Objective Serology could help to define the real extent of SARS-CoV-2 diffusion, especially in individuals considered at higher risk of COVID-19, such as spondyloarthritis (SpA) patients undergoing immunosuppressant. Our aim was to detect, by serology, previous SARS-CoV-2 contact in SpA, compared to health care workers (HCW), and healthy controls. Methods Sera from consecutive patients affected by SpA undergoing cytokine-targeted therapy, HCW and healthy controls from 2015 were analysed through chemiluminescent analytical system for the presence of IgG and IgM anti-SARS-CoV-2. Positive patients (IgM or IgG, or both) additionally underwent real-time Polymerase-Chain-Reaction (RT-PCR) to test for active infection. Serology was repeated at 3-months in SpA. Data across 3 groups were compared by Kruskal Wallis/Chi-square, and between 2 groups by Wilcoxon rank test/Chi-Square. P ≤ 0.05 were considered significant. Results 200 SpA, 95 HCW and 101 controls were recruited. Positive serology was found in 25(12.5%) SpA, 8(8.4%) HCW, 0(0%) controls (p=0.001). SpA patients with positive serology more frequently reported COVID-19-like symptoms than those with negative serology (20% vs. 4%, p=0.009) and 2 had COVID-19 as confirmed by RT-PCR, non severe. No HCW reported symptoms or had positive RT-PCR. In SpA patients, at 3 months, mean IgM titres decreased from 2.76 ± 2.93 to 2.38 ± 2.95 (p=0.001), while IgG titres from 0.89 ± 3.25 to 0.31 ± 0.87 (p=ns). Conclusions Serology revealed that exposure to SARS-CoV-2 in SpA patients and HCW was higher than expected based on reported symptoms. In SpA, anti-cytokine therapy could act as a protective factor for a severe disease course. However, a seroconversion was not observed at 3-months.
【저자키워드】 COVID-19, SARS-CoV-2, serology, Immunosuppression, spondyloarthritis, 【초록키워드】 IgG, IgM, therapy, Health care, serology, health care workers, Infection, Symptom, RT-PCR, anti-SARS-CoV-2, Seroconversion, Patient, Control, Health care worker, group, patients, spondyloarthritis, Immunosuppressant, positive RT-PCR, Contact, IgG and IgM, HCW, exposure to, higher risk, consecutive patients, healthy control, individual, help, positive patients, protective factor, titre, healthy controls, anti-cytokine therapy, Chi-square, diffusion, positive serology, reported symptoms, severe disease course, anti-cytokine, Wilcoxon rank test, repeated, objective, Result, affected, detect, recruited, reported, analysed, to define, expected, consecutive patient, reported symptom,