Abstract
Patients with autoimmune rheumatic diseases (AIRD) are suspected to have less robust immune responses during COVID-19 due to underlying immune dysfunction and the use of immune-suppressive drugs. Fifty consecutive patients with a diagnosis of AIRD on disease-modifying drugs were included at around 30 days after a confirmatory test for COVID-19. Fifty controls matched one to one for age, sex, and severity of COVID-19 were also included at around 30 days after testing positive for COVID-19. Antibody titers for anti-spike protein IgG and anti-nucleocapsid protein IgG were estimated. Cases (mean age 45.9 ± 13; 76% females) and controls (mean age 45.9 ± 13; 76% females) had similar proportion of comorbidities. Of the cases, 4 had moderate and 1 had severe COVID-19, while 3 and 1 of controls had moderate and severe COVID-19 respectively. Positivity of anti-N IgG was similar between patients (80%) and controls (90%) (p = 0.26). Similarly, anti-S IgG was positive in 82% of patients and 86% of controls (p = 0.79). Both the antibodies were negative in seven (14%) patients and five (10%) of controls (p = 0.76, Fischer exact test). Only anti-N IgG titers were lower in patients as compared to controls. In four patients with rheumatoid arthritis, two with spondyloarthritis and one with eosinophilic fasciitis both antibodies were not detectable. They did not differ from the rest of the cohort in clinical characteristics. The patients with AIRD had adequate protective antibody responses to COVID-19 at a median of 30 days post-infection. Thus, the presence of AIRD or the use of immunosuppressants does not seem to influence the development of humoral immune response against COVID-19. Key Points • Patients with autoimmune rheumatic diseases (AIRD) are suspected to have less robust immune responses. • In our cohort of 50 patients with AIRD with confirmed COVID-19, only seven did not have detectable protective antibodies at 30 days post infection. • Patients with AIRD on immunosuppressants have adequate protective antibodies post COVID-19 disease, at rates similar to that in health controls.
Keywords: Autoimmune disease; COVID-19 susceptibility; Immune response; Immunosuppressant; Protective antibody; Rheumatic disease.
【저자키워드】 immune response, Autoimmune disease, COVID-19 susceptibility, Immunosuppressant, Protective antibody, rheumatic disease, 【초록키워드】 COVID-19, IgG, Arthritis, Rheumatic diseases, immune response, severe COVID-19, Clinical characteristics, antibody, Comorbidities, Diagnosis, drugs, Sex, drug, immunosuppressants, rheumatoid arthritis, COVID-19 disease, Autoimmune disease, Protein, Cohort, Health, protective antibodies, severity of COVID-19, immune responses, Patient, Control, age, Autoimmune, humoral immune response, moderate, spondyloarthritis, Antibody titers, anti-N IgG, anti-S IgG, COVID-19 susceptibility, Immunosuppressant, Protective antibody, immune dysfunction, rheumatic disease, positive, anti-spike protein IgG, females, FIVE, controls, fasciitis, robust, Seven, not differ, proportion, detectable, median, less, days post infection, days post-infection, consecutive patient, Point, protective antibody response, the antibody, 【제목키워드】 Antibody Response, Patient, Autoimmune, disease,