Impaired Type I IFN Immunity Due to Autoantibodies or a Genetic Defect: a Prospective National Cohort (COVIFERON)

September 2, 2025 updated by: Institut National de la Santé Et de la Recherche Médicale, France

The major role of human genetic factors in the immune response to infections is now well established, particularly for viral infections. In the context of the COVID-19 pandemic, the following results have identified 1) several inborn errors of immunity (IEI) affecting the response or production of type I interferons (type I IFNs) in around 4% of adult patients with severe clinical disease, and 2) the presence of type I IFN-neutralizing autoantibodies (auto-Abs) in around 15% of severe cases, and 20% of deaths. The investigators would like to carry out a longitudinal immunological and clinical follow-up study on a prospective cohort of patients with either a genetic defect affecting the type I IFN-dependent immune response, or anti-IFN-I auto-Abs, to monitor the incidence of infectious and/or autoimmune events in these individuals, the evolution of neutralizing power, and the kinetics of auto-Abs. This should lead to a better understanding of the prevention and management of these patients.

The research design is a national multicenter prospective cohort of adults with 1) anti-IFN-I auto-Abs or 2) IEI- IFN-I, with follow-up from 1 to 4 years. These individuals may be: 1) patients who have or have had clinical disease (related to COVID-19, other viral infections, autoimmune disorders); or 2) "healthy" participants (e.g. blood donors, relatives of an IEI patient).

Follow-up will include:

  • yearly visits to the Clinical Investigation Center (CIC) or a clinical department with blood sampling;
  • specific visit in case of hospitalization for infectious events or adverse effects of vaccination, exacerbation or new diagnosis of auto-immune disease, new diagnosis of cancer, or SARS-CoV-2 infection whether or not patients are admitted to hospital, with blood sampling.

In addition, a retrospective "passive" follow-up will be implemented through matching with the data from the SNDS (National Health Data System), in order to collect clinical events of and healthcare resource consumption. Moreover, matching with controls adults from the national CONSTANCES cohort, not carrying auto-Abs against type I IFNs nor IEI-IFN-I, will be performed. (ratio 3:1; matching on age (+/- 5 years), gender and geographic region of recruitment). Individuals under long-lasting immunosuppressive or immunomodulatory drugs will not be eligible. Follow-up of controls, which will be carried out as part of the CONSTANCES cohort, will include web-based questionnaires, every 12 months, in addition to linking with SNDS data as already done in this cohort.

Inclusion visit:

After signing the consent form, the following tests will be performed:

  • Demographic characteristics (sex, age, country of birth)
  • Medical history from participant and family member(s) including infectious and auto-immune diseases, cancers and vaccination status and side effects

  • Blood samples for:

    • full blood cell count;
    • classical autoimmune investigations (anti-nuclear, anti-ENA, native anti-DNA, anti- thyroid antibodies, rheumatoid factor);
    • immunophenotyping*;
    • auto-Abs against type I IFNs, other cytokines*, or other target proteins* (dosage and neutralization activity);
    • Genetic explorations by whole-exome or whole-genome sequencing*;

    • Biobanking (DNA, plasma/sera; cryopreserved peripheral blood mononuclear cells (PBMCs).

      • these biological analyses will be carried out as part of dedicated COVIFERON RHU5 workpackages.

In addition, vaccination against SARS-CoV-2 and influenza will be offered to these subjects as a priority, as part of their usual care.

Follow-up visits :

Annual visits to the CIC :

  • Medical history since last visit, including infectious, auto-immune and oncologic events, vaccination status and side effects

  • Blood samples for:

    • full blood cell count;
    • classical autoimmune investigation (anti-nuclear, anti-ENA, native anti- DNA, anti-thyroid antibodies, rheumatoid factor);
    • immunophenotyping;
    • Auto-Abs against type I IFNs, other cytokines, or other target proteins (dosage and neutralization)
    • Biobanking (DNA, plasma, cryopreserved peripheral blood mononuclear cells (PBMCs))

Additional specific visit in the event of a clinical event of interest, at any time during follow-up:

  • In case of SARS-CoV-2 infection, whatever the severity of the disease: blood sampling for determination and neutralization of type I anti-IFN autoAbs, CBC, and biobanking (plasma and PBMC) and teleconsultation with the CIC in charge of patients, as soon as possible.
  • In the event of hospitalization for infectious events or exacerbation or new diagnosis of an auto-immune disease: blood sampling for determination and neutralization of anti-IFN-I autoAbs, CBC, and biobanking (plasma and PBMCs) and collection of the hospitalization report in the case report form on a dedicated page.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Estimated)

500

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • France
      • Lille, France
        • Recruiting
        • Cic Lille
        • Contact:
        • Sub-Investigator:
          • Dominique DEPLANQUE, PU-PU
      • Lyon, France
        • Recruiting
        • Lyon HCL
        • Contact:
        • Sub-Investigator:
          • Alexandre BELOT, PU-PU
      • Montpellier, France
        • Recruiting
        • Cic Montpellier
        • Contact:
        • Sub-Investigator:
          • Florence GALTIER, PH
      • Paris, France
        • Recruiting
        • Cic Bichat
        • Contact:
        • Principal Investigator:
          • Xavier-Marie DUVAL, PU-PU
      • Paris, France
        • Recruiting
        • Cic Creteil
        • Contact:
        • Sub-Investigator:
          • Philippe LE CORVOISIER, PU-PU
      • Paris, France
        • Recruiting
        • Cic La Salpetriere
        • Contact:
        • Sub-Investigator:
          • Joe-Elie SALEM, PU-PU
      • Paris, France
        • Recruiting
        • CIC Necker
        • Contact:
        • Sub-Investigator:
          • Michaela SEMERARO, PH
      • Paris, France
        • Recruiting
        • Cic St Louis
        • Contact:
        • Sub-Investigator:
          • Jean-Jacques KILADJIAN, PU-PU
      • Tours, France
        • Recruiting
        • Cic Tours
        • Contact:
        • Sub-Investigator:
          • Valérie GISSOT, PH

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Adults with auto-Abs against IFN-I or an IEI-IFN-I who: 1) either have or have had a clinical disease (COVID-19 related, other viral infections, adverse effect of vaccination, auto-immune disorders); or 2) are healthy (e.g. blood donor, relatives of a participant).

Description

Inclusion Criteria:

  • Age >18 years
  • History of carrying 1) auto-Abs against type I IFNs or 2) IEI impairing the response to, or the production of, type I IFNs (IFN-I-IEI)
  • Affiliated to social security
  • Written informed consent

Exclusion Criteria:

  • Participation to an interventional clinical trial on a pharmacological treatment
  • Clinical condition leading to life expectancy less than 1 year
  • Subject to a legal protection measure (safeguard of justice, curatorship, tutorship)
  • Individuals deprived of freedom

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Subjects with auto-Abs against type I IFNs or inborn errors of immunity
The study examines how autoantibodies (auto-Abs) against type I interferons (IFNs) and inborn errors of immunity affect susceptibility to infectious diseases, especially COVID-19. Individuals with auto-Abs against type I IFNs have impaired immune responses to viral infections, putting them at higher risk for severe COVID-19, leading to worse outcomes like pneumonia or cytokine storms. Those with inborn errors of immunity have genetic defects that weaken immune function, increasing vulnerability to infections, including COVID-19. The study compares these groups to understand immune dysfunctions and identify potential therapeutic targets.
Other: blood sample
After signature of consent form,blood samples will be collected for full blood cell count;classical autoimmune investigations, immunophenotyping;auto-Abs against type IIFNs, other cytokines, or other target proteins ,Genetic explorations by whole-exome or whole-genome sequencing;Biobanking

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
primary endpoint n°1 : quantitative dosage of auto-Abs against type I IFNs
Time Frame: year 0, year 1, year 2 and year 3
Method: Quantitative trait will be measured by Gyros using commercially available internal control antibodies.
year 0, year 1, year 2 and year 3
primary endpoint n°2 : neutralization capacity evaluation of auto-Abs against type I IFNs
Time Frame: year 0, year 1, year 2 and year 3
The neutralization capacity will be performed as previously reported using an in vitro luciferase system in HEK293 cells
year 0, year 1, year 2 and year 3

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cumulative incidence of clinical events of interest, i.e. infectious events, autoimmune diseases or cancers
Time Frame: Year 0, year 1, year 2 and year 3
Method: annual medical visits, SNDS (PMSI, DCIR). Incidence density rate is defined as the number of newly disease individuals on the sum of time periods for all disease-free individual-at-risk
Year 0, year 1, year 2 and year 3
Clinical and biological factors associated with clinical outcomes
Time Frame: Year 0, year 1, year 2 and year 3
the potential predictor variables will be assessed by bivariate logistic regressions where occurrence of clinical events is the variable to be explained. Factors associated with a p-value less than 0.20 will be included in the multivariate logistic model. Backward selection on pvalue will be applied. Internal validity of the final model will be estimated by cross-validation (Leave-One-Out Cross-Validation method). Discrimination will be assessed by the area under the ROC curve and its 95% confidence interval.
Year 0, year 1, year 2 and year 3
Cumulative incidence of the same clinical events of interest, in control participants who are negative for auto-Abs, matched by age and sex followed through the large CONSTANCES cohort
Time Frame: Year 0, year 1, year 2 and year 3
Cumulative incidence of the same clinical events of interest, in control participants who are negative for auto-Abs, matched by age and sex followed through the large CONSTANCES cohort (Constances database), and its 95% confidence interval: Incidence density rate is defined as the number of newly disease individuals on the sum of time periods for all disease-free individual-at-risk.
Year 0, year 1, year 2 and year 3
Genetic factors associated with the development of auto-Abs against type I IFNs
Time Frame: Year 0, year 1, year 2 and year 3
searching for homozygous deletions using in-house HMZDelFinder-opt method of imagine institue
Year 0, year 1, year 2 and year 3
Genetic factors associated with the development of auto-Abs against type I IFNs
Time Frame: year 0, year 1, year 2 and year 3
Searching for rare candidate coding variants in patients by following an optimal filtering strategy that imagine have optimized over the last 10 years based on multiple variant-level and gene-level criteria to select the candidate variants
year 0, year 1, year 2 and year 3
Genetic factors associated with the development of auto-Abs against type I IFNs
Time Frame: year 0, year 1, year 2 and year 3
Using gene-level criteria to select candidate variants such as the negative selection level measured by the CoNeS approach.
year 0, year 1, year 2 and year 3

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Institut National de la Santé Et de la Recherche Médicale, France

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 9, 2025

Primary Completion (Estimated)

January 1, 2029

Study Completion (Estimated)

January 1, 2029

Study Registration Dates

First Submitted

November 14, 2024

First Submitted That Met QC Criteria

January 6, 2025

First Posted (Actual)

January 7, 2025

Study Record Updates

Last Update Posted (Estimated)

September 8, 2025

Last Update Submitted That Met QC Criteria

September 2, 2025

Last Verified

December 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • C22-73
  • 2023-A02663-42 (Other Identifier: ANSM ID-RCB)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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