Objective: Autoantibodies (AAbs) to interferon alpha, nuclear antigens, cardiolipin, and beta 2 glycoprotein 1, have been associated with COVID-19 severity. Despite relatively low COVID-19 morbidity and mortality in East and Central Africa, AAb prevalence in these populations remain understudied.

Methods: We evaluated AAb seroprevalence in 155 Ugandans, aged 40-50, using paired samples collected before and after the onset of the COVID-19 pandemic. Among these, 117 had serological evidence of SARS-CoV-2 infection, and 38 did not. To assess the effect of SARS-CoV-2 infection on AAb prevalence, we: 1) longitudinally compared AAb prevalence before and after evidence of infection, and 2) cross-sectionally compared AAb prevalence between those with and without infection evidence at both timepoints. Associations between AAbs and health characteristics were also explored.

Results: There was no difference in AAb prevalence between individuals with and without evidence of infection, nor any longitudinal change after evidence of infection. However, we observed a higher-than-expected prevalence anti-beta 2 glycoprotein 1. Additionally, anti-cardiolipin was significantly associated with reported hypertension.

Conclusions: Our findings contribute to the limited literature on AAb prevalence in East Africa and suggest that SARS-CoV-2 does not induce these AAbs.