Type-I interferons (IFNs) mediate antiviral activity and have emerged as important immune mediators during coronavirus disease 19 (COVID-19). Several lines of evidence suggest that impaired type-I IFN signaling may predispose to severe COVID-19. However, the pathophysiologic mechanisms that contribute to illness severity remain unclear. In this study, our goal was to gain insight into how type-I IFNs influence outcomes in patients with COVID-19. To achieve this goal, we compared clinical outcomes between 26 patients with neutralizing type-I IFN autoantibodies (AAbs) and 192 patients without AAbs who were hospitalized for COVID-19 at three Italian hospitals. The presence of circulating AAbs to type-I IFNs was associated with an increased risk of admission to the intensive care unit and a delayed time to viral clearance. However, survival was not adversely affected by the presence of type-I IFN AAbs. Our findings provide further support for the role of type-I IFN AAbs in impairing host antiviral defense and promoting the development of critical COVID-19 pneumonia in severe acute respiratory syndrome coronavirus 2-infected individuals.

中文翻译：

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中和 I 型干扰素自身抗体与 COVID-19 患者的病毒清除延迟和重症监护病房入院有关

I 型干扰素 (IFN) 介导抗病毒活性，并已成为冠状病毒病 19 (COVID-19) 期间的重要免疫介质。几条证据表明，I 型 IFN 信号传导受损可能易患严重的 COVID-19。然而，导致疾病严重程度的病理生理机制仍不清楚。在这项研究中，我们的目标是深入了解 I 型 IFN 如何影响 COVID-19 患者的预后。为了实现这一目标，我们比较了在意大利三家医院因 COVID-19 住院的 26 名中和 I 型 IFN 自身抗体 (AAb) 患者和 192 名无 AAb 患者的临床结果。I 型 IFN 的循环 AAb 的存在与入住重症监护病房的风险增加和病毒清除时间延迟有关。然而，I 型 IFN AAb 的存在不会对生存产生不利影响。我们的研究结果进一步支持 I 型 IFN AAb 在严重急性呼吸综合征冠状病毒 2 感染个体中损害宿主抗病毒防御和促进危重 COVID-19 肺炎发展中的作用。