Objectives Impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on individuals with arthritis has been highlighted whereas data on other rheumatic diseases, e.g., systemic lupus erythematosus (SLE), are scarce. Similarly to SLE, severe SARS-CoV-2 infection includes risks for thromboembolism, an unbalanced type I interferon response, and complement activation. Herein, SARS-CoV-2 antibodies in longitudinal samples collected prior to vaccination were analyzed and compared with SLE progression and antinuclear antibody (ANA) levels. Methods One hundred patients (83 women) with established SLE and a regular visit to the rheumatologist (March 2020 to January 2021) were included. All subjects donated blood and had done likewise prior to the pandemic. SARS-CoV-2 antibody isotypes (IgG, IgA, IgM) to the cell receptor-binding S1-spike outer envelope protein were detected by ELISA, and their neutralizing capacity was investigated. IgG-ANA were measured by multiplex technology. Results During the pandemic, 4% had PCR-confirmed infection but 36% showed SARS-CoV-2 antibodies of ≥1 isotype; IgA was the most common (30%), followed by IgM (9%) and IgG (8%). The antibodies had low neutralizing capacity and were detected also in prepandemic samples. Plasma albumin ( p = 0.04) and anti-dsDNA ( p = 0.003) levels were lower in patients with SARS-CoV-2 antibodies. Blood group, BMI, smoking habits, complement proteins, daily glucocorticoid dose, use of hydroxychloroquine, or self-reported coronavirus disease 2019 (COVID-19) symptoms (except fever, >38.5°C) did not associate with SARS-CoV-2 antibodies. Conclusion Our data from early 2021 indicate that a large proportion of Swedish SLE patients had serological signs of exposure to SARS-CoV-2 but apparently with a minor impact on the SLE course. Use of steroids and hydroxychloroquine showed no distinct effects, and self-reported COVID-19-related symptoms correlated poorly with all antibody isotypes.
【저자키워드】 COVID-19, Antibody Response, lupus (SLE), neutralization (effect of), antinuclear antibodies, complement-immunological terms, 【초록키워드】 coronavirus disease, antibodies, SARS-CoV-2, IgG, IgM, Arthritis, Rheumatic diseases, Coronavirus disease 2019, coronavirus, vaccination, pandemic, Hydroxychloroquine, antibody, SARS-COV-2 infection, Infection, interferon, risk, systemic lupus erythematosus, complement, Proteins, Symptom, progression, smoking, severe acute respiratory syndrome Coronavirus, Steroids, glucocorticoid, ELISA, type I interferon, Complement activation, SARS-CoV-2 antibodies, SARS-CoV-2 antibody, IgA, Impact, Fever, Patient, Thromboembolism, albumin, envelope protein, neutralizing capacity, women, BMI, respiratory, multiplex, serological, antibody isotypes, Blood, Blood Group, dose, steroid, lupus erythematosus, SLE, a minor, the cell, followed by, exposure to, acute respiratory syndrome, Activation, antinuclear antibody, acute respiratory syndrome coronavirus, PCR-confirmed, acute respiratory syndrome coronavirus 2, subject, all subjects, minor, individual, isotype, severe SARS, longitudinal samples, Effects, objective, Cell, cell receptor, anti-dsDNA, rheumatologist, severe SARS-CoV-2, Course, Result, analyzed, collected, include, proportion, investigated, correlated, Swedish, were measured, SLE patient, COVID-19-related symptom, patients with SARS-CoV-2, use of hydroxychloroquine, 【제목키워드】 SARS-CoV-2, drug, activity, Lupus, antinuclear antibodies, systemic, isotype, Year,