Journal Article

Study on the dynamic changes in antinuclear antibody spectrum in SARS-CoV-2 infection: a retrospective analysis

Li, Jun, Zheng, Jing, Chen, Yijun, Zhang, Ying, Shen, Bo, Wang, Jing, Zhu, Guangjun, Zheng, Yufen, Yan, Haixi

2025

Overview

Background Patients with COVID-19 often produce multiple autoantibodies that impact immune function. This study aimed to assess changes in immune status and correlation with SARS-CoV-2 infection by analyzing dynamic shifts in patients’ antinuclear antibody (ANA) profiles. Methods A retrospective analysis was conducted on ANA data and clinical characteristics of 680 patients with novel coronavirus pneumonia admitted to Taizhou Enze Medical Center (Group) between December 7, 2022, and January 31, 2023. The analysis covered three phases: early COVID-19 (within one year before admission, T1), COVID-19 phase (during hospitalization, T2), and late COVID-19 (within one year after discharge, T3). ANA quantification was primarily performed using indirect immunofluorescence, and the magnetic stripe immunofluorescence luminescence method was employed to detect the ANA profile (ENA), including anti-dsDNA, nucleosome, Sm, SS-A/Ro52kD, SS-A/Ro60kD, SS-B/La, PCNA, AMA M2, Scl-70, and Jo-1. Results During the T2 phase, 680 patients were analyzed. The positive rate of the ANA test was 35%. The proportion of autoimmune diseases (AID) in ANA-positive patients was higher than in ANA-negative patients (22%vs.7%). The ANA-positive group with AID showed higher ANA titers compared to the ANA-positive group without AID. During the follow-up one year before and after SARS-CoV-2 infection, in the T1-T2 group, there were two cases of ANA changing from negative to positive (one with AID, one without AID). The positive intensity of ANA increased by 15.6% and decreased by 20%. In the T2-T3 group, the positive intensity of ANA increased by 3.3% and decreased by 33.3%. Followed up of 7 patients with high ANA titers in T2 phase, among whom 5 cases did not support AID from the perspective of diagnosis and medication, and 2 cases were diagnosed with SLE after being infected with SARS-CoV-2. Conclusions SARS-CoV-2 infection induces overactivation of the immune system, significantly impacting patients with autoimmune diseases. For patients without autoimmune diseases, ANA produced due to COVID-19 does not persist. Some COVID-19 patients may trigger their own immune system response.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Analysis / Anti-DNA antibodies / Antibodies / Antibodies, Antinuclear - blood / Antibodies, Antinuclear - immunology / Antinuclear antibodies / Antinuclear antibody / Autoantibodies / Autoimmune diseases / Autoimmune Diseases - immunology / Autoimmunity / Coronaviruses / COVID-19 / COVID-19 - blood / COVID-19 - immunology / Cytokines / Disease / Dynamic changes / Epidemics / Female / Fluorescent antibody technique / Guillain-Barre syndrome / Health aspects / Hospitalization / Humans / Immune response / Immune status / Immune system / Immunofluorescence / Infection / Infections / Infectious Diseases / Internal Medicine / Laboratories / Lung diseases / Lupus / Male / Medical centers / Medical diagnosis / Medical Microbiology / Medicine / Medicine & Public Health / Middle Aged / Parasitology / Patients / Pneumonia / Retrospective Studies / SARS-CoV-2 / SARS-CoV-2 - immunology / Serology / Severe acute respiratory syndrome coronavirus 2 / Systemic lupus erythematosus / Testing / Tropical Medicine / Tumor necrosis factor-TNF / Viral diseases