Abstract
COVID-19 infection exhibits a broad spectrum of clinical outcomes and a combination of host and viral factors interact to drive variability in COVID-19 outcomes. While some studies showed severe COVID-19 patients were more likely to have neutralizing autoantibodies to type-I IFNs relative to the general population, other studies showed preexisting immunity to endemic coronaviruses could be beneficial. This suggests comprehensive evaluation of antibodies and autoantibodies associated with COVID-19 outcomes could reveal important host factors contributing to disease outcomes. Here we profiled antibodies to 87 bacterial and viral proteins, including SARS-CoV-2, and autoantibodies to 383 immune- and autoimmune-associated antigens using the Oncimmune serological profiling technology. A total of 460 patients from two COVID-19 clinical trials (COVACTA, NCT04320615, and MARIPOSA, NCT04363736) were used in this study, and baseline levels of antibodies and autoantibodies in serum samples were associated with COVID-19 outcomes. We observed higher autoantibodies to type-I IFNs and some chemokines were associated with longer time to hospital discharge (TTHD), while higher autoantibodies to IL-6 and IL-36A led to faster TTHD. High levels of antibodies to endemic coronaviruses and seasonal influenza were also associated with faster TTHD. These findings suggest preexisting host antibody and autoantibody repertoire could provide some protection from the more severe consequences of COVID-19.
