DISCUSSION
MERS
VIRAL INFECTION, DISEASE, CRITICALLY ILL
In this study, we found that 24.2% of hospitalized patients with MERS were positive for auto‐Abs against at least one type I IFN. Although patients with auto‐Abs were more likely to be critically ill, the presence of auto‐Abs against at least one type I IFN was not associated with different clinical outcomes or with a difference in the response to treatment with IFN‐β1b and lopinavir‐ritonavir. These observations are similar to those of Abers et al.The neutralizing activity of these type I IFN auto‐Abs was also tested using a neutralizing assay in vitro, which indicates an ability to hinder IFN responses to viral infection and results in increased disease severity.The baseline characteristics of patients with or without type I IFN auto‐Abs were similar in terms of age, gender, body mass index (BMI), and comorbidities. It has been shown previously that auto‐Abs against type I IFNs significantly increased the COVID‐19 mortality rate at all ages.In conclusion, auto‐Abs against at least one type I IFNs were common among hospitalized patients with MERS. Patients with type I IFN auto‐Abs were more likely to be critically ill. The presence of type I IFN auto‐Abs was not associated with clinical outcome or with a difference in the response to treatment with IFN‐β1b and lopinavir‐ritonavir.