TY - JOUR
T1 - Primary SARS-CoV-2 infection in patients with immune-mediated inflammatory diseases
T2 - long-term humoral immune responses and effects on disease activity
AU - van Dam, Koos P. J.
AU - Volkers, Adriaan G.
AU - Wieske, Luuk
AU - Stalman, Eileen W.
AU - Kummer, Laura Y. L.
AU - van Kempen, Zoé L. E.
AU - Killestein, Joep
AU - Tas, Sander W.
AU - Boekel, Laura
AU - Wolbink, Gerrit J.
AU - van der Kooi, Anneke J.
AU - Raaphorst, Joost
AU - Takkenberg, R. Bart
AU - D’Haens, Geert R. A. M.
AU - Spuls, Phyllis I.
AU - Bekkenk, Marcel W.
AU - Musters, Annelie H.
AU - Post, Nicoline F.
AU - Bosma, Angela L.
AU - Hilhorst, Marc L.
AU - Vegting, Yosta
AU - Bemelman, Frederike J.
AU - Voskuyl, Alexandre E.
AU - Broens, Bo
AU - Sanchez, Agner Parra
AU - van Els, C. cile A. C. M.
AU - de Wit, Jelle
AU - Rutgers, Abraham
AU - de Leeuw, Karina
AU - Horváth, Barbara
AU - Verschuuren, Jan J. G. M.
AU - Ruiter, Annabel M.
AU - van Ouwerkerk, Lotte
AU - van der Woude, Diane
AU - Allaart, Renée C. F.
AU - Teng, Y. K. Onno
AU - van Paassen, Pieter
AU - Busch, Matthias H.
AU - Jallah, Papay B. P.
AU - Brusse, Esther
AU - van Doorn, Pieter A.
AU - Baars, Adája E.
AU - Hijnen, Dirk Jan
AU - Schreurs, Corine R. G.
AU - ten Brinke, Anja
AU - van Ham, S. Marieke
AU - Rispens, Theo
AU - on behalf of the T2B! immunity against SARS-CoV-2 study group
AU - Kuijpers, Taco W.
AU - Löwenberg, Mark
AU - Eftimov, Filip
AU - van der Pol, W. Ludo
AU - Goedee, H. Stephan
N1 - Funding Information: We would like to thank ZonMw (The Netherlands Organization for Health Research and Development, grant 10430072010007) for the funding of the study and the T2B partners, including the patient groups and Health Holland for the support in this study. This collaboration project is financed by the PPP Allowance made available by Top Sector Life Sciences & Health to Samenwerkende Gezondheidsfondsen (SGF) under project number LSHM18055-SGF to stimulate public-private partnerships and co-financing by health foundations that are part of the SGF. Also, we would like to thank E.P. Moll van Charante, J.A Bogaards and R.A. Scholte for their guidance in the data safety monitoring board. Funding Information: This study was supported by ZonMw (The Netherlands Organization for Health Research and Development; project number 10430072010007). The sponsor had no role in the design, analysis or reporting of the study. Funding Information: We would like to thank ZonMw (The Netherlands Organization for Health Research and Development, grant 10430072010007) for the funding of the study and the T2B partners, including the patient groups and Health Holland for the support in this study. This collaboration project is financed by the PPP Allowance made available by Top Sector Life Sciences & Health to Samenwerkende Gezondheidsfondsen (SGF) under project number LSHM18055-SGF to stimulate public-private partnerships and co-financing by health foundations that are part of the SGF. Also, we would like to thank E.P. Moll van Charante, J.A Bogaards and R.A. Scholte for their guidance in the data safety monitoring board. Publisher Copyright: © 2023, The Author(s).
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: Patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressants (ISPs) may have impaired long-term humoral immune responses and increased disease activity after SARS-CoV-2 infection. We aimed to investigate long-term humoral immune responses against SARS-CoV-2 and increased disease activity after a primary SARS-CoV-2 infection in unvaccinated IMID patients on ISPs. 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.
AB - Background: Patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressants (ISPs) may have impaired long-term humoral immune responses and increased disease activity after SARS-CoV-2 infection. We aimed to investigate long-term humoral immune responses against SARS-CoV-2 and increased disease activity after a primary SARS-CoV-2 infection in unvaccinated IMID patients on ISPs. 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.
KW - Antibodies
KW - Autoimmune disease
KW - Covid-19
KW - Disease activity
KW - Flare
KW - Immune-mediated inflammatory diseases
KW - Immunity
KW - Immunosuppression
KW - SARS-CoV-2
KW - TNF
UR - http://www.scopus.com/inward/record.url?scp=85159760443&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12879-023-08298-6
DO - https://doi.org/10.1186/s12879-023-08298-6
M3 - Article
C2 - 37198536
SN - 1471-2334
VL - 23
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 1
M1 - 332
ER -