Evaluation of SARS-CoV-2 IgG antibody reactivity in patients with systemic lupus erythematosus: analysis of a multi-racial and multi-ethnic cohort.

Autor:	Saxena A; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Guttmann A; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Masson M; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Kim MY; Division of Biostatistics, Department of Epidemiology & Population Health, Albert Einstein College of Medicine, The Bronx, New York, NY, USA., Haberman RH; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Castillo R; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Scher JU; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Deonaraine KK; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Engel AJ; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Belmont HM; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Blazer AD; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Buyon JP; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Fernandez-Ruiz R; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA., Izmirly PM; Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, NY USA.
Jazyk:	angličtina
Zdroj:	The Lancet. Rheumatology [Lancet Rheumatol] 2021 Aug; Vol. 3 (8), pp. e585-e594. Date of Electronic Publication: 2021 May 27.
DOI:	10.1016/S2665-9913(21)00114-4
Abstrakt:	Background: Patients with systemic lupus erythematosus (SLE) are at risk of developing COVID-19 due to underlying immune abnormalities and regular use of immunosuppressant medications. We aimed to evaluate the presence of SARS-CoV-2 IgG antibodies in patients with SLE with or without previous COVID-19-related symptoms or RT-PCR-confirmed SARS-CoV-2 infection. Methods: For this analysis, we included patients with SLE from two cohorts based in New York City: the Web-based Assessment of Autoimmune, Immune-Mediated and Rheumatic Patients during the COVID-19 pandemic (WARCOV) study; and the NYU Lupus Cohort (a prospective registry of patients at NYU Langone Health and NYC Health + Hospitals/Bellevue). Patients in both cohorts were tested for SARS-CoV-2 IgG antibodies via commercially available immunoassays, processed through hospital or outpatient laboratories. Patients recruited from the NYU Lupus Cohort, referred from affiliated providers, or admitted to hospital with COVID-19 were tested for SARS-CoV-2 IgG antibodies as part of routine surveillance during follow-up clinical visits. Findings: 329 patients with SLE were included in this analysis, 146 from the WARCOV study and 183 from the NYU Lupus Cohort, and were tested for SARS-CoV-2 antibodies between April 29, 2020, and Feb 9, 2021. 309 (94%) were women and 91 (28%) were of Hispanic ethnicity. 51 (16%) of 329 patients had a positive SARS-CoV-2 IgG antibody test. Seropositive patients were more likely than seronegative patients to be Hispanic (24 [47%] of 51 vsz 67 [24%] of 278). Other demographic variables, SLE-specific factors, and immunosuppressant use were not associated with SARS-CoV-2 positivity. Of the 29 patients with COVID-19 previously confirmed by RT-PCR, 18 (62%) were on immunosuppressants; 24 (83%) of 29 patients tested positive for SARS-CoV-2 IgG antibodies. Of 17 patients who had symptoms of COVID-19 but negative concurrent RT-PCR testing, one (6%) developed an antibody response. Of 26 patients who had COVID-19-related symptoms but did not undergo RT-PCR testing, six (23%) developed an antibody response. Of 83 patients who had no symptoms of COVID-19 and no RT-PCR testing, four (5%) developed an antibody response. Among 36 patients who were initially SARS-CoV-2 IgG positive, the majority maintained reactivity serially (88% up to 10 weeks, 83% up to 20 weeks, and 80% up to 30 weeks). Seven (70%) of ten patients with confirmed COVID-19 had antibody positivity beyond 30 weeks from disease onset. Interpretation: Most patients with SLE and confirmed COVID-19 were able to produce and maintain a serological response despite the use of a variety of immunosuppressants, providing reassurance about the efficacy and durability of humoral immunity and possible protection against re-infection with SARS-CoV-2. Funding: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, and Bloomberg Philanthropies COVID-19 Response Initiative Grant. (© 2021 Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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