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Autoantibody production is enhanced after mild SARS-CoV-2 infection despite vaccination in patients with and without long COVID

Visvabharathy, L.; Zhu, C.; Orban, Z. S.; Yarnoff, K.; Palacio, N.; Jimenez, M.; Lim, P.; Penaloza-MacMaster, P.; Koralnik, I. J.

2023-04-12 infectious diseases
10.1101/2023.04.07.23288243 medRxiv
Show abstract

Long COVID patients who experienced severe acute SARS-CoV-2 infection can present with humoral autoimmunity. However, whether mild SARS-CoV-2 infection increases autoantibody responses and whether vaccination can decrease autoimmunity in long COVID patients is unknown. Here, we demonstrate that mild SARS-CoV-2 infection increases autoantibodies associated with systemic lupus erythematosus (SLE) and inflammatory myopathies in long COVID patients with persistent neurologic symptoms to a greater extent than COVID convalescent controls at 8 months post-infection. Furthermore, high titers of SLE-associated autoantibodies in long COVID patients are associated with impaired cognitive performance and greater symptom severity, and subsequent vaccination/booster does not decrease autoantibody titers. In summary, we found that mild SARS-CoV-2 infection can induce persistent humoral autoimmunity in both long COVID patients and healthy COVID convalescents, suggesting that a reappraisal of vaccination and mitigation strategies is warranted.

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