背景:在COVID-19疾病中,针对宿主蛋白如G蛋白偶联受体(GPCRs)和肾素-血管紧张素系统(RAS)的自身抗体(AAbs)的报道越来越多。在这里,我们对COVID-19患者(包括具有长期COVID或COVID后症状的患者)抗GPCRs和RAS的所有AAbs报告进行了系统评价和荟萃分析。
方法:PubMed,Embase,WebofScience,搜索了Scopus数据库,以找到截至2023年3月21日,关于GPCR和RASAAb在COVID-19或COVID后症状的存在和严重程度中的作用的论文。关于AngII或ACE患病率的数据,比较了COVID-19和非COVID-19之间的AngII或ACE,或比较了不同疾病分期的COVID-19患者之间的AngII或ACE,并使用随机或固定效应模型进行了荟萃分析.
结果:搜索共产生1042篇文章,其中68项研究纳入本系统综述,9项纳入荟萃分析.在调查GPCRs和COVID-19严重程度的18项研究中,检测到18种不同的AAbs。此外,在评估后COVID的病例报告中发现了9个AAb,在其他评估COVID后或长期COVID症状的研究中发现了19种AAb。荟萃分析显示,COVID-19患者血清ACE2AAb阳性的数量明显更高(比值比=7.766[2.056,29.208],p=0.002),尤其是在严重疾病中(比值比=11.49[1.04,126.86],p=0.046),而AngII-AAbs血清阳性在COVID-19和对照受试者之间没有差异(比值比=2.890[0.546-15.283],p=0.21)。
结论:GPCR和RASAAbs可能在COVID-19严重程度中起重要作用,疾病进展的发展,长期症状COVID和COVID后症状。
BACKGROUND: There are an increasing number of reports of autoantibodies (AAbs) against host proteins such as G-protein coupled receptors (GPCRs) and the renin-angiotensin system (RAS) in COVID-19 disease. Here we have undertaken a systematic
review and meta-analysis of all reports of AAbs against GPCRs and RAS in COVID-19 patients including those with long-COVID or post-COVID symptoms.
METHODS: PubMed, Embase, Web of Science, and Scopus databases were searched to find papers on the role of GPCR and RAS AAbs in the presence and severity of COVID-19 or post- COVID symptoms available through March 21, 2023. Data on the prevalence of AngII or ACE, comparing AngII or ACE between COVID-19 and non-COVID-19, or comparing AngII or ACE between COVID-19 patients with different disease stages were pooled and a meta-analysed using random- or fixed-effects models were undertaken.
RESULTS: The search yielded a total of 1042 articles, of which 68 studies were included in this systematic
review and nine in the meta-analysis. Among 18 studies that investigated GPCRs and COVID-19 severity, 18 distinct AAbs were detected. In addition, nine AAbs were found in case reports that assessed post- COVID, and 19 AAbs were found in other studies that assessed post- COVID or long- COVID symptoms. Meta-analysis revealed a significantly higher number of seropositive ACE2 AAbs in COVID-19 patients (odds ratio = 7.766 [2.056, 29.208], p = 0.002) and particularly in severe disease (odds ratio = 11.49 [1.04, 126.86], p = 0.046), whereas AngII-AAbs seropositivity was no different between COVID-19 and control subjects (odds ratio = 2.890 [0.546-15.283], p = 0.21).
CONCLUSIONS: GPCR and RAS AAbs may play an important role in COVID-19 severity, the development of disease progression, long-term symptoms COVID and post- COVID symptoms.