Newly identified ‘autoantibody’ mechanism could play key role in COVID deaths in older adults – Clinical Daily News

Jean-Laurent Casanova, MD, Ph.D .; Image credit: Rockefeller University

Investigators have identified a mechanism that explains why some people – and especially the elderly – suffer from more severe COVID-19 disease than others.

A study including residents of nursing homes found that autoantibodies, which mistakenly target a person’s own tissues or organs, block a key part of the antiviral immune response called the type 1 interferon response.

These autoantibodies, which can neutralize the body’s important antiviral response, increase sharply after age 60, according to Jean-Laurent Casanova, MD, Ph.D., of the University of Paris and Rockefeller University, in New York. Additionally, these autoantibodies are present in about 4% of uninfected individuals aged 70 and over and account for 20% of deaths from COVID-19, he and his colleagues reported.

These results may explain part of the variability observed in COVID-19 disease in the elderly. They also have implications for timing of treatment and vaccination, the authors said.

Clinical implications

The results of the study have important clinical implications, according to the researchers. It is “quick and easy” to test autoantibodies against type 1 interferons in people infected with SARS-CoV-2, they wrote. And identifying these autoantibodies can help clinicians determine which patients may benefit from early treatment, early hospitalization, and certain antiviral therapies that could boost their weakened immune responses, they said.

In addition, people with autoantibodies to type 1 interferons should be given priority for COVID-19 vaccination, and live attenuated vaccines should not be given to such people, they warned.

Residents of nursing homes represented

Investigators were able to include nursing home residents in the study with input from Trinity College Dublin and Tallaght University Hospital in Ireland. The data comes from the NH-COVAIR project, a longitudinal survey of COVID-19 among residents of Irish nursing homes. This ongoing project examines the relationship between frailty, clinical outcome, immunophenotype, and vaccine response in nursing home residents.

Study results and ongoing research offer critical insight into the underlying immunological reasons for severe COVID-19 disease in the elderly, said co-author Adam Dyer, MD, geriatrician at both institutions .

“As clinicians, we see immense variability in morbidity and mortality in older people infected with this virus, and we are exploring the underlying immunological reasons why there is an urgent unmet clinical need,” a- he concluded.
Additional clinical implications for these findings can be found in the study, published in the journal Scientific immunology.

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