Vaccination prevents severe COVID-19 outcome in patients with neutralizing type 1 interferon autoantibodies
Anette S.B. Wolff,
Lena Hansen,
Marianne Aa. Grytaas,
Bergithe E. Oftedal,
Lars Breivik,
Fan Zhou,
Karl Ove Hufthammer,
Thea Sjøgren,
Jan Stefan Olofsson,
Mai Chi Trieu,
Anthony Meager,
Anders P. Jørgensen,
Kari Lima,
Kristin Greve-Isdahl Mohn,
Nina Langeland,
Rebecca Jane Cox,
Eystein S. Husebye
Affiliations
Anette S.B. Wolff
Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; Corresponding author
Lena Hansen
Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
Marianne Aa. Grytaas
Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
Bergithe E. Oftedal
Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
Lars Breivik
Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
Fan Zhou
Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
Karl Ove Hufthammer
Centre for Clinical Research, Haukeland University Hospital, 5021 Bergen, Norway
Thea Sjøgren
Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
Jan Stefan Olofsson
Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
Mai Chi Trieu
Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
Anthony Meager
Biotherapeutics Group, The National Institute for Biological Standards and Control, South Mimms, Potters Bar EN6 3QG, UK
Anders P. Jørgensen
Department of Endocrinology, Oslo University Hospital, 0372 Oslo, Norway
Kari Lima
Department of Paediatric Medicine, Oslo University Hospital, 0372 Oslo, Norway; Department of Endocrinology, Akershus University Hospital, 1478 Lørenskog, Norway
Kristin Greve-Isdahl Mohn
Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway; Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
Nina Langeland
Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
Rebecca Jane Cox
Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; Influenza Centre, Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; Department of Microbiology, Haukeland University Hospital, 5021 Bergen, Norway
Eystein S. Husebye
Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway; Department of Clinical Science, University of Bergen, 5021 Bergen, Norway
Summary: A hallmark of patients with autoimmune polyendocrine syndrome type 1 (APS-1) is serological neutralizing autoantibodies against type 1 interferons (IFN-I). The presence of these antibodies has been associated with severe course of COVID-19. The aims of this study were to investigate SARS-CoV-2 vaccine tolerability and immune responses in a large cohort of patients with APS-1 (N = 33) and how these vaccinated patients coped with subsequent infections. We report that adult patients with APS-1 were able to mount adequate SARS-CoV-2 spike-specific antibody responses after vaccination and observed no signs of decreased tolerability. Compared with age- and gender-matched healthy controls, patients with APS-1 had considerably lower peak antibody responses resembling elderly persons, but antibody decline was more rapid in the elderly. We demonstrate that vaccination protected patients with APS-1 from severe illness when infected with SARS-CoV-2 virus, overriding the systemic danger of IFN-I autoantibodies observed in previous studies.
