Systematic assessment of the humoral response against SARS-CoV-2 in a French cohort of 283 patients with rheumatic diseases - 08/05/22
, Olivier Fogel a
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Highlights |
• | The low seroprevalence against SARS-CoV-2 (2.83%) in patients with rheumatic disease and on immunosuppressive drugs indicates low immune protection in this population, demonstrating the importance of the vaccination strategy among these patients. |
• | Combining patients’ interview and anti-N serology is effective to detect COVID-19 infections while anti-S is no longer interpretable in the context of vaccination. |
• | Special care is warranted in patients treated with rituximab considering the potential severity of SARS-CoV-2 infection, regardless of seroconversion, hypogammaglobulinemia and B-cell depletion. |
Abstract |
Objectives |
To estimate the seroprevalence of SARS-CoV-2 infection in patients with rheumatic diseases and to specify the proportion of asymptomatic and symptomatic forms of COVID-19.
Methods |
We screened for SARS-CoV-2 infection among spondyloarthritis (SpA, n=143) or rheumatoid arthritis (RA, n=140) patients in our outpatient clinic at Cochin Hospital in Paris between June and August 2020. We performed a qualitative SARS-CoV-2 serological test which detects IgG directed against the N nucleocapsid protein (anti-N) and, for some patients, against the Spike protein (anti-S). Descriptive analyses were managed.
Results |
During June–August 2020, the SARS-CoV-2 seroprevalence rate in our population was 2.83% (8/283 patients) without significant difference between RA and SpA patients (2.14% and 3.5%, respectively). We report 11 out of 283 patients (3.8%) with a diagnosis of SARS-CoV-2 infection. Among these 11 patients, 1 patient was asymptomatic (9%) with a confirmed diagnosis of COVID-19 by anti-S serology. Of the 283 patients, 85% were under bDMARDs, mainly on rituximab (RTX) (n=44) and infliximab (IFX) (n=136).
Conclusions |
The seroprevalence of SARS-CoV-2 in patients with rheumatic diseases, mainly under bDMARDs treatments, was 2.83%. Among infected patients, 9% were asymptomatic. Detecting SARS-CoV-2 infections could be based on the strategy using patients’ interview and anti-N serology.
Le texte complet de cet article est disponible en PDF.Keywords : COVID-19, Serology, Rheumatoid arthritis, Spondyloarthritis, DMARDs
Plan
Vol 89 - N° 3
Article 105312- mai 2022 Retour au numéro
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