Autoantibodies neutralizing type I interferons in patients with life-threatening COVID-19 pneumonia: a meta-analysis from 2020-2026
Abstract
Autoantibodies neutralizing type I IFNs (AAN-IFN-I) have been found in significant proportions of cases of severe, critical, and fatal COVID-19 pneumonia. We performed a systematic review of 54 studies reporting auto-Abs against type I IFNs and a meta-analysis of 20 studies reporting auto-Abs neutralizing type I IFNs published between 2020 and 2026. The meta-analysis included data for 11,380 SARS-CoV-2-infected individuals from Europe, North America, South America, Asia, the Middle East, North Africa and international multicenter cohorts, including 7,814 with severe or critical disease (69%). The pooled prevalence of AAN-IFN-I was estimated at 7.9% (95% CI, 6.0-10.4). Disease severity was strongly associated with AAN-IFN-I prevalence (OR, 11.7; 95%CI, 7.6-17.9; P=5x10^-29). The pooled prevalence of AAN-IFN-I reached 11.4% (95% CI, 10.2-12.7%) in patients with severe or critical COVID-19 and 15.3% (95% CI, 12.1-19.2%) in those who died. The prevalence of AAN-IFN-I increased with age in patients with severe, critical, or fatal COVID-19. AAN-IFN-I probably accounted for about 1.1 million of the 7.1 million deaths from COVID-19. AAN-IFN-I are strong, common, global determinants of life-threatening COVID-19 pneumonia.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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