Is autoimmune disease linked to some covid-19 deaths?

29 January 2021 | Muriel Cozier

Monitoring anti-body levels may alert clinicians to severity of covid-19

Understanding why covid-19 is deadly for some people and not others, and some individuals show no symptoms at all, has puzzled scientists. Now researchers from New York University are proposing that some deadly cases of covid-19 could be linked to the virus triggering an autoimmune response.

Specifically, the research team examined the levels of antibodies against Annexin A2, a protein found in the lungs that plays an important role in anti-inflammatory processes and maintaining the structure of blood vessels. Antibodies targeting this protein may exacerbate respiratory problems caused by covid-19.

The researchers analysed the antibody levels in 86 patients who were hospitalised with covid-19. Of these, 28 were not critically ill, 36 were critically ill and 22 died. Using logistic regression, the researchers were able to determine the association between antibody level and death. The team found, using margins analysis, that the probability of death increased as a patient’s anti-Annexin A2 antibody levels increased.

The research team points out that its work is yet to be peer reviewed and should not be used as a guide to clinical practice. They also add that a single association study is insufficient to conclude causation, so it’s not yet possible to say definitively that anti-Annexin A2 antibodies are responsible for the higher probability of death. ‘But it is tempting to speculate that they played a role, especially since it is well known that several microbes trigger autoimmune disease. At the very least, anti-Annexin A2 antibody levels seem to predict death, so monitoring them may give clinicians insight into the severity of covid in a patient,’ the researchers said.

DOI: 10.1101/2020.12.28.20248807

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