Autoantibodies in COVID-19: Pathogenic Mechanisms and Implications for Severe Illness and Post-Acute Sequelae

Autor(es)

do-Nascimento, Lais Alves ; Machado, Nicolle Rakanidis ; Bergamasco, Isabella Siuffi ; Borges, Joao Vitor da Silva ; Sgnotto, Fabio da Ressureicao ; Victor, Jefferson Russo

• Tipo de documento: Artigo Científico
• Fonte: COVID; v. 5, n. 8, p. 21-pg., 2025-07-30.

Resumo

The COVID-19 pandemic, caused by SARS-CoV-2, has led to a wide range of acute and chronic disease manifestations. While most infections are mild, a significant number of patients develop severe illness marked by respiratory failure, thromboinflammation, and multi-organ dysfunction. In addition, post-acute sequelae-commonly known as long-COVID-can persist for months. Recent studies have identified the emergence of diverse autoantibodies in COVID-19, including those targeting nuclear antigens, phospholipids, type I interferons, cytokines, endothelial components, and G-protein-coupled receptors. These autoantibodies are more frequently detected in patients with moderate to severe disease and have been implicated in immune dysregulation, vascular injury, and persistent symptoms. This review examines the underlying immunological mechanisms driving autoantibody production during SARS-CoV-2 infection-including molecular mimicry, epitope spreading, and bystander activation-and discusses their functional roles in acute and post-acute disease. We further explore the relevance of autoantibodies in maternal-fetal immunity and comorbid conditions such as autoimmunity and cancer, and we summarize current and emerging therapeutic strategies. A comprehensive understanding of SARS-CoV-2-induced autoantibodies may improve risk stratification, inform clinical management, and guide the development of targeted immunomodulatory therapies. (AU)

• Processo FAPESP: 23/16782-0 - Estudo piloto sobre os eventos celulares envolvidos no efeito imunomodulador de anticorpos IgG murinos sobre a diferenciação tímica de linfócitos TCD4, TCD8, Tgama-delta, e B
• Beneficiário: Lais Alves do Nascimento
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica
• Processo FAPESP: 21/08225-8 - Teoria imunológica dos Anzóis sem isca: elucidação dos eventos celulares e moleculares envolvidos no efeito imunomodulador de anticorpos IgG sobre linfócitos TCD4, TCD8, Tgd, iNKT, MAIT e B com enfoque em doenças atópicas e COVID-19
• Beneficiário: Jefferson Russo Victor
• Modalidade de apoio: Auxílio à Pesquisa - Jovens Pesquisadores