Characteristics of COVID-19 infection and antibody formation in patients known at a tertiary immunology department.

Antibodies COVID-19 Immunocompromised Immunologic deficiency syndromes Immunosuppressive agents

Journal

Journal of translational autoimmunity
ISSN: 2589-9090
Titre abrégé: J Transl Autoimmun
Pays: Netherlands
ID NLM: 101759413

Informations de publication

Date de publication:
2021
Historique:
received: 21 12 2020
revised: 13 01 2021
accepted: 23 01 2021
pubmed: 4 2 2021
medline: 4 2 2021
entrez: 3 2 2021
Statut: ppublish

Résumé

Knowledge about COVID-19 infections is expanding, although knowledge about the disease course and antibody formation in patients with an auto-immune disease or immunodeficiency is not fully unraveled yet. It could be hypothesized that immunodeficient patients, due to immunosuppressive drugs or their disease, have a more severe disease course due to their immunocompromised state. However, it could also be hypothesized that some of the immunosuppressive drugs protect against a hyperinflammatory state. We collected data on the incidence of COVID-19, disease course and SARS-CoV-2 antibody formation in COVID-19 positive patients in a cohort of patients (n ​= ​4497) known at the Clinical Immunology outpatient clinic in a tertiary care hospital in the Netherlands. In the first six months of the pandemic, 16 patients were identified with COVID-19, 14 by nasal swab PCR, and 2 patients by SARS-CoV-2 antibodies. Eight patients were admitted to the hospital. SARS-CoV-2 antibodies were measured in 8 patients and were detectable in all, including one patient on B-cell ablative therapy and one patient with Common Variable Immunodeficiency Disorder. This study indicates that the disease course differs among immunocompromised patients, independently of (dis)continuation of immunosuppressive drugs. Antibody production for SARS-CoV-2 in immunocompromised patients was shown. More research needs to be conducted to confirm these observations and guidelines regarding (dis)continuation of immunosuppressive drugs in COVID-19 positive immunocompromised patients should be developed.

Sections du résumé

BACKGROUND BACKGROUND
Knowledge about COVID-19 infections is expanding, although knowledge about the disease course and antibody formation in patients with an auto-immune disease or immunodeficiency is not fully unraveled yet. It could be hypothesized that immunodeficient patients, due to immunosuppressive drugs or their disease, have a more severe disease course due to their immunocompromised state. However, it could also be hypothesized that some of the immunosuppressive drugs protect against a hyperinflammatory state.
METHODS METHODS
We collected data on the incidence of COVID-19, disease course and SARS-CoV-2 antibody formation in COVID-19 positive patients in a cohort of patients (n ​= ​4497) known at the Clinical Immunology outpatient clinic in a tertiary care hospital in the Netherlands.
RESULTS RESULTS
In the first six months of the pandemic, 16 patients were identified with COVID-19, 14 by nasal swab PCR, and 2 patients by SARS-CoV-2 antibodies. Eight patients were admitted to the hospital. SARS-CoV-2 antibodies were measured in 8 patients and were detectable in all, including one patient on B-cell ablative therapy and one patient with Common Variable Immunodeficiency Disorder.
CONCLUSION CONCLUSIONS
This study indicates that the disease course differs among immunocompromised patients, independently of (dis)continuation of immunosuppressive drugs. Antibody production for SARS-CoV-2 in immunocompromised patients was shown. More research needs to be conducted to confirm these observations and guidelines regarding (dis)continuation of immunosuppressive drugs in COVID-19 positive immunocompromised patients should be developed.

Identifiants

pubmed: 33532723
doi: 10.1016/j.jtauto.2021.100084
pii: S2589-9090(21)00004-6
pmc: PMC7844355
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100084

Informations de copyright

© 2021 The Authors.

Déclaration de conflit d'intérêts

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Auteurs

Niels A D Guchelaar (NAD)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Jan A M van Laar (JAM)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Maud A W Hermans (MAW)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Tim B van der Houwen (TB)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Sibel Atmaca (S)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Maurits S van Maaren (MS)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Zana Brkic (Z)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Paul L A van Daele (PLA)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Virgil A S H Dalm (VASH)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

P Martin van Hagen (PM)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Saskia M Rombach (SM)

Department of Internal Medicine, Division of Allergy and Clinical Immunology, Academic Center for Rare Systemic Immune Diseases, Erasmus MC University Medical Center, Rotterdam, the Netherlands.

Classifications MeSH