{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:40:00Z","timestamp":1791333600399,"version":"4.3.1"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Government of the Amazonas State"},{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["403253\/2020-9"],"award-info":[{"award-number":["403253\/2020-9"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["175855\/2023-4"],"award-info":[{"award-number":["175855\/2023-4"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["#408767\/2022-7"],"award-info":[{"award-number":["#408767\/2022-7"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004916","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado do Amazonas","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004916","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Autoantibodies have been implicated as key players in COVID-19 pathogenesis, with evidence of impacting disease severity and poor outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed autoantibody profiles in 435 PCR-confirmed COVID-19 patients in Manaus, Brazil, comparing hospitalized (263) and nonhospitalized (172) individuals, and 37 healthy controls. Twenty autoantibodies and SARS-CoV-2-specific IgA\/IgG antibodies were measured using multiplex Luminex\u00ae assays from plasma samples collected on days 1, 7, 14, and 28.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Hospitalized patients had significantly higher levels of autoantibodies targeting ACE2, MPO, IFN\u03a9, IFN\u03b11, and IFN\u03b12 at baseline, with 127 hospitalized patients positive for IFN\u03b11, 161 for IFN\u03b12 and 68 for IFN\u03a9. Longitudinal analysis revealed progressively increasing levels of anti-ACE2, B2G1, C1q, IFN\u03b11, IFN\u03b12, PADI4, PF4, and PR3 autoantibodies in hospitalized patients; however, the neutralizing capacity of IFNs were not investigated. Survival analysis showed that elevated type I IFN autoantibodies correlated with reduced survival (P = .023). Stronger correlations between autoantibodies and SARS-CoV-2 IgA\/IgG were found in severe cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort, autoantibodies were linked to COVID-19 severity and mortality, indicating their potential as biomarkers for patient risk stratification and therapeutic targets. Further research is needed to explore their impact in long-term immune dysregulation and postacute sequelae in COVID-19 survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay summary<\/jats:title>\n                    <jats:p>COVID-19 affects people differently. Some recover quickly, while others become very sick or die. Scientists have found that some COVID-19 patients develop autoantibodies, or \u201cself-attacking\u201d antibodies. How and which autoantibodies were relevant in COVID-19 remains to be described. This study conducted in Manaus, Brazil, aimed to understand if these autoantibodies contributed to severe COVID-19 and poor survival outcomes. Manaus was one of the hardest-hit regions by the pandemic. We studied 435 COVID-19 patients (263 hospitalized, 172 nonhospitalized), and 37 healthy individuals. Blood samples were collected over 28 days and tested for 20 different autoantibodies and antibodies against the coronavirus using advanced laboratory assays. Hospitalized patients had notably higher levels of 2 specific autoantibodies. Those that block the body's natural antiviral proteins (type I interferons) and ACE2 (helps regulate systemic and local inflammation, and fluid homeostasis). These autoantibodies were strongly linked with severe illness and a higher risk of death, and increased over time. Patients with strong autoantibody responses also had higher levels of antibodies against the virus, suggesting a link between infection and immune self-attack. Autoantibodies were strongly linked to severe COVID-19 and death. Screening for them could help doctors identify high-risk patients early for effective treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf514","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:16:18Z","timestamp":1760012178000},"page":"498-509","source":"Crossref","is-referenced-by-count":3,"title":["Autoantibodies Against Type I Interferons are a Prominent Feature in SARS-CoV-2 Fatal Disease and Hospitalization"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6702-5681","authenticated-orcid":false,"given":"Rebeca","family":"Linhares Abreu Netto","sequence":"first","affiliation":[{"name":"Departamento de Ensino e Pesquisa, Funda\u00e7\u00e3o de Medicina Tropical , Manaus, Amazonas ,","place":["Brazil"]},{"name":"Escola Superior de Ci\u00eancias da Sa\u00fade, Universidade do Estado do Amazonas , Manaus ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9659-1877","authenticated-orcid":false,"given":"Catherine","family":"Chen","sequence":"additional","affiliation":[{"name":"Population Health and Immunity\/Immunology, Walter and Eliza Hall Institute of Medical Research , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2618-3816","authenticated-orcid":false,"given":"Victor Irungu","family":"Mwangi","sequence":"additional","affiliation":[{"name":"Departamento de Ensino e Pesquisa, Funda\u00e7\u00e3o de Medicina Tropical , Manaus, Amazonas ,","place":["Brazil"]},{"name":"Escola Superior de Ci\u00eancias da Sa\u00fade, Universidade do Estado do Amazonas , Manaus ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Eduardo","family":"Padron de Morais","sequence":"additional","affiliation":[{"name":"Departamento de Ensino e Pesquisa, Funda\u00e7\u00e3o de Medicina Tropical , Manaus, Amazonas ,","place":["Brazil"]},{"name":"Escola Superior de Ci\u00eancias da Sa\u00fade, Universidade do Estado do Amazonas , Manaus ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5398-7414","authenticated-orcid":false,"given":"Mariana","family":"Sim\u00e3o Xavier","sequence":"additional","affiliation":[{"name":"Departamento de Ensino e Pesquisa, Funda\u00e7\u00e3o de Medicina Tropical , Manaus, Amazonas ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9027-2688","authenticated-orcid":false,"given":"Luiz Gustavo","family":"Gardinassi","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Nursing and Public Health, School of Nursing of Ribeir\u00e3o Preto, University of S\u00e3o Paulo , 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,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eamon","family":"Conway","sequence":"additional","affiliation":[{"name":"Population Health and Immunity\/Immunology, Walter and Eliza Hall Institute of Medical Research , Melbourne, Victoria ,","place":["Australia"]},{"name":"The University of Melbourne, Department of Medical Biology , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Mueller","sequence":"additional","affiliation":[{"name":"Population Health and Immunity\/Immunology, Walter and Eliza Hall Institute of Medical Research , Melbourne, Victoria ,","place":["Australia"]},{"name":"The University of Melbourne, Department of Medical Biology , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3374-9985","authenticated-orcid":false,"given":"Marcus Vin\u00edcius","family":"Guimar\u00e3es Lacerda","sequence":"additional","affiliation":[{"name":"Departamento de Ensino e Pesquisa, Funda\u00e7\u00e3o de Medicina Tropical , Manaus, Amazonas ,","place":["Brazil"]},{"name":"Sa\u00fade P\u00fablica, Instituto Le\u00f4nidas e Maria Deane, FIOCRUZ-AM , Manaus ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuelton Marcelo","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Departamento de Ensino e Pesquisa, Funda\u00e7\u00e3o de Medicina Tropical , Manaus, Amazonas ,","place":["Brazil"]},{"name":"Escola Superior de Ci\u00eancias da Sa\u00fade, Universidade do Estado do Amazonas , Manaus ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9995-0249","authenticated-orcid":false,"given":"Fernando","family":"Fonseca Almeida-Val","sequence":"additional","affiliation":[{"name":"Departamento de Ensino e Pesquisa, Funda\u00e7\u00e3o de Medicina Tropical , Manaus, Amazonas ,","place":["Brazil"]},{"name":"Escola Superior de Ci\u00eancias da Sa\u00fade, Universidade do Estado do Amazonas , Manaus ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8155-6005","authenticated-orcid":false,"given":"Gisely Cardoso","family":"de Melo","sequence":"additional","affiliation":[{"name":"Departamento de Ensino e Pesquisa, Funda\u00e7\u00e3o de Medicina Tropical , Manaus, Amazonas ,","place":["Brazil"]},{"name":"Escola Superior de Ci\u00eancias da Sa\u00fade, Universidade do Estado do Amazonas , Manaus ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,10,11]]},"reference":[{"key":"2026031710021629800_jiaf514-B1","author":"World Health Organization 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