immunogenic.
METHODS: Patients ≥18 years old with COVID-19 3/1/2020-8/15/2022 completed the CTD Screening Questionnaire and were tested for 27 autoimmune serologies, SARS-CoV-2 serologies, cell-bound complement activation products (CB-CAPs), and T and B lymphocyte immunophenotypes by flow cytometry. We assessed relationships between symptoms, serologies, and immunophenotypes in earlier (3/1/2020-1/31/2021) vs. later (2/1/2021-8/15/2022) periods, with different predominating SARS-CoV-2 viruses.
RESULTS: 57 subjects had earlier and 23 had later pandemic COVID-19. 35 % of earlier vs. 17 % of later pandemic patients had CTD symptoms (p 0.18). More patients were antinuclear antibody (ANA) positive (44 % vs. 13 %, p 0.01) and had lupus anticoagulant (11 % vs. 4 %, p 0.67). After adjustment for age, race, and sex, earlier (vs. later) COVID-19 was associated with increased ANA positivity (OR 4.60, 95%CI 1.17, 18.15). No subjects had positive CB-CAPs. T and B cell immunophenotypes and SARS-CoV-2 serologies did not differ by group. In heatmap analyses, higher autoantibody variety was seen among those with infection in the early pandemic.
CONCLUSIONS: In this sample, having COVID-19 infection in the earlier (pre-2/1/2021) vs. later pandemic was associated with more CTD symptoms, ANA positivity, and autoantibody reactivities. Earlier SARS-CoV-2 variants circulating in a less vaccinated population with less natural immunity may have been more immunogenic.
摘要：
目的：SARS-CoV-2感染后自身抗体和自身免疫性疾病的报道广泛。鉴于不断发展的变体，轻度感染,增加人口疫苗接种，我们假设SARS-CoV-2在大流行早期感染会与更多自身免疫性结缔组织病(CTD)症状和免疫学异常相关.
方法：年龄≥18岁的COVID-193/2020/1-8/15/2022完成CTD筛查问卷，并检测27种自身免疫性血清学，SARS-CoV-2血清学，细胞结合补体激活产物（CB-CAPs），流式细胞术检测T、B淋巴细胞免疫表型。我们评估了症状之间的关系，血清学,和免疫表型在早期（3/1/2020-1/31/2021）与稍后（2021年2月1日至2022年8月15日）期间，与不同的主要SARS-CoV-2病毒。
结果：57名受试者较早，23名受试者较晚流行COVID-19。35%的早期与17%的晚期大流行患者有CTD症状(p=0.18)。更多患者的抗核抗体（ANA）阳性（44％vs.13%,p0.01）和狼疮抗凝药（11%vs.4%,p0.67)。调整后的年龄，种族,和性,较早(vs.稍后）COVID-19与ANA阳性增加相关（OR4.60，95CI1.17，18.15）。没有受试者具有阳性CB-CAPs。T和B细胞免疫表型和SARS-CoV-2血清学无差异。在热图分析中，在大流行早期感染的人群中，自身抗体的多样性较高。
结论：在此示例中，较早(2021年2月1日之前)感染COVID-19的病例与后来的大流行与更多的CTD症状有关，ANA阳性，和自身抗体反应性。早期的SARS-CoV-2变体在具有较低天然免疫的较少接种疫苗的人群中循环可能具有更大的免疫原性。
方法：年龄≥18岁的COVID-193/2020/1-8/15/2022完成CTD筛查问卷，并检测27种自身免疫性血清学，SARS-CoV-2血清学，细胞结合补体激活产物（CB-CAPs），流式细胞术检测T、B淋巴细胞免疫表型。我们评估了症状之间的关系，血清学,和免疫表型在早期（3/1/2020-1/31/2021）与稍后（2021年2月1日至2022年8月15日）期间，与不同的主要SARS-CoV-2病毒。
结果：57名受试者较早，23名受试者较晚流行COVID-19。35%的早期与17%的晚期大流行患者有CTD症状(p=0.18)。更多患者的抗核抗体（ANA）阳性（44％vs.13%,p0.01）和狼疮抗凝药（11%vs.4%,p0.67)。调整后的年龄，种族,和性,较早(vs.稍后）COVID-19与ANA阳性增加相关（OR4.60，95CI1.17，18.15）。没有受试者具有阳性CB-CAPs。T和B细胞免疫表型和SARS-CoV-2血清学无差异。在热图分析中，在大流行早期感染的人群中，自身抗体的多样性较高。
结论：在此示例中，较早(2021年2月1日之前)感染COVID-19的病例与后来的大流行与更多的CTD症状有关，ANA阳性，和自身抗体反应性。早期的SARS-CoV-2变体在具有较低天然免疫的较少接种疫苗的人群中循环可能具有更大的免疫原性。
