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

Autor: Amit Saxena, Katerina Svigos, Brian Jaros, Janine Sullivan, Alexis J Engel, Pamela Rosenthal, Alexa Steuer, H. Michael Belmont, Miao Chang, Euna Lee, Trevor Young, Yamen Homsi, Andres Piatti, Susan Katz, Mala Masson, Julie Nusbaum, Natalie Azar, Mayce Haj-Ali, Brian D. Golden, Kavini Mehta, Michael Golpanian, Jordan E. Axelrad, Robin Lipschitz, Bruce Garner, Vaish Sekar, Rochelle Castillo, Joshua Novack, Michael Colin, Nazia Hussain, Andrew Porges, Jonathan Samuels, Keshav Mangalick, Lauren Rangel, Ruth Fernandez-Ruiz, Stephen Smiles, Connor Peterson, Stelios Viennas, Paula Rackoff, Steven Carsons, Rebecca H. Haberman, Anang Modi, Soumya M. Reddy, Fardina Malik, Mimi Y. Kim, Jill P. Buyon, Robert Lesser, Kaitlyn Yin, Avani Kolla, Samrachana Adhikari, Sicy Lee, Avram Goldberg, Simon Hong, Shannon Chang, Ashira D Blazer, Andrea L. Neimann, Bruce Solitar, Philip M. Carlucci, Allison Guttmann, Lauren Fried, Jessica Hoey, Di Yan, David Hudesman, Andrea B. Troxel, Gary Zagon, Gary Solomon, Craig Smuda, Alan Chen, Lindsey Quintana, Jose U. Scher, Konstantin Brodetskiy, Benjamin Plotz, Shruti Shankar, Deborah Ramirez, Rebecca B Blank, Peter M. Izmirly, Kimberly Robins, Lenore Brancato, Kristina K Deonaraine, Lily Cao, Lauren Wong, Harry Shen, Sabina Sandigursky, Eileen Lydon, Jennifer Stein
Rok vydání: 2021
Předmět:
Zdroj: The Lancet. Rheumatology
ISSN: 2665-9913
Popis: Summary 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.
Databáze: OpenAIRE
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