Role of antinuclear antibodies in COVID-19 patients.

In their article, Peker et al. investigated the presence of various serum autoreactivities such as antinuclear (ANA) and anti-double stranded DNA (dsDNA), and anti-neutrophil cytoplasmic (ANCA) antibodies (Peker et al., 2021).

By indirect immunofluorescence (IIF), they found that 18% of COVID patients was ANA positive, and 6 (12%) of them exhibited an anti-nucleolar IIF pattern.

Of interest, 8 (88%) of the 9 ANA positive patients, exhibited anti-nucleolar IIF pattern, in agreement with the literature (Pascolini et al., 2021; Muratori et al., 2021; Chang et al., 2021).

In our opinion, the more consistent finding was the detection of antinucleolar reactivity, which, according to the above-mentioned studies, is the most frequently detected among the different ANA patterns.

As well-known, the antinucleolar ANA IIF pattern can be regarded the serological marker of systemic sclerosis (SSc). Since the clinical manifestations of SSc include pulmonary involvement in the form of a restrictive syndrome secondary to an interstitial lung disease that resembles COVID-19 interstitial pneumonia, it is arguable that COVID-19 antinucleolar positive patients might have an increased risk of severe interstitial lung disease.

We, therefore, agree with Peker et al. that future evaluations will define the autoantibody profile in COVID-19 patients and the duration of positivity. However, the Peker's study further support the impact of SARS-CoV-2 on autoimmunity since multiple current data demonstrate the likelihood that patients with COVID-19 will develop autoantibodies associated with autoimmune disease (Dotan et al., 2021).

Funding

No funding was obtained to produce this manuscript.

Declaration of Competing Interest

The Author declares no conflict of interest.