Autoantibodies against type I interferons in COVID-19 infection: a systematic review and meta-analysis.

OBJECTIVE: To study the rate of autoantibodies against type I interferons(IFN) in patients with coronavirus disease 2019 (COVID-19) and analyze its dependence on severity of infection and some other variables. METHODS: A systemic review with the search terms: "COVID-19" or "SARS-CoV-2" and "autoantibodies" or "autoantibody" and "IFN" or "interferon" for the period 20 December 2019 to 15 August 2022 was carried out using PubMed, Embase, Cochrane and Web of Science. R 4.2.1 software was used for meta-analysis of the published results. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. RESULTS: We identified 8 studies involving 7, 729 patients, out of whom 5,097 (66%) had severe COVID-19 and 2,632 (34%) mild or moderate symptoms. The positive rate of anti-Type-I-IFN-autoantibodies in the total dataset was 5% (95% CI, 3%-8%), but reached 10% (95% CI, 7%-14%) in those with severe infection. The most common subtypes were anti-IFN-α (89%) and anti-IFN-ω (77%). The overall prevalence in male patients was 5% (95% CI, 4%-6%) and in female patients 2% (95% CI, 1%-3%). CONCLUSION: Severe COVID-19 is associated with high rates of autoantibodies against Type I IFN and more so in males than in females.