Severe West Nile Virus and Severe Acute Respiratory Syndrome Coronavirus 2 Infections in a Patient With Thymoma and Anti-Type I Interferon Antibodies.

Patients with severe West Nile virus and SARS-CoV-2 infections deserve accurate diagnosis of underlying diseases, determining possible anti-interferon autoantibody production, since they must receive antiviral and immunological therapies to enhance antiviral response. The current study aimed to investigate determinants of severity in a previously healthy patient who experienced 2 life-threatening infections, from West Nile Virus (WNV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). During coronavirus disease 2019 (COVID-19) hospitalization he was diagnosed with a thymoma, retrospectively identified as already present at the time of WNV infection. Heterozygosity for p.Pro554Ser in the TLR3 gene, which increases susceptibility to severe COVID-19, and homozygosity for CCR5 c.554_585del, associated with severe WNV infection, were found. Neutralizing anti-interferon (IFN)-α and anti-IFN-ω autoantibodies were detected, likely induced by the underlying thymoma and increasing susceptibility to both severe COVID-19 pneumonia and West Nile encephalitis.

DOI: 10.1093/infdis/jiae321, PMID: 38976510
Authors: Federica Barzaghi, Camilla Visconti, Giovanni Battista Pipitone, Simone Bondesan, Giulia Molli, Stefania Giannelli, Claudia Sartirana, Vito Lampasona, Elena Bazzigaluppi, Cristina Brigatti, Adrian Gervais, Paul Bastard, Chiara Tassan Din, Chiara Molinari, Lorenzo Piemonti, Jean-Laurent Casanova, Paola Carrera, Giorgio Casari, Alessandro Aiuti