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.

中文翻译：

---

胸腺瘤患者的严重西尼罗病毒和严重急性呼吸系统综合症冠状病毒 2 感染以及抗 I 型干扰素抗体


严重西尼罗河病毒和 SARS-CoV-2 感染患者应准确诊断基础疾病，确定可能产生的抗干扰素自身抗体，因为他们必须接受抗病毒和免疫治疗以增强抗病毒反应。目前的研究旨在调查一名先前健康的患者经历了西尼罗河病毒 (WNV) 和严重急性呼吸综合征冠状病毒 2 (SARS-CoV2) 两种危及生命的感染，其严重程度的决定因素。在 2019 年冠状病毒病 (COVID-19) 住院期间，他被诊断出患有胸腺瘤，回顾性地确定该胸腺瘤在感染西尼罗河病毒时就已存在。 TLR3 基因中 p.Pro554Ser 的杂合性增加了对严重 COVID-19 的易感性，而 CCR5 c.554_585del 的纯合性与严重 WNV 感染相关。检测到中和性抗干扰素 (IFN)-α 和抗 IFN-ω 自身抗体，可能是由潜在的胸腺瘤引起的，并且对严重的 COVID-19 肺炎和西尼罗河脑炎的易感性增加。