Cited by 2,662interferon and immune responsesSARS-CoV-2 and COVID-19 ResearchCOVID-19 Clinical Research Studies

Autoantibodies against type I IFNs in patients with life-threatening COVID-19

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Bastard, Paul, Rosen, Lindsey B., Zhang, Qian, Michailidis, Eleftherios, Hoffmann, Hans-Heinrich, Zhang, Yu, Dorgham, Karim, Philippot, Quentin +747 more·2020·Science

Abstract

The genetics underlying severe COVID-19: The immune system is complex and involves many genes, including those that encode cytokines known as interferons (IFNs). Individuals that lack specific IFNs can be more susceptible to infectious diseases. Furthermore, the autoantibody system dampens IFN response to prevent damage from pathogen-induced inflammation. Two studies now examine the likelihood that genetics affects the risk of severe coronavirus disease 2019 (COVID-19) through components of this system (see the Perspective by Beck and Aksentijevich). Q. Zhang et al. used a candidate gene approach and identified patients with severe COVID-19 who have mutations in genes involved in the regulation of type I and III IFN immunity. They found enrichment of these genes in patients and conclude that genetics may determine the clinical course of the infection. Bastard et al. identified individuals with high titers of neutralizing autoantibodies against type I IFN-α2 and IFN-ω in about 10% of patients with severe COVID-19 pneumonia. These autoantibodies were not found either in infected people who were asymptomatic or had milder phenotype or in healthy individuals. Together, these studies identify a means by which individuals at highest risk of life-threatening COVID-19 can be identified. Science , this issue p. eabd4570 , p. eabd4585 ; see also p. 404

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  • People who cannot produce or respond to type I interferon face a higher risk of severe COVID-19.

    “Furthermore, humans deficient in producing or responding to type I interferon have an increased risk of severe COVID-19 (refs66–68).”
  • Autoantibodies against type I IFN are present in more than 10% of severe COVID-19 patients.

    “presence of a B cell autoimmune phenocopy of inborn type I IFN immunodeficiency in more than 10% of patients with severe COVID-19”

    From COVID-19 and the human innate immune system (2021) · cites this paper as Bastard et al., 2020

  • Early type I IFN treatment may help patients whose IFN system has genetic defects, but not those with autoimmune mimics of such defects.

    “Type I IFN therapy in patients with genetic deficits in the IFN system (Zhang et al., 2020a), but not in those with autoimmune phenocopies of these deficits (Bastard et al., 2020), might be beneficial if provided sufficiently early (Hadjadj et al., 2020; Wang et al., 2020b).”

    From COVID-19 and the human innate immune system (2021) · cites this paper as Bastard et al., 2020

  • SARS-CoV-2 is unusually effective at evading or delaying early innate immune responses, including type I and type III IFNs, in vitro and in humans.

    “In a SARS-CoV-2 infection, the virus is particularly effective at avoiding or delaying triggering intracellular innate immune responses associated with type I and type III IFNs in vitro (Blanco-Melo et al., 2020) and in humans (Arunachalam et al., 2020; Bastard et al., 2020; Blanco-Melo et al., 2020; Laing et al., 2020).”

    From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Bastard et al., 2020

  • Individuals with defective type I IFN responses have very high risk of severe or fatal COVID-19.

    “The risk of a poor early innate immune response to SARS-CoV-2 is highlighted by the striking findings of very high risk of severe or fatal COVID-19 in individuals with defective type I IFN responses (Bastard et al., 2020; Zhang et al., 2020).”

    From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Bastard et al., 2020

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Authors
Bastard, P., Rosen, L. B., Zhang, Q., Michailidis, E., Hoffmann, H.-H., Zhang, Y., Dorgham, K., Philippot, Q., Rosain, J., Béziat, V., Manry, J., Shaw, E., Haljasmägi, L., Peterson, P., Lorenzo, L., Bizien, L., Trouillet-Assant, S., Dobbs, K., de Jesus, A. A., Belot, A., Kallaste, A., Catherinot, E., Tandjaoui-Lambiotte, Y., Le Pen, J., Kerner, G., Bigio, B., Seeleuthner, Y., Yang, R., Bolze, A., Spaan, A. N., Delmonte, O. M., Abers, M. S., Aiuti, A., Casari, G., Lampasona, V., Piemonti, L., Ciceri, F., Bilguvar, K., Lifton, R. P., Vasse, M., Smadja, D. M., Migaud, M., Hadjadj, J., Terrier, B., Duffy, D., Quintana-Murci, L., van de Beek, D., Roussel, L., Vinh, D. C., Tangye, S. G., Haerynck, F., Dalmau, D., Martinez-Picado, J., Brodin, P., Nussenzweig, M. C., Boisson-Dupuis, S., Rodríguez-Gallego, C., Vogt, G., Mogensen, T. H., Oler, A. J., Gu, J., Burbelo, P. D., Cohen, J. I., Biondi, A., Bettini, L. R., D'Angio, M., Bonfanti, P., Rossignol, P., Mayaux, J., Rieux-Laucat, F., Husebye, E. S., Fusco, F., Ursini, M. V., Imberti, L., Sottini, A., Paghera, S., Quiros-Roldan, E., Rossi, C., Castagnoli, R., Montagna, D., Licari, A., Marseglia, G. L., Duval, X., Ghosn, J., Lab, H., NIAID-USUHS Immune Response to COVID Group, Clinicians, C., Clinicians, C.-S., Imagine COVID Group, French COVID Cohort Study Group, The Milieu Intérieur Consortium, Cohort, C.-C., Biobank, A. U. C.-1., Effort, C. H. G., Tsang, J. S., Goldbach-Mansky, R., Kisand, K., Lionakis, M. S., Puel, A., Zhang, S.-Y., Holland, S. M., Gorochov, G., Jouanguy, E., Rice, C. M., Cobat, A., Notarangelo, L. D., Abel, L., Su, H. C., Casanova, J.-L., Arias, A. 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Affiliations
  • Hôpital Necker-Enfants Malades (FR)
  • National Institutes of Health (US)
  • Rockefeller University (US)
  • Inserm (FR)
  • University of Tartu (EE)
  • Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, USA.
  • Tartu University Hospital (EE)
  • Laboratory of Virology and Infectious Disease, The Rockefeller University, New York, NY, USA.
  • Vita-Salute San Raffaele University (IT)
  • Department of Genetics, Yale University School of Medicine, New Haven, CT, USA.
  • Yale University (US)
  • Hôpital Foch (FR)
  • INSERM UMR-S 1140, Biosurgical Research Laboratory (Carpentier Foundation), Paris University and European Georges Pompidou Hospital, Paris, France.
  • Laboratory of Immunogenetics of Pediatric Autoimmune Diseases, INSERM UMR 1163, University of Paris, Imagine Institute, Paris, France.
  • McGill University Health Centre (CA)
  • Garvan Institute of Medical Research, Darlinghurst 2010, NSW, Sydney, Australia.
  • Howard Hughes Medical Institute (US)
  • Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.
  • Department of Infectious Diseases, Aarhus University Hospital, Skejby, Denmark.
  • Azienda Ospedaliera San Gerardo (IT)
  • Pediatric Department and Centro Tettamanti-European Reference Network PaedCan, EuroBloodNet, MetabERN-University of Milano-Bicocca-Fondazione MBBM-Ospedale, San Gerardo, Monza, Italy.
  • University of Milano-Bicocca (IT)
  • Haukeland University Hospital (NO)
  • Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
  • Department of Infectious and Tropical Diseases, University of Brescia and ASST Spedali di Brescia, Brescia, Italy.
  • University of Pavia (IT)
  • Lyon 1 Université (FR)
  • Universidad Fernando Pessoa Canarias (ES)
  • Universitat de Vic - Universitat Central de Catalunya (ES)
  • University Hospital Mútua de Terrassa (ES)
  • Université Paris Cité (FR)
  • Institute of Genetics and Biophysics (IT)
  • Ghent University Hospital (BE)
  • Assistance Publique – Hôpitaux de Paris (FR)
  • Helix (United States) (US)
  • Garvan Institute of Medical Research (AU)
  • Institut Pasteur (FR)
  • Aarhus University (DK)
  • Centre National de la Recherche Scientifique (FR)
  • University Medical Center Utrecht (NL)
  • Amsterdam Neuroscience (NL)
Corresponding author
  • Bastard, Paul
  • Rosen, Lindsey B.
  • Zhang, Qian
  • Michailidis, Eleftherios
  • Hoffmann, Hans-Heinrich
  • Zhang, Yu
  • Dorgham, Karim
  • Rosain, Jérémie
  • Béziat, Vivien
  • Holland, Steven M.
  • Gorochov, Guy
  • Jouanguy, Emmanuelle
  • Rice, Charles M.
  • Cobat, Aurélie
ORCID
Venue
Science
Published
2020-10-23
Volume
370
Issue
6515
Pages
eabd4585
ISSN
  • 0036-8075 (ISSN-L)
  • 1095-9203
OpenAlex
W3088256443
Cited by
2,662
References
38
Citations by year
2026: 122 · 2025: 185 · 2024: 312 · 2023: 394 · 2022: 602 · 2021: 897 · 2020: 148 · 2014: 1 · 2012: 1
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journal article
Language
en
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  • Lirias (KU Leuven) (submittedVersion, cc-by)
  • Repositorio Institucional de la Universidad de Burgos (University of Burgos) (submittedVersion, cc-by)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • HAL (submittedVersion)
  • Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion, other-oa)
  • BOA (University of Milano-Bicocca) (submittedVersion, cc-by)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
  • DIGITAL.CSIC (Spanish National Research Council (CSIC)) (submittedVersion, cc-by)
  • Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion, other-oa)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Työväentutkimus Vuosikirja (submittedVersion)
  • Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
  • IRIS (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion, cc-by)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
  • Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion, cc-by)
  • Bilkent University Institutional Repository (Bilkent University) (submittedVersion)
  • Spiral (Imperial College London) (submittedVersion)
  • Use Siena air (University of Siena) (submittedVersion, cc-by)
Funders
  • U.S. Department of Defense
  • Howard Hughes Medical Institute
  • Burroughs Wellcome Fund
  • American Association for the Advancement of Science
  • St. Giles Foundation (ANR-10-IAHU-01)
  • American Academy of Allergy Asthma and Immunology
  • Yale University
  • George Mason University
  • Fondazione IRCCS Policlinico San Matteo
  • Univerzita Karlova v Praze
  • Aix-Marseille Université (10-LABX-62-IBEID)
  • University of Victoria
  • McGill University Health Centre
  • Universidad de La Laguna
  • Georgia Clinical and Translational Science Alliance (UL1 TR001866)
  • Institut des maladies génétiques Imagine (ANR-10-LABX-62-IBEID, ANR-10-IAHU- 01)
  • Instituto Tecnológico y de Energías Renovables (RTC-2017-6471-1, CGIEU0000219140)
  • Universitat Pompeu Fabra
  • Amsterdam University Medical Centers
  • Universidad de Burgos
  • Imperial College London
  • European Commission (ANR-10-LABX-62-IBEID, ANR-15-IDEX-04-LUE, COVID-19, RECOVER WP 6)
  • Agence Nationale de la Recherche (ANR-15-IDEX- 04-LUE, 2017-, 10-LABX-62-IBEID, ANR-15-RHU-0004, ANR-10-IAHU- 01, ANRS-COV05, ANR-20-COVI-0022, ANR‐10‐LABX‐62‐IBEID, ANR‐10‐LABX‐69‐01, ANR-15-IDEX-0004, LABX-62-IBEID, ANR-20-COVI-0064, 10‐LABX‐69‐01, ANR-10-IAHU-0001, ANR-20, 10-IAHU-01, -15-IDEX-04-LUE, ANR-15-RHUS-0004, ANR-10, ANR-10-LABX, ANR-20-COVI-0025, ANR-10-LABX-0062, ANR-20-COVI-0003, ANR-10-LABX-62, RHU-0004)
  • Institut National de la Santé et de la Recherche Médicale (ANR‐10‐IAHU‐01, EQU201903007798, ANR-10-LABX-62-IBEID, UMR-S1140)
  • University of New South Wales
  • ZonMw
  • Eesti Teadusagentuur (PUT1367)
  • Fondazione Telethon
  • Assistance Publique - Hôpitaux de Paris
  • Fondation pour la Recherche Médicale (ANR-10-LABX-62-IBEID, ANR-10-IAHU-01, ANRS-COV05, EA20 170638020, EQU201903007798)
  • Nederlandse Organisatie voor Wetenschappelijk Onderzoek (20005)
  • Universitair Ziekenhuis Gent
  • Institució Catalana de Recerca i Estudis Avançats
  • University of Hong Kong
  • Karolinska Institutet
  • Università degli Studi di Pavia
  • Ministerio de Ciencia e Innovación (CGIEU0000219140, RTC‐2017‐6471‐1)
  • Universidade de São Paulo
  • Universitat de Barcelona
  • Shahid Beheshti University of Medical Sciences
  • Hospital for Sick Children
  • Università degli Studi di Brescia
  • Fondation Bettencourt Schueller (EA20170638020)
  • Mansoura University
  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
  • Novo Nordisk Fonden (NNF14OC0011005)
  • Assistance publique-Hôpitaux de Paris
  • Regione Lombardia
  • Universitat Autònoma de Barcelona
  • Necmettin Erbakan Üniversitesi
  • Sorbonne Université
  • National Institutes of Health (ANR-10-LABX-62-IBEID, ANR-10-IAHU-01, P01-AI138398-S1, COVID-19, TR001866, UL1TR001863, UL1TR001866)
  • Uniformed Services University of the Health Sciences (ANR-10-IAHU-01)
  • Biomedical Advanced Research and Development Authority (HHSO10201600031C)
  • Mercatus Center, George Mason University
  • Medical Research Council (ANR-10-LABX-62-IBEID, COVID-19)
  • National Health and Medical Research Council
  • Japan Society for the Promotion of Science (18K07814)
  • Instituto de Salud Carlos III (COV20/01333, COV20/01334)
  • Agencia Estatal de Investigación (RTC-2017-6471-1)
  • Lee Kong Chian School of Medicine, Nanyang Technological University
  • National Human Genome Research Institute (UM1HG006504, U24HG008956)
  • National Cancer Institute
  • National Institute of Allergy and Infectious Diseases (P01 AI138398-S1, COVID-19, R01AI091707, HHSN27200002, R01AI088364, P01AI061093, HHSN316201300006W, ANR-10-LABX-62-IBEID, ANR-10-IAHU-01, U19AI111825, P01AI138938, K08AI135091)
  • National Center for Advancing Translational Sciences (ANR-10-LABX-62-IBEID, ANR-10-IAHU-01, TR001866, EQU201903007798)
  • Institute of Genetics
  • NHLBI Division of Intramural Research
Topics
  • Life Sciences › Immunology and Microbiology › Immunology › interferon and immune responses
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords
COVID-19 pandemic, type I interferon, autoantibodies, interferon alpha 2, interferon omega, severe COVID-19, genetic susceptibility, interferon lambda, neutralizing autoantibodies, pneumonia, candidate gene association, interferon response
MeSH terms
Betacoronavirus, Interferon alpha-2, COVID-19, SARS-CoV-2, Adult, Aged, Aged, 80 and over, Autoantibodies, Female, Humans, Immunoglobulin G, Interferon Type I, Male, Middle Aged, Pneumonia, Viral, Case-Control Studies, Critical Illness, Coronavirus Infections, Antibodies, Neutralizing, Asymptomatic Infections, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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