Primary SARS-CoV-2 infection in patients with immune-mediated inflammatory diseases: long-term humoral immune responses and effects on disease activity.
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van Dam Koos P J, Volkers Adriaan G, Wieske Luuk, Stalman Eileen W, Kummer Laura Y L, van Kempen Zoé L E, Killestein Joep, Tas Sander W, Boekel Laura, Wolbink Gerrit J, van der Kooi Anneke J, Raaphorst Joost, Takkenberg R Bart, D'Haens Geert R A M, Spuls Phyllis I, Bekkenk Marcel W, Musters Annelie H, Post Nicoline F, Bosma Angela L, Hilhorst Marc L, Vegting Yosta, Bemelman Frederike J, Voskuyl Alexandre E, Broens Bo, Sanchez Agner Parra, van Els Cécile A C M, de Wit Jelle, Rutgers Abraham, de Leeuw Karina, Horváth Barbara, Verschuuren Jan J G M, Ruiter Annabel M, van Ouwerkerk Lotte, van der Woude Diane, Allaart Renée C F, Teng Y K Onno, van Paassen Pieter, Busch Matthias H, Jallah Papay B P, Brusse Esther, van Doorn Pieter A, Baars Adája E, Hijnen Dirk Jan, Schreurs Corine R G, van der Pol W Ludo, Goedee H Stephan, Steenhuis Maurice, Keijzer Sofie, Keijser Jim B D, Cristianawati Olvi, Ten Brinke Anja, Verstegen Niels J M, van Ham S Marieke, Rispens Theo, Kuijpers Taco W, Löwenberg Mark, Eftimov Filip, T2B! Immunity against SARS-CoV-2 study group
Аннотация
METHODS: IMID patients on active treatment with ISPs and controls (i.e. IMID patients not on ISP and healthy controls) with a confirmed SARS-CoV-2 infection before first vaccination were included from an ongoing prospective cohort study (T2B! study). Clinical data on infections and increased disease activity were registered using electronic surveys and health records. A serum sample was collected before first vaccination to measure SARS-CoV-2 anti-receptor-binding domain (RBD) antibodies.
RESULTS: In total, 193 IMID patients on ISP and 113 controls were included. Serum samples from 185 participants were available, with a median time of 173 days between infection and sample collection. The rate of seropositive IMID patients on ISPs was 78% compared to 100% in controls (p < 0.001). Seropositivity rates were lowest in patients on anti-CD20 (40.0%) and anti-tumor necrosis factor (TNF) agents (60.5%), as compared to other ISPs (p < 0.001 and p < 0.001, respectively). Increased disease activity after infection was reported by 68 of 260 patients (26.2%; 95% CI 21.2-31.8%), leading to ISP intensification in 6 out of these 68 patients (8.8%).
CONCLUSION: IMID patients using ISPs showed reduced long-term humoral immune responses after primary SARS-CoV-2 infection, which was mainly attributed to treatment with anti-CD20 and anti-TNF agents. Increased disease activity after SARS-CoV-2 infection was reported commonly, but was mostly mild.
TRIAL REGISTRATION: NL74974.018.20, Trial ID: NL8900. Registered on 9 September 2020.