BTG3 and acute respiratory distress syndrome: While it is conceivable that ANA titers rise and specific autoantibodies may appear in severely ill patients in general, we think that the observed clustering of high ANA titers with specific, sclerosis-associated autoantibodies in the COVID-19 ARDS group is reliable, raising the question of how these autoantibodies arise in the context of SARS-CoV-2 infection.