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Antinuclear Antibodies in Post-Acute Sequelae after COVID-19
Test for Auto-Immunity is Positive in Patients with Respiratory Long-COVID
By Peter A. McCullough, MD, MPH
Among an array of tests I obtain in patients with post-acute sequelae after SARS-CoV-2 infection or COVID-19 vaccine is the antinuclear antibody. First described in 1948, ANA identification has been the foundation of diagnosis for autoimmune connective tissue disease, including systemic lupus erythematosus (SLE), Sjogren's syndrome, and polymyositis/dermatomyositis.
Before the pandemic, I have found most ANA positive syndromes responsive to chronic hydroxychloroquine therapy among other agents. It is interesting that HCQ became one of several choices in the standard of care for the early ambulatory management of high-risk COVID-19 as established by the McCullough Protocol.
Son et al, evaluated severe COVID-19 cases, many of whom were hospitalized early in the pandemic and found that research grade ANA assays were positive in a large fraction with persistent respiratory and chest symptoms such as fatigue, cough, and dyspnea. Their findings suggest SARS-CoV-2 infection itself induces auto-immunity, particularly with severe infections.
While there are no randomized trials of HCQ in long-COVID, it has been my observation that ANA positive patients improve on HCQ when they are suffering from post-acute sequalae after SARS-CoV-2 infection and/or COVID-19 vaccination. So don’t be surprised if you see patients taking HCQ on a longer-term basis as they recover through the pandemic.
These data suggest Biden’s Office of Long COVID Research and Practice should focus on the generic drugs we were finding useful for acute treatment including HCQ, IVM, colchicine, etc. Instead the disastrous research program has spent $1B and produced no new therapies or protocols for patients suffering in the community.
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Peter A. McCullough, MD, MPH
President, McCullough Foundation
Son K, Jamil R, Chowdhury A, Mukherjee M, Venegas C, Miyasaki K, Zhang K, Patel Z, Salter B, Yuen ACY, Lau KS, Cowbrough B, Radford K, Huang C, Kjarsgaard M, Dvorkin-Gheva A, Smith J, Li QZ, Waserman S, Ryerson CJ, Nair P, Ho T, Balakrishnan N, Nazy I, Bowdish DME, Svenningsen S, Carlsten C, Mukherjee M. Circulating anti-nuclear autoantibodies in COVID-19 survivors predict long COVID symptoms. Eur Respir J. 2023 Jan 12;61(1):2200970. doi: 10.1183/13993003.00970-2022. PMID: 36137590; PMCID: PMC9515477.