ArticlemedRxiv : the preprint server for health sciences2026
High risk of hypoxemic COVID-19 pneumonia in myasthenia gravis patients with type I IFN autoantibodies.
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69 authors.
Adrian GervaisLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Astrid MarchalLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Alexis MaillardLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Tom Le VoyerLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Jérémie RosainLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Quentin PhilipotLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Lucy BizienLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Jessica PeelSt. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.
Axel CederholmScience for Life Laboratory, Department of Medical Sciences, Uppsala University, Uppsala 75237, Sweden, EU.
Mélanie MigaudLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Sylvie PonsJoint Research Unit Civil Hospices of Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
Kahina SakerJoint Research Unit Civil Hospices of Lyon-bioMérieux, Hospices Civils de Lyon, Lyon Sud Hospital, Pierre-Bénite, France.
Pascal LaforetNeurology Department, Nord/Est/ Île-de-France Neuromuscular Reference Center, Raymond-Poincaré Teaching Hospital, AP-HP, Garches, France, EU.
Mélodie AubartLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Cyril GitiauxDepartment of Pediatric Neurology, Necker Hospital for Sick Children, Paris Cité University, Paris, France, EU.
Catherine BiggsDepartment of Pediatrics, British Columbia Children's Hospital, The University of British Columbia, Vancouver, BC, Canada.
Rafael Leon LopezHospital Universitario Reina Sofía, Cordoba, Spain.
Sarah SouvannanorathReference Center for Neuromuscular Diseases, Henri Mondor University Hospital, Assistance Publique - Hôpitaux de Paris (AP-HP), Créteil, France, EU.
Céline TardCHU de Lille, Inserm U1171, Reference Center for Neuromuscular Disorders Nord/Est/Île-de-France, Lille, France, EU.
Aleksandra Nadaj PaklezaNeurology Department, Reference Center for Neuromuscular Diseases 'Nord-Est-Ile de France', University Hospitals of Strasbourg, and ERN EURO-NMD, Strasbourg, France, EU.
Aude-Marie GrapperonReference Center for Neuromuscular Diseases and ALS, ERN EURO-NMD, La Timone University Hospital, Aix-Marseille University, Marseille, France, EU.
Nicholas HemingLaboratory of Infection & Inflammation-U1173, School of Medicine, INSERM, University Versailles Saint Quentin-University Paris Saclay, Garches, France, EU.
Djillali AnnaneLaboratory of Infection & Inflammation-U1173, School of Medicine, INSERM, University Versailles Saint Quentin-University Paris Saclay, Garches, France, EU.
Annie VerschuerenReference Center for Neuromuscular Diseases and ALS, ERN EURO-NMD, La Timone University Hospital, Aix-Marseille University, Marseille, France, EU.
Shahram AttarianReference Center for Neuromuscular Diseases and ALS, ERN EURO-NMD, La Timone University Hospital, Aix-Marseille University, Marseille, France, EU.
Kévin BigautNeurology Department, Reference Center for Neuromuscular Diseases 'Nord-Est-Ile de France', University Hospitals of Strasbourg, and ERN EURO-NMD, Strasbourg, France, EU.
Karolina HankiewiczDepartment of Neurology, Hôpital Pierre Delafontaine, Centre Hospitalier de Saint-Denis, F-93200 Saint-Denis, France.
Ludivine KoutonReference Center for Neuromuscular Diseases and ALS, ERN EURO-NMD, La Timone University Hospital, Aix-Marseille University, Marseille, France, EU.
Rocio-Nur Villar-QuilesCentre de Référence des Maladies Neuromusculaires Nord / Est / Ile-de-France. Sorbonne Université Centre de Recherche en Myologie - UMRS974 Groupe Hospitalier Pitié-Salpêtrière, Paris, France, EU.
Cécile CauquilInserm U 1195, Service de Neurologie, CRMR Neuropathies Amyloïdes et Autres Neuropathies Périphériques Rares, DMU Neurosciences, Paris Saclay University, CHU Bicêtre, AP-HP, NNERf FILNEMUS, Le Kremlin-Bicêtre, France, EU.
Marie-Céline FleuryNeurology Department, Reference Center for Neuromuscular Diseases 'Nord-Est-Ile de France', University Hospitals of Strasbourg, and ERN EURO-NMD, Strasbourg, France, EU.
Emilie RocherNeurology Department, Reference Center for Neuromuscular Diseases 'Nord-Est-Ile de France', University Hospitals of Strasbourg, and ERN EURO-NMD, Strasbourg, France, EU.
Guillaume NicolasNeurology Department, Nord/Est/ Île-de-France Neuromuscular Reference Center, Raymond-Poincaré Teaching Hospital, AP-HP, Garches, France, EU.
Eduardo de Paula EstephanDepartment of Neurology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
Maria da Penha Ananias MoritaFaculdade de Medicina de São José do Rio Preto, Departamento de Ciências Neurológicas, Psiquiatria e Psicologia Médica, São José do Rio Preto SP, Brazil.
Edmar ZanoteliDepartment of Neurology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil.
Zakaria SaiedNational Institute Mongi Ben Hamida of Neurology - Faculty of Medicine Tunis El Manar University - 1007 - Tunis - Tunisia.
Amine RachdiNational Institute Mongi Ben Hamida of Neurology - Faculty of Medicine Tunis El Manar University - 1007 - Tunis - Tunisia.
Amouri RimDepartment of Molecular Neurobiology and Neuropathology, National Institute Mongi Ben Hamida of Neurology - 1007 - Tunis- Tunisia.
Samir BelalNational Institute Mongi Ben Hamida of Neurology - Faculty of Medicine Tunis El Manar University - 1007 - Tunis - Tunisia.
Samia Ben SassiNational Institute Mongi Ben Hamida of Neurology - Faculty of Medicine Tunis El Manar University - 1007 - Tunis - Tunisia.
Annemarie HübersDepartment of Neurology, University Hospital Düsseldorf, 40223 Düsseldorf, Germany, EU.
Emmanuel FaureDepartment of Neurology, Sorbonne University, AP-HP, University Hospitals - Pitié-Salpétrière Charles Foix, Paris, France, EU.
Isabelle DesguerreDepartment of Pediatric Neurology, Necker Hospital for Sick Children, Paris Cité University, Paris, France, EU.
Clémence BasseInstitut du Thorax Curie Montsouris, Institut Curie, Paris, France, EU.
Nicolas GirardInstitut du Thorax Curie Montsouris, Institut Curie, Paris, France, EU.
Vivien BéziatLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Qiang Pan-HammarströmDepartment of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden, EU.
Lennart HammarströmDepartment of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden, EU.
Aaron BodanskyDepartment of Pediatric Critical Care Medicine, University of California, San Francisco, San Francisco, USA.
Audrey V ParentDepartment of Pediatric Critical Care Medicine, University of California, San Francisco, San Francisco, USA.
Mark S AndersonDiabetes Center, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Joseph L DeRisiDepartment of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA 94158, USA.
Sophie DemeretSorbonne University, INSERM, Institute of Myology, Center of Research in Myology, UMRS 974, F-75013 Paris, France.
Frédérique TruffaultSorbonne University, INSERM, Institute of Myology, Center of Research in Myology, UMRS 974, F-75013 Paris, France.
Romain FortDepartment of Anesthesia and Intensive Care Unit, Lyon Sud Hospital, Hospices Civils de Lyon, 69149 Pierre Bénite, France.
Florence AderService de Maladies Infectieuses et Tropicales, Hospices Civils de Lyon, Hôpital de la Croix Rousse, Lyon, France.
Florent WalletMédecine Intensive Réanimation, Centre Hospitalier Universitaire Lyon Sud, Hospices Civiles de Lyon, Lyon, France.
Laurent AbelLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Thierry MolinaParis Cité University, Imagine Institute, Paris, France, EU.
Marie-Alexandra AlyanakianNecker Biological Resource Center and Immunology Laboratory, Necker Hospital for Sick Children, AP-HP, Paris, France.
Rozen Le PanseSorbonne University, INSERM, Institute of Myology, Center of Research in Myology, UMRS 974, F-75013 Paris, France.
Guilhem SoléDepartment of Neurology and Neuromuscular Disorders, Reference Center for Neuromuscular Disorders AOC, University Hospitals of Bordeaux (Pellegrin University Hospital), place Amélie-Raba-Léon, Bordeaux, France, EU.
Aurélie CobatLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Nils LandegrenScience for Life Laboratory, Department of Medical Sciences, Uppsala University, Uppsala 75237, Sweden, EU.
Jean-Laurent CasanovaLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Anne PuelLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Paul BastardLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Emmanuelle JouanguyLaboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France, EU.
Funding
Developing, Demonstrating, and Disseminating Innovative Programs to Achieve Translational SuccessUL1TR001866 · NCATS · ROCKEFELLER UNIVERSITY · PI COLLER, BARRY, KRUEGER, JAMES G · 2016 to 2025
$40.6MInborn errors of immunity in patients with life-threatening COVID-19R01AI163029 · NIAID · ROCKEFELLER UNIVERSITY · PI CASANOVA, JEAN-LAURENT, ZHANG, QIAN · 2021 to 2025
$3.7MNCATS NIH HHS UL1 TR001866NIAID NIH HHS R01 AI163029
Abstract
Patients with myasthenia gravis (MG) may produce autoantibodies neutralizing type I interferons (AAN-I-IFN), which have been shown to 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 with no antiviral treatment. Hypoxemic pneumonia occurred in 48 of these patients, including 22 (45.8%) with AAN-I-IFN, which neutralized both IFN-α2 and IFN-ω in 14 (29.2%) patients. Six (16.2%) of the remaining 37 patients had AAN-I-IFN, which neutralized both IFN-α2 and IFN-ω in three patients. The risk of hypoxemic pneumonia was greater in MG patients with AAN-I-IFN neutralizing 10 ng/mL of both IFN-α2 and IFN-ω (odds ratio and 95% confidence interval (OR [95% CI]): 12.7 [2.1-78.9],
Indexed as
autoantibodiesBiological SciencesCOVID-19Immunology and Inflammationinterferonsmyasthenia gravis
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