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Natl. Acad. Sci. U.S.A."],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:p>\n                    Patients with myasthenia gravis (MG) may produce autoantibodies neutralizing type I interferons (AAN-I-IFN), which underlie severe viral diseases, including critical COVID-19 pneumonia, in patients without MG. We studied an international cohort of 85 unvaccinated SARS-CoV-2-infected MG patients not given antiviral treatment. Hypoxemic pneumonia occurred in 48 of these patients, including 22 (45.8%) with AAN-I-IFN, which neutralized both IFN-\u03b12 and IFN-\u03c9 in 14 (29.2%) patients. Six (16.2%) of the remaining 37 patients had AAN-I-IFN, neutralizing both IFN-\u03b12 and IFN-\u03c9 in three patients. The risk of hypoxemic pneumonia was greater in MG patients with AAN-I-IFN neutralizing 10 ng\/mL of both IFN-\u03b12 and IFN-\u03c9 (odds ratio and 95% confidence interval (OR [95% CI]): 12.7 [2.1 to 78.9],\n                    <jats:italic toggle=\"yes\">\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    <\/jats:italic>\n                    = 0.0010) or IFN-\u03b12 at any dose (OR [95% CI]: 4.7 [1.5 to 15.0],\n                    <jats:italic toggle=\"yes\">\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    <\/jats:italic>\n                    = 0.0054) than in those without such autoantibodies. The risk of producing AAN-I-IFN was much higher in MG patients than in the general population (OR [95% CI]: 28.9 [10.8 to 77.7],\n                    <jats:italic toggle=\"yes\">\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    <\/jats:italic>\n                    = 4.9 \u00d7 10\n                    <jats:sup>\u221227<\/jats:sup>\n                    ). Thymoma was found in 14 patients and increased the risk of AAN-I-IFN (64% versus 27%, (OR [95% CI]: 5.6 [1.6 to 19.4],\n                    <jats:italic toggle=\"yes\">\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    <\/jats:italic>\n                    = 0.0050) and hypoxemic pneumonia (9.2 [1.9 to 44.2];\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.0019). Thymoma is, thus, associated with a higher risk of producing AAN-I-IFN, which are, in turn, associated with a higher risk of developing life-threatening COVID-19 pneumonia in patients with MG.\n                  <\/jats:p>","DOI":"10.1073\/pnas.2518581123","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T16:08:22Z","timestamp":1785514102000},"update-policy":"https:\/\/doi.org\/10.1073\/pnas.cm10313","source":"Crossref","is-referenced-by-count":0,"title":["High risk of hypoxemic COVID-19 pneumonia in myasthenia gravis patients with type I IFN autoantibodies"],"prefix":"10.1073","volume":"123","author":[{"given":"Adrian","family":"Gervais","sequence":"first","affiliation":[{"name":"Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children","place":["Paris, France"]},{"id":[{"id":"https:\/\/ror.org\/05rq3rb55","id-type":"ROR","asserted-by":"publisher"}],"name":"Imagine Institute, Paris 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