| Author |
van Dam, Koos P. J. Volkers, Adriaan G. Wieske, Luuk Stalman, Eileen W. Kummer, Laura Y. L. van Kempen, Zoé L. E. Killestein, Joep Tas, Sander W. Boekel, Laura Wolbink, Gerrit J. van der Kooi, Anneke J. Raaphorst, Joost Takkenberg, R. Bart D’Haens, Geert R. A. M. Spuls, Phyllis I. Bekkenk, Marcel W. Musters, Annelie H. Post, Nicoline F. Bosma, Angela L. Hilhorst, Marc L. Vegting, Yosta Bemelman, Frederike J. Voskuyl, Alexandre E. Broens, Bo Sanchez, Agner Parra van Els, Cécile A. C. M. de Wit, Jelle Rutgers, Abraham de Leeuw, Karina Horváth, Barbara Verschuuren, Jan J. G. M. Ruiter, Annabel M. van Ouwerkerk, Lotte van der Woude, Diane Allaart, Renée C. F. Teng, Y. K. Onno van Paassen, Pieter Busch, Matthias H. Jallah, Papay B. P. Brusse, Esther van Doorn, Pieter A. Baars, Adája E. Hijnen, Dirk Jan Schreurs, Corine R. G. van der Pol, W. Ludo Goedee, H. Stephan Steenhuis, Maurice Keijzer, Sofie Keijser, Jim B. D. Cristianawati, Olvi ten Brinke, Anja Verstegen, Niels J. M. van Ham, S. Marieke Rispens, Theo Kuijpers, Taco W. Löwenberg, Mark Eftimov, Filip |
| Abstract |
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. |
