{Reference Type}: Journal Article
{Title}: Earlier vs. later time period of COVID-19 infection and emergent autoimmune signs, symptoms, and serologies.
{Author}: Oakes EG;Dillon E;Buhler KA;Guan H;Paudel M;Marks K;Adejoorin I;Yee J;Ellrodt J;Tedeschi S;Sparks J;Case SM;Hsu T;Solomon DH;Jonsson AH;Alexander RV;Rao DA;Choi MY;Costenbader KH;
{Journal}: J Autoimmun
{Volume}: 148
{Issue}: 0
{Year}: 2024 Sep 2
{Factor}: 14.511
{DOI}: 10.1016/j.jaut.2024.103299
{Abstract}: <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.