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Angiotensin II receptor I auto-antibodies following SARS-CoV-2 infection

Harrington, Whitney E. and Jiang, Yonghou and Duffy, Fergal and Hadlock, Jennifer and Raappana, Andrew and Styrchak, Sheila and Beck, Ingrid and Chour, William and Houck, John and Duvvuri, Venkata and Yeung, Winnie and Haglund, Micaela and Wallner, Jackson and Wallick, Julie A. and Hardy, Samantha and Oldroyd, Alyssa and Ko, Daisy and Gervassi, Ana and Murray, Kim M. and Kaplan, Henry and Aitchison, John D. and Heath, James R. and Sather, D. Noah and Goldman, Jason D. and Frenkel, Lisa (2021) Angiotensin II receptor I auto-antibodies following SARS-CoV-2 infection. . (Unpublished)

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Background: Coronavirus disease 2019 (COVID-19) is associated with endothelial activation and coagulopathy, which may be related to pre-existing or infection-induced pro-thrombotic autoantibodies such as those targeting angiotensin II type I receptor (AT1R-Ab). Methods: We compared prevalence and levels of AT1R-Ab in COVID-19 cases with mild or severe disease to age and sex matched negative controls. Results: There were no significant differences between cases and controls. However, there were trends toward a higher proportion with AT1R-Ab positivity among severe cases versus controls (32% vs. 11%, p=0.1) and higher levels in those with mild COVID-19 compared to controls (median 9.5U/mL vs. 5.9U/mL, p=0.06). Conclusions: These findings suggest that AT1R-Ab are not consistently associated with COVID-19 but do not exclude a contribution to endothelial pathology in a subset of people.

Item Type:Report or Paper (Discussion Paper)
Related URLs:
URLURL TypeDescription Paper
Harrington, Whitney E.0000-0002-0121-978X
Chour, William0000-0003-1817-0123
Heath, James R.0000-0001-5356-4385
Goldman, Jason D.0000-0002-3825-6832
Alternate Title:AT1R-Ab after SARS-CoV-2 infection
Additional Information:The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license. This version posted July 5, 2021. This work was supported by Seattle Childrens Research Institute [to LF, WEH, NS, and JDA]; the National Institute of Allergy and Infectious Diseases [K08 AI135072 to WEH]; the Burroughs Wellcome Fund [CAMS 1017213 to WEH]; the Biomedical Advanced Research and Development Authority [HHSO10201600031C to JRH]; and the Swedish Medical Center Foundation [to JDG]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Data Availability: Data is available upon request from Dr. Harrington. Author contributions: WEH, YJ, FD, JH, AR, SS, WC, JH, VD, WY, MH, HW, JW, SH, IB, AO, DO, AG, KM collected data. WEH, YJ, HK, JA, JR, DNS, JG, and LF conceived and designed the analysis. WEH, YJ, FD, AR, NDS, JDG, and LF performed the analysis. WEH, YJ, FD, JH, AR, WC, JDG, and LF wrote the paper. Author Declarations: I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes. The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Mild COVID-19 cases were from the Seattle Childrens SARS-CoV-2 Recovered Cohort and the Seattle Childrens SARS-CoV-2 Prospective Cohort both approved by Seattle Childrens Hospital IRB. Severe COVID-19 cases were participants in the Swedish-Institute for Systems Biology Novel Coronavirus (INCOV) Biobank, approved by Providence St. Joseph Health IRB. Healthy controls were derived from the Childrens SARS-CoV-2 Prospective Cohort. All participants provided written informed consent. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes. I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes. I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes. Competing Interest Statement: J.D.G. declared research support from Gilead, Lilly, and Regeneron, and Monogram Biosciences and served on advisory board for Gilead. The other authors declare no conflicts of interest.
Funding AgencyGrant Number
Seattle Childrens Research InstituteUNSPECIFIED
NIHK08 AI135072
Burroughs Wellcome FundCAMS 1017213
Biomedical Advanced Research and Development AuthorityHHSO10201600031C
Swedish Medical Center FoundationUNSPECIFIED
Record Number:CaltechAUTHORS:20210714-152527909
Persistent URL:
Official Citation:Angiotensin II receptor I auto-antibodies following SARS-CoV-2 infection. Whitney E. Harrington, Yonghou Jiang, Fergal Duffy, Jennifer Hadlock, Andrew Raappana, Sheila Styrchak, Ingrid Beck, William Chour, John Houck, Venkata Duvvuri, Winnie Yeung, Micaela Haglund, Jackson Wallner, Julie A. Wallick, Samantha Hardy, Alyssa Oldroyd, Daisy Ko, Ana Gervassi, Kim M. Murray, Henry Kaplan, John D. Aitchison, James R. Heath, D. Noah Sather, Jason D. Goldman, Lisa Frenkel. medRxiv 2021.06.30.21259796; doi:
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:109806
Deposited By: Tony Diaz
Deposited On:14 Jul 2021 18:15
Last Modified:14 Jul 2021 18:15

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