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 - on behalf of the T2B! immunity against SARS-CoV-2 study group
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, Cécile 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 - van der Pol, W. Ludo
AU - Goedee, H. Stephan
AU - Steenhuis, Maurice
AU - Keijzer, Sofie
AU - Verstegen, Niels J.M.
AU - van Ham, S. Marieke
N1 - Publisher Copyright: © 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
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 - 10.1186/s12879-023-08298-6
DO - 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 -