免疫系统对SARS-CoV-2的扩增反应可能导致自身抗体的产生,但它们对疾病严重程度和结局的具体影响尚不清楚.这项研究旨在评估住院的COVID-19患者是否基于ANA的存在而面临更差的预后,即使没有自身免疫性疾病。我们做了一个回顾,单中心,观察性队列研究,于2020年4月至2021年3月在福贾(意大利)的“PoliclinicoRiuniti”医院招募638名COVID-19患者住院。ANA检测阳性的COVID-19患者的30天生存率显着降低(64.4%vs.83.0%),住院期间发生严重呼吸系统并发症的可能性高于ANA筛查阴性的患者(35.4%vs.17.0%)(p<0.001)。通过计算HALP评分(血红蛋白-白蛋白-淋巴细胞-血小板)来确定不良预后与ANA状态之间的关联,与ANA阴性患者相比,ANA检测阳性的COVID-19患者的这一比例较低(108.1±7.4vs.218.6±11.2AU;p<0.011)。详细来说,低HALP的COVID-19患者的30天生存率较低(99.1%与83.6%与高55.2%,中等,和低HALP,分别;p<0.001),与高和中HALP患者相比,不良呼吸事件的发生率更高(13.1%vs.35.2%与64.6%为高,中等,和低HALP,分别为;p<0.001)。总之,COVID-19患者的ANA阳性似乎与更具侵袭性的疾病表型相关,生存率降低。此外,我们认为HALP评分可作为评估COVID-19患者预后的一个有价值的参数.
The immune system\'s amplified response to SARS-CoV-2 may lead to the production of autoantibodies, but their specific impact on disease severity and outcome remains unclear. This
study aims to assess if hospitalized COVID-19 patients face a worse prognosis based on ANA presence, even without autoimmune diseases. We performed a retrospective, single-center, observational cohort
study, enrolling 638 COVID-19 patients hospitalized from April 2020 to March 2021 at Hospital \"Policlinico Riuniti\" of Foggia (Italy). COVID-19 patients with a positive ANA test exhibited a significantly lower 30-day survival rate (64.4% vs. 83.0%) and a higher likelihood of severe respiratory complications during hospitalization than those with negative ANA screening (35.4% vs. 17.0%) (p < 0.001). The association between poor prognosis and ANA status was identified by calculating the HALP score (Hemoglobin-Albumin-Lymphocyte-Platelet), which was lower in COVID-19 patients with a positive ANA test compared to ANA-negative patients (108.1 ± 7.4 vs. 218.6 ± 11.2 AU; p < 0.011). In detail, COVID-19 patients with a low HALP showed a lower 30-day survival rate (99.1% vs. 83.6% vs. 55.2% for high, medium, and low HALP, respectively; p < 0.001) and a higher incidence of adverse respiratory events compared to those with high and medium HALP (13.1% vs. 35.2% vs. 64.6% for high, medium, and low HALP, respectively; p < 0.001). In summary, ANA positivity in COVID-19 patients appears to be linked to a more aggressive disease phenotype with a reduced survival rate. Furthermore, we propose that the HALP score could serve as a valuable parameter to assess prognosis for COVID-19 patients.