High levels of autoimmune antibodies are observed in COVID-19 patients but their specific contribution to disease severity and clinical manifestations remains poorly understood. We performed a retrospective study of 115 COVID-19 hospitalized patients with different degrees of severity to analyze the generation of autoimmune antibodies to common antigens: a lysate of erythrocytes, the lipid phosphatidylserine (PS) and DNA. High levels of IgG autoantibodies against erythrocyte lysates were observed in a large percentage (up to 36%) of patients. Anti-DNA and anti-PS antibodies determined upon hospital admission correlated strongly with later development of severe disease, showing a positive predictive value of 85.7% and 92.8%, respectively. Patients with positive values for at least one of the two autoantibodies accounted for 24% of total severe cases. Statistical analysis identified strong correlations between anti-DNA antibodies and markers of cell injury, coagulation, neutrophil levels and erythrocyte size. Anti-DNA and anti-PS autoantibodies may play an important role in the pathogenesis of COVID-19 and could be developed as predictive biomarkers for disease severity and specific clinical manifestations.

中文翻译：

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自身免疫性抗 DNA 和抗磷脂酰丝氨酸抗体可预测严重 COVID-19 的发展。

在 COVID-19 患者中观察到高水平的自身免疫抗体，但它们对疾病严重程度和临床表现的具体贡献仍知之甚少。我们对 115 名不同严重程度的 COVID-19 住院患者进行了一项回顾性研究，以分析针对常见抗原的自身免疫抗体的产生：红细胞裂解物、脂质磷脂酰丝氨酸 (PS) 和 DNA。在很大比例（高达 36%）的患者中观察到高水平的针对红细胞裂解物的 IgG 自身抗体。入院时测定的抗 DNA 和抗 PS 抗体与后期严重疾病的发展密切相关，阳性预测值分别为 85.7% 和 92.8%。两种自身抗体中至少一种阳性的患者占重症病例总数的 24%。统计分析确定了抗 DNA 抗体与细胞损伤、凝血、中性粒细胞水平和红细胞大小的标志物之间的强相关性。抗 DNA 和抗 PS 自身抗体可能在 COVID-19 的发病机制中发挥重要作用，并可开发为疾病严重程度和特定临床表现的预测生物标志物。