Autoimmunity as a novel mechanism in post-COVID syndrome

After recovering from COVID-19, many people keep having bad health outcomes, with an increased risk of hospitalizations and death compared to similar people who did not have COVID-19. Moreover, even if not requiring hospitalization, many of them continue to suffer for a long time from low health-related quality of life, with cognitive dysfunction ("brain fog"), sensory losses (taste, smell) and weakness. This has been termed "Long COVID" in the common media, or post-COVID syndrome in the medical world. The reason for this is currently unknown, yet it is likely related to a similar syndrome that affects people after other severe diseases, called post-ICU (intensive care unit) syndrome. In this application we propose to study the post-COVID syndrome and its relationship with post-ICU syndrome. Our main hypothesis is that autoimmunity plays a role in post-COVID syndrome, and we intend to study it in 3 aims: 1) Map the autoimmune landscape of acute COVID-19 by assessing a broad variety of autoantibodies among severe COVID-19 patients over time, and their association with specific organ dysfunction 2) Study the development of these autoantibodies using immune mediators and measurements of immune cells. 3) Validate our findings in long-term post-COVID patients, to see if the same autoantibodies and the same organ dysfunction happen to them as well. Our findings would allow us to understand the role of autoantibodies in post-COVID syndrome. This knowledge would facilitate the use of existing immune-modulating medications to help treat patients with post-COVID syndrome and even prevent it from happening.