{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T20:06:13Z","timestamp":1790539573565,"version":"4.1.0"},"reference-count":0,"publisher":"European Respiratory Society (ERS)","funder":[{"name":"Weston Foundation"},{"DOI":"10.13039\/501100000245","name":"Michael Smith Foundation for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]},{"name":"COVID-19 Immunity Task Force"},{"DOI":"10.13039\/501100005247","name":"University of British Columbia","doi-asserted-by":"publisher","award":["Strategic Initiative Fund"],"award-info":[{"award-number":["Strategic Initiative Fund"]}],"id":[{"id":"10.13039\/501100005247","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Cyclomedica"}],"content-domain":{"domain":["ersjournals.com"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Autoimmunity has been reported in patients with severe COVID-19. We investigated whether antinuclear\/extractable-nuclear antibodies (ANAs) were present up to a year after infection, and if they were associated with the development of clinically relevant Post-Acute Sequalae of COVID-19 (PASC) symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A rapid assessment line immunoassay was used to measure circulating levels of ANA\/ENAs in 106 convalescent COVID-19 patients with varying acute phase severities at 3, 6, and 12\u2005months post-recovery. Patient-reported fatigue, cough, and dyspnea were recorded at each timepoint. Multivariable logistic regression model and receiver-operating curves (ROC) were used to test the association of autoantibodies with patient-reported outcomes and pro-inflammatory cytokines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to age- and sex-matched healthy controls (n=22) and those who had other respiratory infections (n=34), patients with COVID-19 had higher detectable ANAs at 3\u2005months post-recovery (p&lt;0.001). The mean number of ANA autoreactivities per individual decreased from 3 to 12 months (3.99 to 1.55) with persistent positive titers associated with fatigue, dyspnea, and cough severity. Antibodies to U1-snRNP and anti-SS-B\/La were both positively associated with persistent symptoms of fatigue (p&lt;0.028, AUC=0.86) and dyspnea (p&lt;0.003, AUC=0.81). Pro-inflammatory cytokines such as tumour necrosis factor alpha (TNF\u03b1) and C-reactive protein predicted the elevated ANAs at 12\u2005months. TNF\u03b1, D-dimer, and IL-1\u03b2 had the strongest association with symptoms at 12\u2005months. Regression analysis showed TNF\u03b1 predicted fatigue (\u03b2=4.65, p=0.004) and general symptomaticity (\u03b2=2.40, p=0.03) at 12\u2005months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Persistently positive ANAs at 12\u2005months post-COVID are associated with persisting symptoms and inflammation (TNF\u03b1) in a subset of COVID-19 survivors. This finding indicates the need for further investigation into the role of autoimmunity in PASC.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.00970-2022","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T12:45:13Z","timestamp":1663850713000},"page":"2200970","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":122,"title":["Circulating anti-nuclear autoantibodies in COVID-19 survivors predict long-COVID symptoms"],"prefix":"10.1183","author":[{"given":"Kiho","family":"Son","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rameen","family":"Jamil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhiroop","family":"Chowdhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manan","family":"Mukherjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Venegas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Miyasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zil","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Salter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes 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