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Minopoulou I, Tascilar K, Corte G, Mutlu MY, Schmidt K, Bohr D, Hartmann F, Manger K, Manger B, Korn K, Kleyer A, Simon D, Harrer T, Schett G, Fagni F. Tixagevimab/cilgavimab for the prevention of COVID-19 in vaccine-refractory patients with autoimmune diseases: a prospective cohort study. Rheumatology (Oxford) 2024; 63:1377-1383. [PMID: 37531288 DOI: 10.1093/rheumatology/kead391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/28/2023] [Accepted: 07/13/2023] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVES To investigate the effects of passive immunization with the anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibodies tixagevimab/cilgavimab on humoral responses and on coronavirus disease 2019 (COVID-19) outcomes in vaccine-refractory patients with immune-mediated inflammatory diseases (IMIDs) at high risk of severe COVID-19. METHODS A prospective cohort study was performed on a cohort of high-risk vaccine-refractory IMID patients treated with a single dose of tixagevimab/cilgavimab (150 mg/150 mg). COVID-19 outcomes as well as serum and salivary anti-SARS-CoV-2 IgG were assessed at baseline and for at least 6 months. Results were compared with an untreated high-risk vaccine-refractory IMID population. Standardized incidence ratios (SIRs) of COVID-19 compared with the general population were calculated for both groups. RESULTS A total of 38 high-risk IMID patients received tixagevimab/cilgavimab and were compared with 114 untreated high-risk IMID controls. Serum anti-spike IgG increased to 6.6 OD (s.d. 0.8) at day 1 and remained positive up to month 6 [6.3 OD (s.d. 1.4)]. Salivary anti-spike IgG peaked at month 2 [1.6 OD (s.d. 1.1)] and decreased from month 3 [0.8 OD (s.d. 0.3)]. No severe or extended infection was observed in the tixagevimab/cilgavimab group. Compared with the general population, the SIR of COVID-19 in treated patients was 0.76 (95% CI 0.24, 1.58) despite the increased risk profile. The SIR of the control group was 1.51 (95% CI 1.07, 2.02), corresponding to a significantly increased incidence. CONCLUSIONS Passive immunization with tixagevimab/cilgavimab is safe and effective in inducing anti-SARS-CoV-2 immunity and potentially in preventing COVID-19 in high-risk vaccine-refractory IMID patients. These data provide a proof of concept for the use of monoclonal antibodies as a preventative strategy against SARS-CoV-2 in vulnerable populations.
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Affiliation(s)
- Ioanna Minopoulou
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Giulia Corte
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Melek Yalcin Mutlu
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Katja Schmidt
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Daniela Bohr
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Fabian Hartmann
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Bernhard Manger
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Klaus Korn
- Institute of Virology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - David Simon
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Thomas Harrer
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Filippo Fagni
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
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Andreev D, Kachler K, Liu M, Chen Z, Krishnacoumar B, Ringer M, Frey S, Krönke G, Voehringer D, Schett G, Bozec A. Eosinophils preserve bone homeostasis by inhibiting excessive osteoclast formation and activity via eosinophil peroxidase. Nat Commun 2024; 15:1067. [PMID: 38316791 PMCID: PMC10844633 DOI: 10.1038/s41467-024-45261-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 01/18/2024] [Indexed: 02/07/2024] Open
Abstract
Eosinophils are involved in tissue homeostasis. Herein, we unveiled eosinophils as important regulators of bone homeostasis. Eosinophils are localized in proximity to bone-resorbing osteoclasts in the bone marrow. The absence of eosinophils in ΔdblGATA mice results in lower bone mass under steady-state conditions and amplified bone loss upon sex hormone deprivation and inflammatory arthritis. Conversely, increased numbers of eosinophils in IL-5 transgenic mice enhance bone mass under steady-state conditions and protect from hormone- and inflammation- mediated bone loss. Eosinophils strongly inhibit the differentiation and demineralization activity of osteoclasts and lead to profound changes in the transcriptional profile of osteoclasts. This osteoclast-suppressive effect of eosinophils is based on the release of eosinophil peroxidase causing impaired reactive oxygen species and mitogen-activated protein kinase induction in osteoclast precursors. In humans, the number and the activity of eosinophils correlates with bone mass in healthy participants and rheumatoid arthritis patients. Taken together, experimental and human data indicate a regulatory function of eosinophils on bone.
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Affiliation(s)
- Darja Andreev
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.
- Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany.
| | - Katerina Kachler
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - Mengdan Liu
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
- Department of Rheumatology, Zhejiang University - School of Medicine, Hangzhou, China
| | - Zhu Chen
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
- Department of Rheumatology and Immunology, Anhui Medical University Affiliated Provincial Hospital, Hefei, China
| | - Brenda Krishnacoumar
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
- Institute of Physiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mark Ringer
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - Silke Frey
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - Gerhard Krönke
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
- Department of Rheumatology and Clinical Immunology, Charité University Medicine, Berlin, Germany
| | - David Voehringer
- Department of Infection Biology, FAU Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany
| | - Aline Bozec
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander-University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.
- Deutsches Zentrum für Immuntherapie (DZI), Erlangen, Germany.
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3
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Tian Z, Chen Y, Yao Y, Chen L, Zhu X, Shen Z, Yang S, Jin H. Immunogenicity and risk factors for poor humoral immune response to SARS-CoV-2 vaccine in patients with autoimmune hepatitis: a systematic review and meta-analysis. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2024. [PMID: 38235657 DOI: 10.17235/reed.2024.10053/2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
BACKGROUND Research on the immunogenicity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in patients with autoimmune hepatitis (AIH) has produced varied results, and the determinants of the immunological response remain largely elusive. METHODS A comprehensive search of three primary databases (PubMed, Embase, and Web of Science) yielded pertinent studies on the topic. The data extraction was a collaborative effort among three independent researchers, who subsequently reconvened to validate the key data that were collated. The primary outcomes were the magnitudes of humoral and cellular immune responses to the vaccines. The secondary outcomes were related to factors affecting the humoral immune response post-vaccination. RESULT Our systematic review incorporated eight studies, and the meta-analysis involved three. The average antibody response rates after one, two, and three doses of the SARS-CoV-2 vaccine were 86%, 82%, and 91%, respectively. Unexpectedly, the antibody concentrations of seropositive patients were markedly lower than those of their healthy counterparts. The cellular immune response rates after two and three vaccine doses were 74% and 56%, respectively. Treatment with mycophenolate mofetil and corticosteroids was associated with a notable decrease in seropositivity [pooled odds ratio (95% confidence interval): 2.62 (2.12-3.25) and 2.4 (1.51-3.82), respectively]. In contrast, azathioprine had no discernable impact on the humoral response. CONCLUSION In patients with AIH, the immune response to COVID-19 vaccination is attenuated. Specific immunosuppressive agents, such as steroids and MMF, have been found to reduce antibody responses. Recognizing these determinants is foundational to formulating individualized vaccination strategies for patients with AIH. Further research with an emphasis on post-vaccination cellular immunity will be essential to refine the vaccination approaches for this demographic.
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Affiliation(s)
- Zhaoxu Tian
- Critical Care Medicine, Pingyao Campus of The First People's Hospital of Hangzhou,
| | - Yonghua Chen
- Critical Care Medicine, Pingyao Campus of The First People's Hospital of Hangzhou
| | - Yingxin Yao
- Critical Care Medicine, Pingyao Campus of The First People's Hospital of Hangzhou
| | - Lihua Chen
- Critical Care Medicine , Pingyao Campus of The First People's Hospital of Hangzhou
| | - Xiakai Zhu
- Critical Care Medicine, Pingyao Campus of The First People's Hospital of Hangzhou
| | - Zhaocong Shen
- Critical Care Medicine, Pingyao Campus of The First People's Hospital of Hangzhou
| | - Shanwei Yang
- Critical Care Medicine, Pingyao Campus of The First People's Hospital of Hangzhou
| | - Hangbin Jin
- Critical Care Medicine, Pingyao Campus of The First People's Hospital of Hangzhou
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Kharouf F, Eviatar T, Braun M, Pokroy-Shapira E, Brodavka M, Zloof Y, Agmon-Levin N, Toledano K, Oren S, Lidar M, Zisman D, Tavor Y, Amit-Vazina M, Sabbah F, Breuer GS, Dagan A, Beshara-Garzuzi R, Markovits D, Elias M, Feld J, Tayer-Shifman O, Gazitt T, Reitblatt T, Rubin L, Haddad A, Giryes S, Paran D, Peleg H, Molad Y, Elkayam O, Mevorach D, Balbir-Gurman A, Braun-Moscovici Y. A deep look into the storm: Israeli multi-center experience of coronavirus disease 2019 (COVID-19) in patients with autoimmune inflammatory rheumatic diseases before and after vaccinations. Front Immunol 2023; 14:1064839. [PMID: 36993961 PMCID: PMC10040776 DOI: 10.3389/fimmu.2023.1064839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectiveWe aimed to characterize the course of COVID-19 in autoimmune inflammatory rheumatic disease (AIIRD) patients in Israel, taking into consideration several remarkable aspects, including the outcomes of the different outbreaks, the effect of vaccination campaigns, and AIIRD activity post-recovery.MethodsWe established a national registry of AIIRD patients diagnosed with COVID-19, including demographic data, AIIRD diagnosis, duration and systemic involvement, comorbidities, date of COVID-19 diagnosis, clinical course, and dates of vaccinations. COVID-19 was diagnosed by a positive SARS-CoV-2 polymerase chain reaction.ResultsIsrael experienced 4 outbreaks of COVID-19 until 30.11.2021. The first three outbreaks (1.3.2020 – 30.4.2021) comprised 298 AIIRD patients. 64.9% had a mild disease and 24.2% had a severe course; 161 (53.3%) patients were hospitalized, 27 (8.9%) died. The 4th outbreak (delta variant), starting 6 months after the beginning of the vaccination campaign comprised 110 patients. Despite similar demographic and clinical characteristics, a smaller proportion of AIIRD patients had negative outcomes as compared to the first 3 outbreaks, with regards to severity (16 patients,14.5%), hospitalization (29 patients, 26.4%) and death (7 patients, 6.4%). COVID-19 did not seem to influence the AIIRD activity 1-3 months post-recovery.ConclusionsCOVID-19 is more severe and has an increased mortality in active AIIRD patients with systemic involvement, older age and comorbidities. Vaccination with 3 doses of the mRNA vaccine against SARS-CoV-2 protected from severe COVID-19, hospitalization and death during the 4th outbreak. The pattern of spread of COVID-19 in AIIRD patients was similar to the general population.
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Affiliation(s)
- Fadi Kharouf
- The Department of Medicine, Rheumatology Unit and Rare Disease Research Center, Hadassah Medical Center, Jerusalem, Israel
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tali Eviatar
- Rheumatology Department, Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maya Braun
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Elisheva Pokroy-Shapira
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Rheumatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Michal Brodavka
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Rheumatology Unit, Sheba Medical Center, Ramat Gan, Israel
| | - Yair Zloof
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Nancy Agmon-Levin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Clinical Immunology, Angioedema and Allergy Unit, Sheba Medical Center, Ramat Gan, Israel
| | - Kochava Toledano
- Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
| | - Shirly Oren
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Rheumatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Merav Lidar
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Rheumatology Unit, Sheba Medical Center, Ramat Gan, Israel
| | - Devy Zisman
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
- Rheumatology Unit, Carmel Medical Center, Haifa, Israel
| | - Yonit Tavor
- Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
| | - Mirit Amit-Vazina
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Rheumatology Service, Shamir Medical Center, Be’er Ya’akov, Israel
| | - Firas Sabbah
- Rheumatology Service, Baruch Padeh Medical Center, Tiberias, Israel
| | - Gabriel S. Breuer
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Rheumatology Unit, Shaare Tzedek Medical Center, Jerusalem, Israel
| | - Amir Dagan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Rheumatology Clinic, Assuta Ashdod Hospital, Ashdod, Israel
| | - Rima Beshara-Garzuzi
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
- Rheumatology Unit, Carmel Medical Center, Haifa, Israel
| | - Doron Markovits
- Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
| | - Muna Elias
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
- Rheumatology Unit, Carmel Medical Center, Haifa, Israel
| | - Joy Feld
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
- Rheumatology Unit, Carmel Medical Center, Haifa, Israel
| | - Oshrat Tayer-Shifman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Rheumatology Unit, Meir Medical Center, Kfar Saba, Israel
| | - Tal Gazitt
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
- Rheumatology Unit, Carmel Medical Center, Haifa, Israel
| | | | - Limor Rubin
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
- Allergy and Clinical Immunology Unit, Department of medicine, Hadassah Medical Center, Jerusalem, Israel
| | - Amir Haddad
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
- Rheumatology Unit, Carmel Medical Center, Haifa, Israel
| | - Sami Giryes
- Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
| | - Daphna Paran
- Rheumatology Department, Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hagit Peleg
- The Department of Medicine, Rheumatology Unit and Rare Disease Research Center, Hadassah Medical Center, Jerusalem, Israel
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yair Molad
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Rheumatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Ori Elkayam
- Rheumatology Department, Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dror Mevorach
- The Department of Medicine, Rheumatology Unit and Rare Disease Research Center, Hadassah Medical Center, Jerusalem, Israel
- The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Alexandra Balbir-Gurman
- Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
| | - Yolanda Braun-Moscovici
- Rheumatology Institute, Rambam Health Care Campus, Haifa, Israel
- Rappaport Faculty of Medicine, Israeli Institute of Technology-Technion, Haifa, Israel
- *Correspondence: Yolanda Braun-Moscovici,
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5
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van Ouwerkerk L, van der Woude D, Rispens T, Allaart CF, Huizinga T. Presence of SARS-CoV-2 antibodies in patients with COVID-19 like symptoms from the IENIMINI cohort. Scand J Rheumatol 2023; 52:196-199. [PMID: 35833317 DOI: 10.1080/03009742.2022.2092269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To evaluate the relationship between reported coronavirus disease 2019 (COVID-19)-like symptoms and the presence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies in patients with an immune-mediated inflammatory disorder or post-solid organ transplantation (IMIDT) with and without immunosuppressive medication (imed) and controls. METHOD The IENIMINI cohort was a prospective cohort study set up in the Netherlands in March 2020, with 2 monthly (paper) or weekly (online) questionnaires about COVID-19-like symptoms. Participants from this cohort who reported these symptoms between March 2020 and November 2020 were approached for this substudy. SARS-CoV-2 antibodies were tested using a total antibody assay. RESULTS Of the 1203 participants approached, 629 agreed to participate and were sent a fingerprick test; 565 participants collected a capillary blood sample, of which 562 were usable. Analysis showed that 57/202 (28.2%) of the tested IMIDT group with imed, 48/16 3(29.4%) of the IMIDT group without imed, and 69/197 (35.0%) of the control group tested positive for SARS-CoV-2 antibodies. Seroprevalences of SARS-CoV-2 antibodies between males and females, biological disease-modifying anti-rheumatic drug users and non-users, and those who had had a serious disease period (defined as an episode with dyspnoea and fever) and those who had not, were not statistically different between the three groups. CONCLUSIONS Approximately 30% of patients who had reported COVID-19-like symptoms had SARS-CoV-2 antibodies. The seroprevalence of SARS-CoV-2 antibodies after reported COVID-19-like symptoms was similar in IMIDT patients with and without imed compared to controls.
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Affiliation(s)
- L van Ouwerkerk
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - D van der Woude
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - T Rispens
- Biologics Lab, Sanquin Diagnostic Services, Amsterdam, The Netherlands.,Department of Immunopathology, Sanquin Research and Landsteiner Laboratory, Academic Medical Center, Amsterdam, The Netherlands
| | - C F Allaart
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Twj Huizinga
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
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6
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Chin LK, Yang JY, Chousterman B, Jung S, Kim DG, Kim DH, Lee S, Castro CM, Weissleder R, Park SG, Im H. Dual-Enhanced Plasmonic Biosensing for Point-of-Care Sepsis Detection. ACS NANO 2023; 17:3610-3619. [PMID: 36745820 PMCID: PMC10150330 DOI: 10.1021/acsnano.2c10371] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Rapid, sensitive, simultaneous quantification of multiple biomarkers in point-of-care (POC) settings could improve the diagnosis and management of sepsis, a common, potentially life-threatening condition. Compared to high-end commercial analytical systems, POC systems are often limited by low sensitivity, limited multiplexing capability, or low throughput. Here, we report an ultrasensitive, multiplexed plasmonic sensing technology integrating chemifluorescence signal enhancement with plasmon-enhanced fluorescence detection. Using a portable imaging system, the dual chemical and plasmonic amplification enabled rapid analysis of multiple cytokine biomarkers in 1 h with sub-pg/mL sensitivities. Furthermore, we also developed a plasmonic sensing chip based on nanoparticle-spiked gold nanodimple structures fabricated by wafer-scale batch processes. We used the system to detect six cytokines directly from clinical plasma samples (n = 20) and showed 100% accuracy for sepsis detection. The described technology could be employed in rapid, ultrasensitive, multiplexed plasmonic sensing in POC settings for myriad clinical conditions.
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Affiliation(s)
- Lip Ket Chin
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Electrical Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR
| | - Jun-Yeong Yang
- Department of Nano-Bio Convergence, Korea Institute of Materials Science, 797 Changwondae-ro, Changwon 51508, Republic of Korea
| | - Benjamin Chousterman
- Département d’Anesthésie-Réanimation, Hôpital Lariboisière, AP-HP, 75010, Paris, France
| | - Sunghoon Jung
- Department of Nano-Bio Convergence, Korea Institute of Materials Science, 797 Changwondae-ro, Changwon 51508, Republic of Korea
| | - Do-Geun Kim
- Department of Nano-Bio Convergence, Korea Institute of Materials Science, 797 Changwondae-ro, Changwon 51508, Republic of Korea
| | - Dong-Ho Kim
- Department of Nano-Bio Convergence, Korea Institute of Materials Science, 797 Changwondae-ro, Changwon 51508, Republic of Korea
| | - Seunghun Lee
- Department of Nano-Bio Convergence, Korea Institute of Materials Science, 797 Changwondae-ro, Changwon 51508, Republic of Korea
| | - Cesar M. Castro
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114, USA
- Cancer Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Ralph Weissleder
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114, USA
- Cancer Center, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Systems Biology, Harvard Medical School, 200 Longwood Ave, Boston, MA 02115, USA
| | - Sung-Gyu Park
- Department of Nano-Bio Convergence, Korea Institute of Materials Science, 797 Changwondae-ro, Changwon 51508, Republic of Korea
- Corresponding authors: Hyungsoon Im (), Sung-Gyu Park ()
| | - Hyungsoon Im
- Center for Systems Biology, Massachusetts General Hospital, Boston, MA 02114, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA
- Corresponding authors: Hyungsoon Im (), Sung-Gyu Park ()
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7
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Teich N, Stallmach A. COVID-19 und chronisch-entzündliche Darmerkrankungen. DIE GASTROENTEROLOGIE 2023. [PMCID: PMC9969944 DOI: 10.1007/s11377-023-00679-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Die Pandemie durch die Coronavirus Disease 2019 (COVID-19) beeinflusst weiter das Leben von Patient*innen mit chronisch-entzündlichen Darmerkrankungen (CED). Umfangreiche Untersuchungen der letzten 3 Jahre ergaben, dass die allermeisten Infektionen durch „severe acute respiratory syndrome coronavirus type 2“ (SARS-CoV-2) bei CED-Patient*innen blande verlaufen. In der Regel wird die Krankheitsaktivität der CED nicht negativ beeinflusst; bei einem Teil der Patient*innen können passager gastrointestinale Symptome auftreten. Häufig eingesetzte immunmodulierende Medikamente hatten mit Ausnahme systemischer Glukokortikoide keinen Einfluss auf den Schweregrad einer COVID-19-Erkrankung und die Gesamtletalität unterschied sich nicht von der übrigen Bevölkerung. Die Impfantwort ist jedoch substanzabhängig erniedrigt. In dieser Übersichtsarbeit werden die wichtigsten Studien praxisrelevant zusammengefasst.
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Affiliation(s)
- Niels Teich
- Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselkrankheiten Leipzig und Schkeuditz, Nordstr. 21, 04105 Leipzig, Deutschland
| | - Andreas Stallmach
- Klinik für Innere Medizin IV, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Deutschland
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8
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Sebastian S. Coronavirus disease - 19 immunity in inflammatory bowel disease patients: The progressive discovery from ignorance. Indian J Gastroenterol 2023; 42:11-13. [PMID: 36800151 PMCID: PMC9936120 DOI: 10.1007/s12664-023-01342-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- Shaji Sebastian
- IBD Unit, Department of Gastroenterology, Hull University Hospitals NHS Trust, Hull, HU17 9RZ, UK.
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9
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Schulze-Koops H, Skapenko A, Krause A, Krueger K, Lorenz HM, Sewerin P, Specker C, Wagner UG, Voormann A, Mueller-Ladner U, Voll RE. Correspondence to 'Risk factors for hospital admissions related to COVID-19 in patients with autoimmune inflammatory rheumatic diseases'. Ann Rheum Dis 2023; 82:e1. [PMID: 33127664 DOI: 10.1136/annrheumdis-2020-218997] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/27/2020] [Accepted: 09/30/2020] [Indexed: 02/03/2023]
Affiliation(s)
- Hendrik Schulze-Koops
- Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, Ludwig Maximilians University of Munich, Munich, Germany
| | - Alla Skapenko
- Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, Ludwig Maximilians University of Munich, Munich, Germany
| | - Andreas Krause
- Department of Rheumatology, Clinical Immunology and Osteology, Immanuel Hospital Berlin-Wannsee Branch, Berlin, Germany
| | | | - Hanns-Martin Lorenz
- Division of Rheumatology, Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Philipp Sewerin
- Department and Hiller-Research-Unit fpr Rheumatology, University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
| | - Christof Specker
- Klinik für Rheumatologie und Klinische Immunologie, Kliniken Essen-Mitte-KEM, Essen, Germany
| | - Ulf G Wagner
- Division of Rheumatology, Department for Endocrinology, Nephrology, Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Anna Voormann
- Deutsche Gesellschaft für Rheumatologie eV, Berlin, Germany
| | - Ulf Mueller-Ladner
- Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus-Liebig-University Giessen, Giessen, Germany
| | - Reinhard E Voll
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany.,Centre for Chronic Immunodeficiency, Faculty of Medicine, Medical Center-University of Freiburg, Freiburg, Germany
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10
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Geldof J, Truyens M, Sabino J, Ferrante M, Lambert J, Lapeere H, Hillary T, Van Laethem A, de Vlam K, Verschueren P, Padalko E, Lobaton T, Vermeire S. SARS-CoV-2 infection and COVID19 vaccination across eight immune-mediated inflammatory disorders: A prospective, real-life Belgian cohort study - the BELCOMID study. Front Immunol 2023; 14:1126351. [PMID: 36936974 PMCID: PMC10014825 DOI: 10.3389/fimmu.2023.1126351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
Background The risks and impact of COVID19 disease and vaccination in patients with Immune Mediated Inflammatory Diseases (IMID) remain incompletely understood. IMID patients and particularly patients receiving immunosuppressive treatment were excluded from the original, registrational phase-3 COVID19 vaccination efficacy and safety trials. Real-world observational data can help to fill this gap in knowledge. The BELCOMID study aims to explore the interaction between IMIDs, immune-modulating treatment modalities and SARS-CoV-2 infection and vaccination in a real-life patient cohort. Methods A multidisciplinary, prospective, observational cohort study was set up. Consecutive patients with IMIDs of the gut, joints and skin followed at two high-volume referral centers were invited. Both patients under conventional treatment or targeted immune modulating therapies were included. Patient data and serological samples were collected at 3 predefined periods (before COVID19 vaccination, before booster vaccination, after booster vaccination). Primary endpoints were positive PCR-test and SARS-CoV-2 serology reflecting previous SARS-CoV-2 infection or vaccination. Associations with IMID treatment modality and IMID disease activity were assessed. Results of the first two inclusion periods (before booster vaccination) are reported. Results At the first inclusion period data was assessed of 2165 IMID-patients before COVID19 vaccination. At the second inclusion period, data of 2065 patients was collected of whom 1547 had received complete baseline COVID19 vaccination and 222 were partially vaccinated. SARS-CoV-2 infection rate remained low in both groups. No significant increase in IMID flare-up rate was noted in patients with prior SARS-CoV-2 infection. Multiple logistic regression analyses did not show a significant influence of IMID-treatment modality or IMID activity on SARS-CoV-2 infection risk (based on PCR positivity or N-serology). Patients treated with conventional immunomodulators, systemic steroids, and patients on advanced therapies such as biologics or small molecules, had reduced S-antibody seroconversion. S-antibody response was also lower in patients without prior SARS-CoV-2 infection and in active smokers. A subset of patients (4.1%) had no S- nor N-antibody seroconversion following complete baseline vaccination. Conclusion The BELCOMID study results confirm the benign course of COVID19 infection and vaccination in a large real-life IMID-population. However, our results underscore the need for repeated vaccination and smoking cessation in patients with IMIDs treated with immune-modulating therapies or systemic steroids during the pandemic.
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Affiliation(s)
- Jeroen Geldof
- Ghent University Hospital, Department of Gastroenterology and Hepatology, Ghent, Belgium
- Ghent University, Department of Internal Medicine and Pediatrics, Ghent, Belgium
- *Correspondence: Jeroen Geldof,
| | - Marie Truyens
- Ghent University Hospital, Department of Gastroenterology and Hepatology, Ghent, Belgium
- Ghent University, Department of Internal Medicine and Pediatrics, Ghent, Belgium
| | - João Sabino
- University Hospitals Leuven, Department of Gastroenterology and Hepatology, Leuven, Belgium
- KU Leuven, Translational Research in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), Leuven, Belgium
| | - Marc Ferrante
- University Hospitals Leuven, Department of Gastroenterology and Hepatology, Leuven, Belgium
- KU Leuven, Translational Research in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), Leuven, Belgium
| | - Jo Lambert
- Ghent University Hospital, Department of Dermatology, Ghent, Belgium
| | - Hilde Lapeere
- Ghent University Hospital, Department of Dermatology, Ghent, Belgium
| | - Tom Hillary
- University Hospitals Leuven, Department of Dermatology, Leuven, Belgium
| | - An Van Laethem
- University Hospitals Leuven, Department of Dermatology, Leuven, Belgium
| | - Kurt de Vlam
- University Hospitals Leuven, Department of Rheumatology, Leuven, Belgium
| | | | - Elizaveta Padalko
- Ghent University Hospital, Department of Laboratory Medicine, Ghent, Belgium
- Ghent University, Department of Diagnostic Sciences, Ghent, Belgium
| | - Triana Lobaton
- Ghent University Hospital, Department of Gastroenterology and Hepatology, Ghent, Belgium
- Ghent University, Department of Internal Medicine and Pediatrics, Ghent, Belgium
| | - Séverine Vermeire
- University Hospitals Leuven, Department of Gastroenterology and Hepatology, Leuven, Belgium
- KU Leuven, Translational Research in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (CHROMETA), Leuven, Belgium
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11
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Stallmach A, Reuken PA, Grunert P, Teich N. [Inflammatory bowel disease during the COVID-19 pandemic: manifestations and management]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2022; 60:1795-1801. [PMID: 35148564 DOI: 10.1055/a-1744-6697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic is significantly affecting the lives of patients with inflammatory bowel disease (IBD). Those affected and their relatives have numerous questions about the risk of the disease, the course of a possible SARS-CoV-2 infection or the influence of CED-specific therapy on these. Many IBD patients also have additional questions about the safety and effectiveness of a vaccination against SARS-CoV-2. The aim of this review is to summarize the latest findings on COVID-19 and IBD, but also to discuss vaccine response (humoral/cellular), the influence of ongoing therapy on the vaccine response as well as the frequency of side effects and the importance of booster immunizations and to create an evidence-based basis for discussion with patients.
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Affiliation(s)
- Andreas Stallmach
- Klinik für Innere Medizin IV, Universitatsklinikum Jena, Jena, Germany
| | - Philipp A Reuken
- Klinik für Innere Medizin IV, Universitatsklinikum Jena, Jena, Germany
| | - Philip Grunert
- Klinik für Innere Medizin IV, Universitatsklinikum Jena, Jena, Germany
| | - Niels Teich
- Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselkrankheiten, Leipzig, Germany
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12
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Inflammation Causes Exacerbation of COVID-19: How about Skin Inflammation? Int J Mol Sci 2022; 23:ijms232012260. [PMID: 36293117 PMCID: PMC9603600 DOI: 10.3390/ijms232012260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/10/2022] [Accepted: 09/27/2022] [Indexed: 01/24/2023] Open
Abstract
COVID-19 is a recently emerged viral infection worldwide. SARS-CoV-2, the causative virus, is believed to have emerged from bat coronaviruses, probably through host conversion. The bat coronavirus which has the highest gene homology to SARS-CoV-2 specifically infects deep forest bats in China whose habitat extends through the Middle East to Southern Europe. Host conversion might have occurred due to the deforestation by humans exposing wild bats to the environment they had never encountered before. SARS-CoV-2 infects cells through two mechanisms: through its receptor ACE2 with the help of enzyme TMPRSS and through membrane fusion with the help of elastases in the inflammatory condition. Obesity, hypertension, diabetes mellitus, and pulmonary diseases cause poor prognosis of COVID-19. Aging is another factor promoting poor prognosis. These diseases and aging cause low-level and persistent inflammation in humans, which can promote poor prognosis of COVID-19. Psoriasis and atopic dermatitis are the major inflammatory skin diseases. These inflammatory skin conditions, however, do not seem to cause poor prognosis for COVID-19 based on the epidemiological data accumulated so far. These mechanisms need to be elucidated.
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13
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Simon D, Tascilar K, Fagni F, Kleyer A, Krönke G, Meder C, Dietrich P, Orlemann T, Mößner J, Taubmann J, Mutlu MY, Knitza J, Kemenes S, Liphardt AM, Schönau V, Bohr D, Schuster L, Hartmann F, Minopoulou I, Leppkes M, Ramming A, Pachowsky M, Schuch F, Ronneberger M, Kleinert S, Hueber AJ, Manger K, Manger B, Atreya R, Berking C, Sticherling M, Neurath MF, Schett G. Intensity and longevity of SARS-CoV-2 vaccination response in patients with immune-mediated inflammatory disease: a prospective cohort study. THE LANCET RHEUMATOLOGY 2022; 4:e614-e625. [PMID: 35966645 PMCID: PMC9363042 DOI: 10.1016/s2665-9913(22)00191-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Concerns have been raised about the reduced immunogenicity of vaccines against SARS-CoV-2 in patients with immune-mediated inflammatory diseases and the higher risk of breakthrough infections. The objective of our study was to investigate the intensity and longevity of SARS-CoV-2 vaccination responses in patients with immune-mediated inflammatory diseases, and to assess the effects of diagnosis, treatment, and adapted vaccination schedules. Methods SARS-CoV-2 IgG antibody response after SARS-CoV-2 vaccination was measured over time in a large prospective cohort of healthy controls and participants with immune-mediated inflammatory diseases (attending or admitted to affiliated centres) between Dec 15, 2020, and Dec 1, 2021. Cohort participants with immune-mediated inflammatory diseases and control participants with no diagnosis of immune-mediated inflammatory diseases, were eligible for this analysis. Demographic data and disease-specific data were collected using a questionnaire. Humoral response was compared across treatment and disease groups, and with respect to the receipt of additional vaccinations. SARS-CoV-2 antibody response was measured by ELISA using optical density ratio units and modelled over time with age and sex adjustment using mixed-effects models. Using these models, marginal mean antibody titres and marginal risks of a poor response (optical density ratio <1·1) were calculated for each week starting from week 8 after the first vaccination to week 40. Findings Among 5076 individuals registered, 2535 participants with immune-mediated inflammatory diseases (mean age 55·0 [15·2] years; 1494 [58·9%] women and 1041 [41·1%] men) and 1198 healthy controls (mean age 40·7 [13·5] years; 554 [46·2%] women and 644 [53·8%] men) were included in this analysis. Mean antibody titres were higher in healthy controls compared with people with immune-mediated inflammatory diseases at all timepoints, with a peak antibody response in healthy controls (mean optical density ratio 12·48; 95% CI 11·50–13·53) of more than twice that in participants with immune-mediated inflammatory diseases (5·50; 5·23–5·77; mean difference 6·98; 5·92–8·04). A poor response to vaccination was observed in participants with immune-mediated inflammatory diseases who were taking B-cell inhibitors (peak mean difference from healthy controls 11·68; 10·07–13·29) and T-cell inhibitors (peakmean difference from healthy controls 10·43; 8·33–12·53). Mean differences in antibody responses between different immune-mediated inflammatory diseases were small. Participants with immune-mediated inflammatory diseases who were given a third vaccine dose had higher mean antibody titres than did healthy controls vaccinated with two vaccine doses at 40 weeks after the initial vaccination (mean difference 1·34; 0·01–2·69). Interpretation People with immune-mediated inflammatory diseases show a lower and less durable SARS-CoV-2 vaccination response and are at risk of losing humoral immune protection. Adjusted vaccination schedules with earlier booster doses or more frequent re-doses, or both, could better protect people with immune-mediated inflammatory diseases. Funding Deutsche Forschungsgemeinschaft, Bundesministerium für Bildung und Forschung, European Research Council, Innovative Medicine Initiative, Friedrich-Alexander-Universität Erlangen-Nürnberg, Else Kröner-Memorial Foundation.
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14
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SARS-CoV-2-Antikörper-Antwort auf die zweite COVID-19-Impfung bei neuromuskulären Patienten unter immunmodulierender Therapie. DER NERVENARZT 2022; 93:1219-1227. [PMID: 35997783 PMCID: PMC9395911 DOI: 10.1007/s00115-022-01363-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 12/04/2022]
Abstract
Einer erfolgreichen Impfung (adäquater Anstieg der Anti-S[Spike]-Protein-Antikörper) gegen SARS-CoV‑2 (engl. severe acute respiratory syndrome coronavirus type 2) wird ein suffizienter Schutz gegen einen schweren Verlauf von COVID-19 (engl. coronavirus disease 2019) zugeschrieben. Bei Patient*innen mit chronisch-inflammatorischen Erkrankungen (engl. „chronic inflammatory diseases“ [CID]) und Immunsuppression ist der Impferfolg weiterhin im wissenschaftlichen Diskurs. Daher evaluierten wir bei Patient*innen mit einer neuromuskulären Erkrankung (NME), die zu regelmäßigen Infusionen von Immunglobulinen in unserer neurologischen Tagesklinik/Ambulanz vorstellig wurden, 2 Wochen nach vollständiger Immunisierung die Antikörpertiter gegen das S1 (S1-Untereinheit des Spike-Proteins) -Antigen von SARS-CoV‑2. Unsere Daten zeigen, dass Patient*innen mit einer chronischen autoimmunen NME und gleichzeitiger immunsuppressiver bzw. immunmodulierender Therapie nach einer Impfung sowohl mit einem mRNA- als auch mit einem Vektorimpfstoff eine Antikörperantwort aufwiesen. Im Vergleich zu gesunden Proband*innen zeigte sich eine vergleichbare Anzahl an Serokonversionen durch die Impfung. Eine Korrelation zwischen Immunglobulindosierung und Impfantwort sowie Infusionsintervall und Impfantwort ließ sich nicht feststellen. Demgegenüber zeigte jedoch insbesondere die Kombination aus Mycophenolatmofetil (MMF) und Prednisolon eine signifikante Reduktion der spezifischen Antikörpersynthese.
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15
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Favalli A, Favalli EG, Gobbini A, Zagato E, Bombaci M, Maioli G, Pesce E, Donnici L, Gruarin P, Biggioggero M, Curti S, Manganaro L, Marchisio E, Bevilacqua V, Martinovic M, Fabbris T, Sarnicola ML, Crosti M, Marongiu L, Granucci F, Notarbartolo S, Bandera A, Gori A, De Francesco R, Abrignani S, Caporali R, Grifantini R. Immunosuppressant Treatment in Rheumatic Musculoskeletal Diseases Does Not Inhibit Elicitation of Humoral Response to SARS-CoV-2 Infection and Preserves Effector Immune Cell Populations. Front Immunol 2022; 13:873195. [PMID: 35757699 PMCID: PMC9226581 DOI: 10.3389/fimmu.2022.873195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
COVID-19 has proven to be particularly serious and life-threatening for patients presenting with pre-existing pathologies. Patients affected by rheumatic musculoskeletal disease (RMD) are likely to have impaired immune responses against SARS-CoV-2 infection due to their compromised immune system and the prolonged use of disease-modifying anti-rheumatic drugs (DMARDs), which include conventional synthetic (cs) DMARDs or biologic and targeted synthetic (b/ts) DMARDs. To provide an integrated analysis of the immune response following SARS-CoV-2 infection in RMD patients treated with different classes of DMARDs we carried out an immunological analysis of the antibody responses toward SARS-CoV-2 nucleocapsid and RBD proteins and an extensive immunophenotypic analysis of the major immune cell populations. We showed that RMD individuals under most DMARD treatments mount a sustained antibody response to the virus, with neutralizing activity. In addition, they displayed a sizable percentage of effector T and B lymphocytes. Among b-DMARDs, we found that anti-TNFα treatments are more favorable drugs to elicit humoral and cellular immune responses as compared to CTLA4-Ig and anti-IL6R inhibitors. This study provides a whole picture of the humoral and cellular immune responses in RMD patients by reassuring the use of DMARD treatments during COVID-19. The study points to TNF-α inhibitors as those DMARDs permitting elicitation of functional antibodies to SARS-CoV-2 and adaptive effector populations available to counteract possible re-infections.
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Affiliation(s)
- Andrea Favalli
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy.,Ph.D. Program in Translational and Molecular Medicine, Dottorato in Medicina Molecolare e Traslazionale (DIMET), University of Milan-Bicocca, Monza, Italy
| | - Ennio Giulio Favalli
- Division of Clinical Rheumatology, Aziende Socio Sanitarie Territoriali (ASST) Gaetano Pini-Centro Traumatologico Ortopedico (CTO) Institute, Milan, Italy
| | - Andrea Gobbini
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy.,Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Elena Zagato
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Mauro Bombaci
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Gabriella Maioli
- Division of Clinical Rheumatology, Aziende Socio Sanitarie Territoriali (ASST) Gaetano Pini-Centro Traumatologico Ortopedico (CTO) Institute, Milan, Italy
| | - Elisa Pesce
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Lorena Donnici
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Paola Gruarin
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Martina Biggioggero
- Division of Clinical Rheumatology, Aziende Socio Sanitarie Territoriali (ASST) Gaetano Pini-Centro Traumatologico Ortopedico (CTO) Institute, Milan, Italy
| | - Serena Curti
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Lara Manganaro
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy.,Department of Pharmacological and Biomolecular Sciences (DiSFeB), University of Milan, Milan, Italy
| | | | - Valeria Bevilacqua
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Martina Martinovic
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Tanya Fabbris
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Maria Lucia Sarnicola
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Mariacristina Crosti
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Laura Marongiu
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy.,Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Francesca Granucci
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy.,Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Samuele Notarbartolo
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Alessandra Bandera
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Infectious Diseases Unit, Foundation Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale MaggiorePoliclinico, Milan, Italy.,Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Andrea Gori
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Infectious Diseases Unit, Foundation Istituto Di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale MaggiorePoliclinico, Milan, Italy.,Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy
| | - Raffaele De Francesco
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy.,Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Sergio Abrignani
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Roberto Caporali
- Division of Clinical Rheumatology, Aziende Socio Sanitarie Territoriali (ASST) Gaetano Pini-Centro Traumatologico Ortopedico (CTO) Institute, Milan, Italy.,Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, University of Milan, Milan, Italy
| | - Renata Grifantini
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
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16
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Cruz-Machado AR, Barreira SC, Bandeira M, Veldhoen M, Gomes A, Serrano M, Duarte C, Rato M, Miguel Fernandes B, Garcia S, Pinheiro F, Bernardes M, Madeira N, Miguel C, Torres R, Bento Silva A, Pestana J, Almeida D, Mazeda C, Cunha Santos F, Pinto P, Sousa M, Parente H, Sequeira G, Santos MJ, Fonseca JE, Romão VC. Risk Factors for Infection, Predictors of Severe Disease, and Antibody Response to COVID-19 in Patients With Inflammatory Rheumatic Diseases in Portugal-A Multicenter, Nationwide Study. Front Med (Lausanne) 2022; 9:901817. [PMID: 35770002 PMCID: PMC9234392 DOI: 10.3389/fmed.2022.901817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To identify risk factors for SARS-CoV-2 infection and for severe/critical COVID-19, and to assess the humoral response after COVID-19 in these patients. Methods Nationwide study of adult patients with inflammatory RMDs prospectively followed in the Rheumatic Diseases Portuguese Register-Reuma.pt-during the first 6 months of the pandemic. We compared patients with COVID-19 with those who did not develop the disease and patients with mild/moderate disease with those exhibiting severe/critical COVID-19. IgG antibodies against SARS-CoV-2 were measured ≥3 months after infection and results were compared with matched controls. Results 162 cases of COVID-19 were registered in a total of 6,363 appointments. Patients treated with TNF inhibitors (TNFi; OR = 0.160, 95% CI 0.099-0.260, P < 0.001) and tocilizumab (OR 0.147, 95% CI 0.053-0.408, P < 0.001) had reduced odds of infection. Further, TNFi tended to be protective of severe and critical disease. Older age, major comorbidities, and rituximab were associated with an increased risk of infection and worse prognosis. Most patients with inflammatory RMDs (86.2%) developed a robust antibody response. Seroconversion was associated with symptomatic disease (OR 13.46, 95% CI 2.21-81.85, P = 0.005) and tended to be blunted by TNFi (OR 0.17, 95% CI 0.03-1.05; P = 0.057). Conclusions TNFi and tocilizumab reduced the risk of infection by SARS-CoV-2. Treatment with TNFi also tended to reduce rates of severe disease and seroconversion. Older age, general comorbidities and rituximab were associated with increased risk for infection and worse prognosis, in line with previous reports. Most patients with RMDs developed a proper antibody response after COVID-19, particularly if they had symptomatic disease.
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Affiliation(s)
- Ana Rita Cruz-Machado
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Sofia C. Barreira
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Matilde Bandeira
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Marc Veldhoen
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Andreia Gomes
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Marta Serrano
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Catarina Duarte
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Maria Rato
- Rheumatology Department, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Bruno Miguel Fernandes
- Rheumatology Department, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Salomé Garcia
- Rheumatology Department, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Filipe Pinheiro
- Rheumatology Department, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Miguel Bernardes
- Rheumatology Department, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - Nathalie Madeira
- Rheumatology Department, Instituto Português de Reumatologia, Lisbon, Portugal
| | - Cláudia Miguel
- Rheumatology Department, Instituto Português de Reumatologia, Lisbon, Portugal
| | - Rita Torres
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Ana Bento Silva
- Rheumatology Department, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
| | - Jorge Pestana
- Rheumatology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Diogo Almeida
- Rheumatology Department, Hospital de Braga, Braga, Portugal
| | - Carolina Mazeda
- Rheumatology Department, Centro Hospitalar do Baixo Vouga and iBiMED, Institute for Biomedicine, University of Aveiro, Aveiro, Portugal
| | | | - Patrícia Pinto
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Marlene Sousa
- Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Hugo Parente
- Rheumatology Department, Unidade Local de Saúde do Alto Minho, Ponte de Lima, Portugal
| | - Graça Sequeira
- Rheumatology Department, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | | | - João Eurico Fonseca
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Vasco C. Romão
- Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon Academic Medical Center and European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ERN-ReCONNET), Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Gros C, Mariaggi AA, Meritet JF, André E, Boisson M, Combier A, Descamps E, Frantz C, Wanono S, Morel J, Avouac J, Rozenberg F, Miceli-Richard C, Fogel O. Évaluation systématique de la réponse humorale contre le SARS-CoV-2 dans une cohorte française de 283 patients atteints d’un rhumatisme inflammatoire chronique ☆. REVUE DU RHUMATISME (ED. FRANCAISE : 1993) 2022; 89:405-411. [PMID: 35530370 PMCID: PMC9059432 DOI: 10.1016/j.rhum.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 12/14/2022]
Abstract
Objectifs Estimer la séroprévalence de l’infection par le SARS-CoV-2 chez les patients atteints de rhumatisme inflammatoire chronique et préciser la proportion de formes asymptomatiques et symptomatiques de COVID-19. Méthodes Nous avons réalisé un dépistage systématique de l’infection à COVID-19 parmi les patients atteints de spondyloarthrite (SpA, n = 143) et de polyarthrite rhumatoïde (PR, n = 140) suivis en hôpital de jour de rhumatologie à l’hôpital Cochin à Paris entre juin et août 2020. Pour chaque patient, un test sérologique détectant les IgG dirigées contre la protéine nucléocapside N (anti-N) et, pour certains patients, contre la protéine Spike (anti-S) du SARS-CoV 2, était réalisé. Nous avons effectué une analyse descriptive des données. Résultats Durant la période de juin à août 2020, la séroprévalence (IgG anti-N) du SARS-CoV-2 dans notre population était de 2,83 % (8/283 patients) sans distinction entre les patients atteints de PR et de SpA (2,14 % et 3,5 % respectivement). Sur les 283 patients, 11 ont eu un diagnostic d’infection à SARS-CoV-2 (3,8 %). Parmi ces 11 patients, 2 patients ont fait une forme asymptomatique de COVID-19 (18 %) dont le diagnostic a été confirmé sur la positivité de la sérologie anti-S. Sur les 283 patients, 85 % étaient sous biothérapie, principalement sous Rituximab (RTX) (n = 44) et Infliximab (IFX) (n = 136). Conclusion La séroprévalence du SARS-CoV-2 chez les patients atteints de rhumatismes inflammatoires chroniques, principalement sous biothérapie, était de 2,83 %. Parmi les patients infectés, 18 % étaient asymptomatiques. La stratégie associant interrogatoire des patients et sérologie anti-N est performante pour dépister les infections à SARS-CoV-2.
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Affiliation(s)
- Clothilde Gros
- Université Paris Descartes, service de rhumatologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Alice-Andrée Mariaggi
- Université Paris Descartes, service de virologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Jean-François Meritet
- Université Paris Descartes, service de virologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Emma André
- Université Paris Descartes, service de rhumatologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Margaux Boisson
- Université Paris Descartes, service de rhumatologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Alice Combier
- Université Paris Descartes, service de rhumatologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Elise Descamps
- Université Paris Descartes, service de rhumatologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Camelia Frantz
- Université Paris Descartes, service de rhumatologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Sarah Wanono
- Université Paris Descartes, service de rhumatologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Jacques Morel
- Service de rhumatologie, CHU et Université de Montpellier, France
| | - Jérôme Avouac
- Université Paris Descartes, service de rhumatologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Flore Rozenberg
- Université Paris Descartes, service de virologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Corinne Miceli-Richard
- Université Paris Descartes, service de rhumatologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France,Unité Mixte AP–HP/Institut Pasteur, Institut Pasteur, unité immunorégulation, Paris, France,Auteur correspondant
| | - Olivier Fogel
- Université Paris Descartes, service de rhumatologie, hôpital Cochin, AP–HP, 27, rue du Faubourg Saint Jacques, 75014, Paris, France
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Graphene-Based Biosensors for Molecular Chronic Inflammatory Disease Biomarker Detection. BIOSENSORS 2022; 12:bios12040244. [PMID: 35448304 PMCID: PMC9030187 DOI: 10.3390/bios12040244] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 11/17/2022]
Abstract
Chronic inflammatory diseases, such as cancer, diabetes mellitus, stroke, ischemic heart diseases, neurodegenerative conditions, and COVID-19 have had a high number of deaths worldwide in recent years. The accurate detection of the biomarkers for chronic inflammatory diseases can significantly improve diagnosis, as well as therapy and clinical care in patients. Graphene derivative materials (GDMs), such as pristine graphene (G), graphene oxide (GO), and reduced graphene oxide (rGO), have shown tremendous benefits for biosensing and in the development of novel biosensor devices. GDMs exhibit excellent chemical, electrical and mechanical properties, good biocompatibility, and the facility of surface modification for biomolecular recognition, opening new opportunities for simple, accurate, and sensitive detection of biomarkers. This review shows the recent advances, properties, and potentialities of GDMs for developing robust biosensors. We show the main electrochemical and optical-sensing methods based on GDMs, as well as their design and manufacture in order to integrate them into robust, wearable, remote, and smart biosensors devices. We also describe the current application of such methods and technologies for the biosensing of chronic disease biomarkers. We also describe the current application of such methods and technologies for the biosensing of chronic disease biomarkers with improved sensitivity, reaching limits of detection from the nano to atto range concentration.
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19
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Tang KT, Hsu BC, Chen DY. Immunogenicity, Effectiveness, and Safety of COVID-19 Vaccines in Rheumatic Patients: An Updated Systematic Review and Meta-Analysis. Biomedicines 2022; 10:biomedicines10040834. [PMID: 35453585 PMCID: PMC9030402 DOI: 10.3390/biomedicines10040834] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Vaccination is one of the most important measures worldwide to halt the spread of the corona virus disease 2019 (COVID-19). However, the efficacy and safety of these vaccines in rheumatic patients are not well explored. Therefore, we conducted a systematic review and meta-analysis. Methods: We performed a literature search of the PubMed and EMBASE databases on 17 November 2021. Forty-seven studies relevant to the immunogenicity, efficacy/effectiveness, and safety of COVID-19 vaccines were selected. Results: Our results demonstrated that COVID-19 vaccination is effective in protecting rheumatic patients from severe illness caused by the virus. Both the humoral and cellular immunogenicity of vaccines were impaired in rheumatic patients, which were greatly enhanced after the second vaccine dose. Receiving anti-CD20 therapy was associated with impaired humoral immunogenicity. Adverse events due to COVID-19 vaccines in rheumatic patients were similar to those in healthy controls, except for an increased incidence of arthralgia. The incidence of disease flares after COVID-19 vaccination was low. Conclusion: Our systematic review indicated the importance of full vaccination in rheumatic patients. Withholding anti-CD20 therapy was found to be potentially beneficial for the immunogenicity. Furthermore, the vaccines were found to be safe in general. Despite significant heterogeneity between studies, we recommend that rheumatic patients receive these vaccines amidst the global pandemic.
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Affiliation(s)
- Kuo-Tung Tang
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung 407, Taiwan;
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Ph.D. Program in Translational Medicine, Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan
| | - Bo-Chueh Hsu
- Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital Puli Branch, Nantou 545, Taiwan;
| | - Der-Yuan Chen
- College of Medicine, China Medical University, Taichung 404, Taiwan
- Translational Medicine Laboratory, Rheumatology and Immunology Center, China Medical University Hospital, Taichung 404, Taiwan
- Correspondence: ; Tel.: +886-4-22052121 (ext. 4628); Fax: +886-4-22073812
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20
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Fernández-Rojas MA, Luna-Ruiz Esparza MA, Campos-Romero A, Calva-Espinosa DY, Moreno-Camacho JL, Mendlovic F, Plett-Torres T, Alcántar-Fernández J. Seroconversion dynamic and SARS-CoV-2 seropositivity in unvaccinated population during the first and second outbreaks in Mexico. Sci Rep 2022; 12:5241. [PMID: 35347208 PMCID: PMC8960100 DOI: 10.1038/s41598-022-09395-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/22/2022] [Indexed: 12/23/2022] Open
Abstract
Serosurveillance helps establish reopening guidelines and determine the immunity levels in different populations to reach herd immunity. Then, there is an urgent need to estimate seroprevalence population wide. In Mexico, information about COVID-19 cases and related deaths is scarce. Also, there is no official serosurveillance, limiting our knowledge of the impact of the SARS-CoV-2 pandemic. Here, we report the prevalence of anti-SARS-CoV-2 antibodies in 522,690 unvaccinated people from July 5th to December 31st, 2020. The overall seroprevalence was 32.8% and highest in adults aged 30–39 years (38.5%) than people under 20 years (33.0%) or older (28.9%). Moreover, in a cohort of 1655 individuals confirmed COVID-19 by PCR, we found that symptomatic people (HR = 2.56) increased seroconversion than presymptomatic. Also, we identified that the most discriminative symptoms for COVID-19 that could predict seroconversion were anosmia and ageusia (HR = 1.70), fever, myalgia/arthralgia, and cough (HR = 1.75). Finally, we found that obese people had lower seroconversion (HR = 0.53) than healthy people, but the opposite happens in diabetic people (HR = 1.39). These findings reveal that around one-third of Mexican outpatients had anti-SARS-CoV-2 antibodies before vaccination. Also, some symptoms improve empirically COVID-19 diagnosis and seroconversion. This information could help fine-tune vaccination schemes and the reopening and back-to-work algorithms.
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Affiliation(s)
- Miguel A Fernández-Rojas
- Innovation and Research Department, Salud Digna A.C., Francisco Villa 113 sur, 80000, Culiacán, Sinaloa, Mexico
| | - Marco A Luna-Ruiz Esparza
- Innovation and Research Department, Salud Digna A.C., Francisco Villa 113 sur, 80000, Culiacán, Sinaloa, Mexico
| | - Abraham Campos-Romero
- Innovation and Research Department, Salud Digna A.C., Francisco Villa 113 sur, 80000, Culiacán, Sinaloa, Mexico
| | | | - José L Moreno-Camacho
- Clinical Laboratory Department, Salud Digna, 80000, Culiacán, Sinaloa, Mexico.,National Reference Center "Culiacan", Salud Digna, 80300, Culiacán, Sinaloa, Mexico
| | - Fela Mendlovic
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.,Facultad de Ciencias de la Salud, Universidad Anáhuac México Norte, Huixquilucan, Estado de Mexico, Mexico
| | - Tanya Plett-Torres
- Plan de Estudios Combinados en Medicina, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Jonathan Alcántar-Fernández
- Innovation and Research Department, Salud Digna A.C., Francisco Villa 113 sur, 80000, Culiacán, Sinaloa, Mexico.
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21
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Schmidt KG, Harrer EG, Tascilar K, Kübel S, El Kenz B, Hartmann F, Simon D, Schett G, Nganou-Makamdop K, Harrer T. Characterization of Serum and Mucosal SARS-CoV-2-Antibodies in HIV-1-Infected Subjects after BNT162b2 mRNA Vaccination or SARS-CoV-2 Infection. Viruses 2022; 14:651. [PMID: 35337058 PMCID: PMC8952283 DOI: 10.3390/v14030651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/15/2022] [Accepted: 03/19/2022] [Indexed: 12/19/2022] Open
Abstract
Only limited data are available regarding the immunogenicity of the BNT162b2 mRNA vaccine in HIV-1+ patients. Therefore, we investigated the humoral immune response after BNT162b2-mRNA vaccination or SARS-CoV-2 infection in HIV-1+ patients on antiretroviral therapy compared to HIV-1-uninfected subjects. Serum and saliva samples were analysed by SARS-CoV-2 spike-specific IgG and IgA ELISAs and a surrogate neutralization assay. While all subjects developed anti-spike IgG and IgA and neutralizing antibodies in serum after two doses of BNT162b2 mRNA vaccine, the HIV-1+ subjects displayed significantly lower neutralizing capacity and anti-spike IgA in serum compared to HIV-1-uninfected subjects. Serum levels of anti-spike IgG and neutralizing activity were significantly higher in vaccinees compared to SARS-CoV-2 convalescents irrespective of HIV-1 status. Among SARS-CoV-2 convalescents, there was no significant difference in spike-specific antibody response between HIV-1+ and uninfected subjects. In saliva, anti-spike IgG and IgA antibodies were detected both in vaccinees and convalescents, albeit at lower frequencies compared to the serum and only rarely with detectable neutralizing activity. In summary, our study demonstrates that the BNT162b2 mRNA vaccine induces SARS-CoV-2-specific antibodies in HIV-1-infected patients on antiretroviral therapy, however, lower vaccine induced neutralization activity indicates a lower functionality of the humoral vaccine response in HIV-1+ patients.
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Affiliation(s)
- Katja G. Schmidt
- Infectious Diseases and Immunodeficiency Section, Department of Internal Medicine 3, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.G.S.); (E.G.H.); (B.E.K.)
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.T.); (F.H.); (D.S.); (G.S.)
| | - Ellen G. Harrer
- Infectious Diseases and Immunodeficiency Section, Department of Internal Medicine 3, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.G.S.); (E.G.H.); (B.E.K.)
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.T.); (F.H.); (D.S.); (G.S.)
| | - Koray Tascilar
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.T.); (F.H.); (D.S.); (G.S.)
| | - Sabrina Kübel
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.K.); (K.N.-M.)
| | - Boutaina El Kenz
- Infectious Diseases and Immunodeficiency Section, Department of Internal Medicine 3, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.G.S.); (E.G.H.); (B.E.K.)
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.K.); (K.N.-M.)
| | - Fabian Hartmann
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.T.); (F.H.); (D.S.); (G.S.)
| | - David Simon
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.T.); (F.H.); (D.S.); (G.S.)
| | - Georg Schett
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.T.); (F.H.); (D.S.); (G.S.)
| | - Krystelle Nganou-Makamdop
- Institute of Clinical and Molecular Virology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (S.K.); (K.N.-M.)
| | - Thomas Harrer
- Infectious Diseases and Immunodeficiency Section, Department of Internal Medicine 3, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.G.S.); (E.G.H.); (B.E.K.)
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany; (K.T.); (F.H.); (D.S.); (G.S.)
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22
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Favalli EG, Gobbini A, Bombaci M, Maioli G, Biggioggero M, Pesce E, Favalli A, Martinovic M, Fabbris T, Marchisio E, Bandera A, Gori A, Abrignani S, Grifantini R, Caporali R. The Impact of Anti-rheumatic Drugs on the Seroprevalence of Anti-SARS-CoV-2 Antibodies in a Cohort of Patients With Inflammatory Arthritis: The MAINSTREAM Study. Front Med (Lausanne) 2022; 9:850858. [PMID: 35360719 PMCID: PMC8963104 DOI: 10.3389/fmed.2022.850858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 02/10/2022] [Indexed: 12/31/2022] Open
Abstract
Objectives Given the high occurrence of asymptomatic subsets, the true prevalence of SARS-CoV-2 infection in rheumatic patients is still underestimated. This study aims to evaluate the seroprevalence of SARS-CoV-2 antibodies in rheumatic musculoskeletal diseases (RMD) patients receiving immunomodulatory drugs. Methods All consecutive patients with rheumatoid arthritis or spondyloarthritis receiving disease-modifying antirheumatic drugs (DMARDs) evaluated between 4th May and 16th June 2020 were included. All participants were tested for anti-SARS-CoV-2 antibodies (IgG, IgM, IgA) by ELISA and were questioned about previous COVID-19 symptoms and clinical course. Results were compared with healthy population from the same region and with a control group of healthy subjects diagnosed with confirmed COVID-19. Results The study population includes 358 patients. The overall prevalence of anti-SARS-CoV-2 antibodies (18.4%) was higher than prevalence rate based on swab-positivity (1.12%) or clinically suspected cases (10.6%), but consistent with seroprevalence observed in the healthy population. Among seropositive patients 58% were asymptomatic. Mean anti-SARS-CoV-2 titer was comparable with the control group. No differences in seroprevalence were observed according to age, sex, rheumatic disease and treatment with conventional, biologic or targeted synthetic DMARDs, whereas glucocorticoids and comorbidities resulted in higher seroprevalence rate. Conclusions The results of this study are reassuring about the low impact of RMDs and immunomodulatory therapies on the risk and clinical course of COVID-19 and on humoral immune response to SARS-CoV-2 infection.
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Affiliation(s)
- Ennio Giulio Favalli
- Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, Italy
- Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Milan, Italy
- *Correspondence: Ennio Giulio Favalli
| | - Andrea Gobbini
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Mauro Bombaci
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Gabriella Maioli
- Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, Italy
- Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Milan, Italy
| | - Martina Biggioggero
- Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, Italy
| | - Elisa Pesce
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Andrea Favalli
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Martina Martinovic
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Tanya Fabbris
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | | | - Alessandra Bandera
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, Milan, Italy
| | - Andrea Gori
- Infectious Diseases Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Centre for Multidisciplinary Research in Health Science (MACH), Università degli Studi di Milano, Milan, Italy
| | - Sergio Abrignani
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Renata Grifantini
- Istituto Nazionale Genetica Molecolare, Padiglione Romeo ed Enrica Invernizzi, Milan, Italy
| | - Roberto Caporali
- Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, Italy
- Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano, Milan, Italy
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23
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Interleukin-6 blocking therapy for COVID-19: From immune pathogenesis to clinical outcomes. RHEUMATOLOGY AND IMMUNOLOGY RESEARCH 2022; 3:11-16. [PMID: 35772080 PMCID: PMC9242140 DOI: 10.2478/rir-2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 01/23/2022] [Indexed: 12/02/2022]
Abstract
As a newly emerged infectious disease, the coronavirus disease 2019 (COVID-19) has caused millions of deaths, resulting in a global health challenge. Currently, several vaccines have been approved with significant benefits against disease transmission. However, effective therapies are still needed for the clinical management of infected COVID-19 patients. Available evidence has indicated elevated levels of proinflammatory cytokines, including interleukin-6 (IL-6), in COVID-19 patients, with cytokine storm involving excessive cytokine release being observed in some severe cases. Several clinical studies have shown the promising effects of IL-6-blocking strategy in treating severe COVID-19 patients, but some observational studies have reported that IL-6-blocking therapy has no effects in preventing disease progression or death among COVID-19 patients. Herein, we review recent findings on the immunopathogenesis of COVID-19, with specific emphasis on the proinflammatory function of IL-6 and discuss the therapeutic potential of IL-6-blocking therapy for the treatment of COVID-19 patients, especially those with rheumatic diseases.
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24
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Chappell H, Patel R, Driessens C, Tarr AW, Irving WL, Tighe PJ, Jackson HJ, Harvey-Cowlishaw T, Mills L, Shaunak M, Gbesemete D, Leahy A, Lucas JS, Faust SN, de Graaf H. Immunocompromised children and young people are at no increased risk of severe COVID-19. J Infect 2022; 84:31-39. [PMID: 34785268 PMCID: PMC8590622 DOI: 10.1016/j.jinf.2021.11.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES We aimed to prospectively describe the incidence and clinical spectrum of SARS-CoV-2 infection in immunocompromised paediatric patients in the UK. METHODS From March 2020 to 2021 weekly questionnaires were sent to immunocompromised paediatric patients or their parents. Information, including symptom presentation and SARS-CoV-2 PCR test results, was collected from 1527 participants from 46 hospitals. Cross-sectional serology was investigated in February and March 2021. RESULTS Until the end of September 2020, no cases were reported. From September 28th 2020 to March 2021 a total of 38 PCR-detected SARS-CoV-2 infections were reported. Of these, four children were admitted to hospital but none had acute severe COVID-19. Increasing age in association with immunodeficiency increased reporting of SARS-CoV-2 infection. Worsening of fever, cough, and sore throat were associated with participants reporting SARS-CoV-2 infection. Serology data included 452 unvaccinated participants. In those reporting prior positive SARS-CoV-2 PCR, there were detectable antibodies in 9 of 18 (50%). In those with no prior report of infection, antibodies were detected in 32 of 434 (7•4%). CONCLUSIONS This study shows SARS-CoV-2 infections have occurred in immunocompromised children and young people with no increased risk of severe disease. No children died.
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Affiliation(s)
- H Chappell
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK
| | - R Patel
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton SO16 6YD, UK
| | - C Driessens
- NIHR Applied Research Collaboration Wessex, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
| | - A W Tarr
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK; School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK; Wolfson Centre for Global Virus Research
| | - W L Irving
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK; School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK; Wolfson Centre for Global Virus Research
| | - P J Tighe
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, Nottingham, UK; School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - H J Jackson
- School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - T Harvey-Cowlishaw
- School of Life Sciences, University of Nottingham, Nottingham NG7 2RD, UK
| | - L Mills
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK
| | - M Shaunak
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK
| | - D Gbesemete
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton SO16 6YD, UK
| | - A Leahy
- Paediatric Medicine, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
| | - J S Lucas
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton SO16 6YD, UK; Paediatric Medicine, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
| | - S N Faust
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton SO16 6YD, UK; Paediatric Medicine, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
| | - H de Graaf
- NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Trust, Tremona Road, Southampton SO16 6YD, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton SO16 6YD, UK; Paediatric Medicine, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK.
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25
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Simon D, Tascilar K, Kleyer A, Fagni F, Krönke G, Meder C, Dietrich P, Orlemann T, Kliem T, Mößner J, Liphardt AM, Schönau V, Bohr D, Schuster L, Hartmann F, Leppkes M, Ramming A, Pachowsky M, Schuch F, Ronneberger M, Kleinert S, Hueber AJ, Manger K, Manger B, Atreya R, Berking C, Sticherling M, Neurath MF, Schett G. Impact of cytokine inhibitor therapy on the prevalence, seroconversion rate and longevity of the humoral immune response against SARS-CoV-2 in an unvaccinated cohort. Arthritis Rheumatol 2021; 74:783-790. [PMID: 34951137 PMCID: PMC9011429 DOI: 10.1002/art.42035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the impact of biological DMARD treatment on the prevalence, seroconversion rate and longevity of the humoral immune response against SARS-CoV-2 in IMID patients. METHODS Anti-SARS-CoV-2 IgG antibodies were measured in a prospective cohort of healthcare and non-healthcare controls and IMID patients receiving no treatment or treated with conventional or biological DMARDs during the first and second COVID-19 waves. Regression models adjusting for age, sex, sampling-time and exposure risk behavior were used for calculating relative risks of seropositivity. Seroconversion rates were assessed in participants with PCR-proven SARS-CoV-2 infection. Antibody response longevity was evaluated by re-assessing participants who tested positive during the first wave. RESULTS 4508 participants (2869 IMID patients, 1639 total controls) were analyzed. Unadjusted (RR 0.44; 95% CI: 0.31-0.62) and adjusted (RR 0.50; 95% CI: 0.34-0.73) relative risks for SARS-CoV2 IgG were significantly (p<0.001) lower in IMID patients treated with bDMARDs compared to non-healthcare controls, primarily driven by TNF-alpha, IL-17 and IL-23 inhibitors-treated patients. Adjusted relative risks of untreated IMID patients (1.12; 0.75-1.67) or IMID patients receiving csDMARDs (0.70; 0.45-1.08) were not significantly different from non-healthcare controls. Lack of seroconversion in PCR+ participants was more common (38.7%) among bDMARD-treated patients than in non-healthcare controls (16%). Overall 44% of positive participants lost SARS-CoV2 antibodies at follow-up, with higher rates in IMID patients treated with bDMARDs (RR:2.86; 95%CI: 1.43-5.74). CONCLUSIONS IMID patients treated with bDMARDs have a lower prevalence of SARS-CoV-2 antibodies, seroconvert less frequently after SARS-CoV-2 infection and may exhibit a reduced longevity of their humoral immune response. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- David Simon
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Filippo Fagni
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Gerhard Krönke
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Christine Meder
- Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Department of Dermatology, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Peter Dietrich
- Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Department of Internal Medicine 1, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Institute of Biochemistry, Emil-Fischer-Zentrum, FAU Erlangen-Nuremberg, Fahrstraße 17, 91054, Erlangen, Germany
| | - Till Orlemann
- Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Department of Internal Medicine 1, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Thorsten Kliem
- Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Department of Internal Medicine 1, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Johanna Mößner
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Anna-Maria Liphardt
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Verena Schönau
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Daniela Bohr
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Louis Schuster
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Fabian Hartmann
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Moritz Leppkes
- Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Department of Internal Medicine 1, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Andreas Ramming
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Milena Pachowsky
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Florian Schuch
- Rheumatology Clinical Practice Erlangen, Möhrendorferstraße 1c, 91056, Erlangen, Germany
| | - Monika Ronneberger
- Rheumatology Clinical Practice Erlangen, Möhrendorferstraße 1c, 91056, Erlangen, Germany
| | - Stefan Kleinert
- Rheumatology Clinical Practice Erlangen, Möhrendorferstraße 1c, 91056, Erlangen, Germany
| | - Axel J Hueber
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Rheumatology Section, Sozialstiftung Bamberg, Buger Straße 80-82, 96049, Bamberg, Germany
| | - Karin Manger
- Rheumatology Practice Bamberg, Hainstraße 6, 96047, Bamberg, Germany
| | - Bernhard Manger
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Raja Atreya
- Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Department of Internal Medicine 1, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Carola Berking
- Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Department of Dermatology, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Michael Sticherling
- Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Department of Dermatology, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Markus F Neurath
- Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Department of Internal Medicine 1, FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), FAU Erlangen-Nuremberg and Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Germany
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26
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Systematic assessment of the humoral response against SARS-CoV-2 in a French cohort of 283 patients with rheumatic diseases. Joint Bone Spine 2021; 89:105312. [PMID: 34883243 PMCID: PMC8647388 DOI: 10.1016/j.jbspin.2021.105312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 11/26/2022]
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.
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27
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McGregor CG, Adams A, Sadler R, Arancibia-Cárcamo CV, Palmer R, Ambrose T, Brain O, Walsh A, Klenerman P, Travis SP, Croft NM, Lindsay JO, Satsangi J. Maintenance therapy with infliximab or vedolizumab in IBD is not associated with increased SARS-CoV-2 seroprevalence: UK experience in the 2020 pandemic. Gut 2021; 70:2398-2400. [PMID: 33579788 DOI: 10.1136/gutjnl-2021-324116] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/18/2022]
Affiliation(s)
- Colleen Gc McGregor
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Alex Adams
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Ross Sadler
- Department of Laboratory Immunology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Carolina V Arancibia-Cárcamo
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Rebecca Palmer
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Tim Ambrose
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Oliver Brain
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Alissa Walsh
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Paul Klenerman
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Simon Pl Travis
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
| | - Nicholas M Croft
- Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London, UK.,Departments of Gastroenterology and Paediatric Gastroenterology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - James O Lindsay
- Centre for Immunobiology, Blizard Institute, Queen Mary University of London, London, UK.,Departments of Gastroenterology and Paediatric Gastroenterology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Jack Satsangi
- Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, University of Oxford, Oxford, UK
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28
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Dewanjee S, Kandimalla R, Kalra RS, Valupadas C, Vallamkondu J, Kolli V, Dey Ray S, Reddy AP, Reddy PH. COVID-19 and Rheumatoid Arthritis Crosstalk: Emerging Association, Therapeutic Options and Challenges. Cells 2021; 10:3291. [PMID: 34943795 PMCID: PMC8699554 DOI: 10.3390/cells10123291] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 02/07/2023] Open
Abstract
Hyperactivation of immune responses resulting in excessive release of pro-inflammatory mediators in alveoli/lung structures is the principal pathological feature of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The cytokine hyperactivation in COVID-19 appears to be similar to those seen in rheumatoid arthritis (RA), an autoimmune disease. Emerging evidence conferred the severity and risk of COVID-19 to RA patients. Amid the evidence of musculoskeletal manifestations involving immune-inflammation-dependent mechanisms and cases of arthralgia and/or myalgia in COVID-19, crosstalk between COVID-19 and RA is often debated. The present article sheds light on the pathological crosstalk between COVID-19 and RA, the risk of RA patients in acquiring SARS-CoV-2 infection, and the aspects of SARS-CoV-2 infection in RA development. We also conferred whether RA can exacerbate COVID-19 outcomes based on available clinical readouts. The mechanistic overlapping in immune-inflammatory features in both COVID-19 and RA was discussed. We showed the emerging links of angiotensin-converting enzyme (ACE)-dependent and macrophage-mediated pathways in both diseases. Moreover, a detailed review of immediate challenges and key recommendations for anti-rheumatic drugs in the COVID-19 setting was presented for better clinical monitoring and management of RA patients. Taken together, the present article summarizes available knowledge on the emerging COVID-19 and RA crosstalk and their mechanistic overlaps, challenges, and therapeutic options.
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Affiliation(s)
- Saikat Dewanjee
- Advanced Pharmacognosy Research Laboratory, Department of Pharmaceutical Technology, Jadavpur Unversity, Kolkata 700032, India;
| | - Ramesh Kandimalla
- Applied Biology, CSIR-Indian Institute of Technology, Uppal Road, Tarnaka, Hyderabad 50000, India;
- Department of Biochemistry, Kakatiya Medical College, Warangal 506007, India
| | - Rajkumar Singh Kalra
- AIST-INDIA DAILAB, National Institute of Advanced Industrial Science & Technology (AIST), Higashi 1-1-1, Tsukuba 305-8565, Japan;
| | - Chandrasekhar Valupadas
- Department of Medicine, Mahatma Gandhi Memorial Hospital, Warangal 506007, India;
- Department of Medicine, Kakatiya Medical College Superspeciality Hospital, Warangal 506007, India
| | | | - Viswakalyan Kolli
- Department of Biochemistry, GITAM Institute of Medical Sciences and Research, Visakhapatnam 530045, India;
| | - Sarbani Dey Ray
- Department of Pharmaceutical Sciences, Assam University, Silchar 788011, India;
| | - Arubala P. Reddy
- Nutritional Sciences Department, College of Human Sciences, Texas Tech University, 1301 Akron Ave, Lubbock, TX 79409, USA;
| | - P. Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Departments of Neurology, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Public Health Department of Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
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29
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Simon D, Tascilar K, Fagni F, Schmidt K, Krönke G, Kleyer A, Ramming A, Schoenau V, Bohr D, Knitza J, Harrer T, Manger K, Manger B, Schett G. Efficacy and safety of SARS-CoV-2 revaccination in non-responders with immune-mediated inflammatory disease. Ann Rheum Dis 2021; 81:1023-1027. [PMID: 34819271 DOI: 10.1136/annrheumdis-2021-221554] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 10/19/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To test whether patients with immune-mediated inflammatory disease (IMIDs), who did not respond to two doses of the SARS-CoV-2 vaccine, develop protective immunity, if a third vaccine dose is administered. METHODS Patients with IMID who failed to seroconvert after two doses of SARS-CoV-2 vaccine were subjected to a third vaccination with either mRNA or vector-based vaccines. Anti-SARS-CoV-2 IgG, neutralising activity and T cell responses were assessed at baseline and 3 weeks after revaccination and also evaluated seprarately in rituximab (RTX) and non-RTX exposed patients. RESULTS 66 non-responders were recruited, 33 treated with RTX, and 33 non-exposed to RTX. Overall, 49.2% patients seroconverted and 50.0% developed neutralising antibody activity. Seroconversion (78.8% vs 18.2%) and neutralising activity (80.0% vs 21.9%) was higher in non-RTX than RTX-treated patients with IMID, respectively. Humoral vaccination responses were not different among patients showing positive (59.3%) or negative (49.7%) T cell responses at baseline. Patients remaining on mRNA-based vaccines showed similar vaccination responses compared with those switching to vector-based vaccines. CONCLUSIONS Overall, these data strongly argue in favor of a third vaccination in patients with IMID lacking response to standard vaccination irrespective of their B cell status.
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Affiliation(s)
- David Simon
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Filippo Fagni
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Katja Schmidt
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Gerhard Krönke
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Andreas Ramming
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Verena Schoenau
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Daniela Bohr
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Johannes Knitza
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Thomas Harrer
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Karin Manger
- Rheumatology Practice Bamberg, Erlangen, Germany
| | - Bernhard Manger
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany .,Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuremberg and Universiätsklinikum Erlangen, Erlangen, Germany
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30
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Vaselli NM, Hungerford D, Shenton B, Khashkhusha A, Cunliffe NA, French N. The seroprevalence of SARS-CoV-2 during the first wave in Europe 2020: A systematic review. PLoS One 2021; 16:e0250541. [PMID: 34727115 PMCID: PMC8562786 DOI: 10.1371/journal.pone.0250541] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/23/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection. OBJECTIVES This systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity. METHODS We searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019-30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country. RESULTS 115 studies were included spanning 17 European countries, that estimated the seroprevalence of SARS-CoV-2 from samples obtained between November 2019 -August 2020. A total of 54/115 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence between different age groups and the majority of studies reported there was no significant difference by gender. CONCLUSION This review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.
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Affiliation(s)
- Natasha Marcella Vaselli
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Daniel Hungerford
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Gastrointestinal Infections at the University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Emerging and Zoonotic Infections at the University of Liverpool, Liverpool, United Kingdom
| | - Ben Shenton
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Arwa Khashkhusha
- School of Medicine, Faculty of Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Nigel A. Cunliffe
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Gastrointestinal Infections at the University of Liverpool, Liverpool, United Kingdom
| | - Neil French
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Emerging and Zoonotic Infections at the University of Liverpool, Liverpool, United Kingdom
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31
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Patients with COVID-19: in the dark-NETs of neutrophils. Cell Death Differ 2021; 28:3125-3139. [PMID: 34031543 PMCID: PMC8142290 DOI: 10.1038/s41418-021-00805-z] [Citation(s) in RCA: 162] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 02/07/2023] Open
Abstract
SARS-CoV-2 infection poses a major threat to the lungs and multiple other organs, occasionally causing death. Until effective vaccines are developed to curb the pandemic, it is paramount to define the mechanisms and develop protective therapies to prevent organ dysfunction in patients with COVID-19. Individuals that develop severe manifestations have signs of dysregulated innate and adaptive immune responses. Emerging evidence implicates neutrophils and the disbalance between neutrophil extracellular trap (NET) formation and degradation plays a central role in the pathophysiology of inflammation, coagulopathy, organ damage, and immunothrombosis that characterize severe cases of COVID-19. Here, we discuss the evidence supporting a role for NETs in COVID-19 manifestations and present putative mechanisms, by which NETs promote tissue injury and immunothrombosis. We present therapeutic strategies, which have been successful in the treatment of immunο-inflammatory disorders and which target dysregulated NET formation or degradation, as potential approaches that may benefit patients with severe COVID-19.
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32
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Werner SG, Langer HE, Chatelain R. [COVID-19 in Routine Rheumatologic Care]. RHEUMA PLUS 2021; 20:267-271. [PMID: 34745375 PMCID: PMC8558759 DOI: 10.1007/s12688-021-00474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 12/01/2022]
Abstract
Seit dem ersten Fall einer Infektion mit SARS‐CoV‐2 („severe acute respiratory syndrome coronavirus 2“) und der damit assoziierten COVID-19-Erkrankung („corona virus disease 19“) existiert eine weltweite Pandemie. Diese führt zu anhaltenden, weitreichenden Folgen für das Gesundheitssystem und die Gesellschaft insgesamt. Unsere Patienten mit entzündlich-rheumatischen Erkrankungen galten initial, insbesondere bei bestehender immunsuppressiver und/oder immunmodulatorischer Therapie (DMARD), als hochgefährdet, sich mit SARS‐CoV‐2 zu infizieren. Man nahm an, dass es im Fall einer Infektion zu einem schweren COVID‐19-Verlauf kommen könnte. Die PCR-Diagnostik gilt zwar gemeinhin als Goldstandard zur Frühdiagnose einer aktiven Infektion mit SARS-CoV‑2, es zeigt sich jedoch, dass sie nicht immer zur Diagnosesicherung von COVID-19 als solches gewertet werden sollte. Eine ergänzende Antikörpertestung scheint empfehlenswert und kann bei typischer Symptomatologie auch noch rückwirkend zur Diagnosesicherung Abhilfe schaffen. Dem Anschein nach sind Patienten mit einer entzündlich-rheumatischen Erkrankung und unter einer DMARD-Therapie im Fall einer SARS-CoV-2-Infektion nicht grundsätzlich besonders gefährdet. Ob dies an besseren Hygienemaßnahmen oder verstärkten Kontaktbeschränkungen der Patienten mit entzündlich-rheumatischer Grunderkrankung liegt oder ob die laufende DMARD-Therapie einen gewissen Schutz vor einem schweren Verlauf von COVID-19 bietet, lässt sich aus den vorliegenden Daten nicht sagen. Die wichtigen Fragen zur Verträglichkeit und Wirksamkeit der COVID-19-Impfung sind noch nicht zu beantworten. Zusammenfassend besteht weiterhin ein deutlicher Forschungsbedarf, um unsere Patienten besser beraten zu können.
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Affiliation(s)
- S G Werner
- RHIO (Rheumatologie, Immunologie und Osteologie) Düsseldorf und RHIO Forschungsinstitut Düsseldorf, Reichsstr. 59, 40217 Düsseldorf, Deutschland
| | - H-E Langer
- RHIO (Rheumatologie, Immunologie und Osteologie) Düsseldorf und RHIO Forschungsinstitut Düsseldorf, Reichsstr. 59, 40217 Düsseldorf, Deutschland
| | - R Chatelain
- Fakultät für Gesundheit, Department für Humanmedizin, Universität Witten/Herdecke, Witten, Deutschland.,Klinik für Dermatologie und Allergologie, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Deutschland
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33
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[Corona pandemic in the practice : A flashback and reflection from the rheumatological practice]. Z Rheumatol 2021; 80:795-800. [PMID: 34618211 PMCID: PMC8495666 DOI: 10.1007/s00393-021-01110-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 10/27/2022]
Abstract
The corona pandemic changed the lives of people in Germany in 2020. Completely new challenges had to be met in outpatient care and of course also in rheumatology practices. The rapid development, the constant changes, the readjustment, the accompaniment of patients and staff team in this global catastrophe are described. The influence on the daily work and the implementation of new scientific knowledge, e.g. the recommendations of the German Society of Rheumatology (DGRh), are reported. Experiences and insights into what can be learned and taken away from crisis situations are outlined. A detailed chronology of the events, taking the special rheumatological features into account, completes this report of experiences.
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34
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Mrak D, Tobudic S, Koblischke M, Graninger M, Radner H, Sieghart D, Hofer P, Perkmann T, Haslacher H, Thalhammer R, Winkler S, Blüml S, Stiasny K, Aberle JH, Smolen JS, Heinz LX, Aletaha D, Bonelli M. SARS-CoV-2 vaccination in rituximab-treated patients: B cells promote humoral immune responses in the presence of T-cell-mediated immunity. Ann Rheum Dis 2021; 80:1345-1350. [PMID: 34285048 PMCID: PMC8295012 DOI: 10.1136/annrheumdis-2021-220781] [Citation(s) in RCA: 187] [Impact Index Per Article: 62.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/12/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Evidence suggests that B cell-depleting therapy with rituximab (RTX) affects humoral immune response after vaccination. It remains unclear whether RTX-treated patients can develop a humoral and T-cell-mediated immune response against SARS-CoV-2 after immunisation. METHODS Patients under RTX treatment (n=74) were vaccinated twice with either mRNA-1273 or BNT162b2. Antibodies were quantified using the Elecsys Anti-SARS-CoV-2 S immunoassay against the receptor-binding domain (RBD) of the spike protein and neutralisation tests. SARS-CoV-2-specific T-cell responses were quantified by IFN-γ enzyme-linked immunosorbent spot assays. Prepandemic healthy individuals (n=5), as well as healthy individuals (n=10) vaccinated with BNT162b2, served as controls. RESULTS All healthy controls developed antibodies against the SARS-CoV-2 RBD of the spike protein, but only 39% of the patients under RTX treatment seroconverted. Antibodies against SARS-CoV-2 RBD significantly correlated with neutralising antibodies (τ=0.74, p<0.001). Patients without detectable CD19+ peripheral B cells (n=36) did not develop specific antibodies, except for one patient. Circulating B cells correlated with the levels of antibodies (τ=0.4, p<0.001). However, even patients with a low number of B cells (<1%) mounted detectable SARS-CoV-2-specific antibody responses. SARS-CoV-2-specific T cells were detected in 58% of the patients, independent of a humoral immune response. CONCLUSIONS The data suggest that vaccination can induce SARS-CoV-2-specific antibodies in RTX-treated patients, once peripheral B cells at least partially repopulate. Moreover, SARS-CoV-2-specific T cells that evolved in more than half of the vaccinated patients may exert protective effects independent of humoral immune responses.
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Affiliation(s)
- Daniel Mrak
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Selma Tobudic
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | | | | | - Helga Radner
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daniela Sieghart
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Philipp Hofer
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Renate Thalhammer
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Stefan Winkler
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Vienna, Austria
| | - Stephan Blüml
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Karin Stiasny
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Judith H Aberle
- Center for Virology, Medical University of Vienna, Vienna, Austria
| | - Josef S Smolen
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Leonhard X Heinz
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Daniel Aletaha
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
| | - Michael Bonelli
- Department of Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria
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35
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Haberman RH, Herati R, Simon D, Samanovic M, Blank RB, Tuen M, Koralov SB, Atreya R, Tascilar K, Allen JR, Castillo R, Cornelius AR, Rackoff P, Solomon G, Adhikari S, Azar N, Rosenthal P, Izmirly P, Samuels J, Golden B, Reddy SM, Neurath MF, Abramson SB, Schett G, Mulligan MJ, Scher JU. Methotrexate hampers immunogenicity to BNT162b2 mRNA COVID-19 vaccine in immune-mediated inflammatory disease. Ann Rheum Dis 2021; 80:1339-1344. [PMID: 34035003 PMCID: PMC8219484 DOI: 10.1136/annrheumdis-2021-220597] [Citation(s) in RCA: 168] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 05/10/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate the humoral and cellular immune response to messenger RNA (mRNA) COVID-19 vaccines in patients with immune-mediated inflammatory diseases (IMIDs) on immunomodulatory treatment. METHODS Established patients at New York University Langone Health with IMID (n=51) receiving the BNT162b2 mRNA vaccination were assessed at baseline and after second immunisation. Healthy subjects served as controls (n=26). IgG antibody responses to the spike protein were analysed for humoral response. Cellular immune response to SARS-CoV-2 was further analysed using high-parameter spectral flow cytometry. A second independent, validation cohort of controls (n=182) and patients with IMID (n=31) from Erlangen, Germany, were also analysed for humoral immune response. RESULTS Although healthy subjects (n=208) and patients with IMID on biologic treatments (mostly on tumour necrosis factor blockers, n=37) demonstrate robust antibody responses (over 90%), those patients with IMID on background methotrexate (n=45) achieve an adequate response in only 62.2% of cases. Similarly, patients with IMID on methotrexate do not demonstrate an increase in CD8+ T-cell activation after vaccination. CONCLUSIONS In two independent cohorts of patients with IMID, methotrexate, a widely used immunomodulator for the treatment of several IMIDs, adversely affected humoral and cellular immune response to COVID-19 mRNA vaccines. Although precise cut-offs for immunogenicity that correlate with vaccine efficacy are yet to be established, our findings suggest that different strategies may need to be explored in patients with IMID taking methotrexate to increase the chances of immunisation efficacy against SARS-CoV-2 as has been demonstrated for augmenting immunogenicity to other viral vaccines.
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Affiliation(s)
- Rebecca H Haberman
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- NYU Langone Psoriatic Arthritis Center, New York University School of Medicine, New York, New York, USA
| | - Ramin Herati
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - David Simon
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Marie Samanovic
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - Rebecca B Blank
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - Michael Tuen
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - Sergei B Koralov
- Department of Pathology, New York University Grossman School of Medicine, New York, New York, USA
| | - Raja Atreya
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Department of Internal Medicine 1, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Joseph R Allen
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Rochelle Castillo
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- NYU Langone Psoriatic Arthritis Center, New York University School of Medicine, New York, New York, USA
| | - Amber R Cornelius
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
| | - Paula Rackoff
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Gary Solomon
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Samrachana Adhikari
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Natalie Azar
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Pamela Rosenthal
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Peter Izmirly
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Jonathan Samuels
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- Department of Medicine, NYU Langone Orthopedic Hospital, New York, New York, USA
| | - Brian Golden
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
| | - Soumya M Reddy
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- NYU Langone Psoriatic Arthritis Center, New York University School of Medicine, New York, New York, USA
| | - Markus F Neurath
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Steven B Abramson
- New York University Grossman School of Medicine, New York, New York, USA
- Rheumatology Research, NYU-NYU Langone Orthopedic Hospital, New York, New York, USA
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Mark J Mulligan
- Divison of Infectious Disease and Immunology and NYU Langone Vaccine Center, Department of Medicine, New York University School of Medicine, New York, NY, USA
- New York University Grossman School of Medicine, New York, New York, USA
| | - Jose U Scher
- Division of Rheumatology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA
- NYU Langone Psoriatic Arthritis Center, New York University School of Medicine, New York, New York, USA
- New York University Grossman School of Medicine, New York, New York, USA
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Fagni F, Simon D, Tascilar K, Schoenau V, Sticherling M, Neurath MF, Schett G. COVID-19 and immune-mediated inflammatory diseases: effect of disease and treatment on COVID-19 outcomes and vaccine responses. THE LANCET. RHEUMATOLOGY 2021; 3:e724-e736. [PMID: 34485930 PMCID: PMC8397302 DOI: 10.1016/s2665-9913(21)00247-2] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
At the beginning of the COVID-19 pandemic, patients with immune-mediated inflammatory diseases were considered to be at high risk for SARS-CoV-2 infection and the development of severe COVID-19. Data collected over the past year, however, suggest that a diagnosis of inflammatory arthritis, psoriasis, or inflammatory bowel diseases does not increase risk for SARS-CoV-2 infection or severe COVID-19 compared with people without these diseases. Furthermore, substantial data suggest that certain medications frequently used in patients with immune-mediated inflammatory diseases, in particular cytokine inhibitors, might even lower the risk for severe COVID-19. Conversely, glucocorticoids and potentially B-cell-depleting treatments seem to worsen COVID-19 outcomes. Additionally, the first data on SARS-CoV-2 vaccination in patients with these diseases suggest that tolerability of vaccination in patients with immune-mediated inflammatory diseases is good, although the immune response to vaccination can be somewhat reduced in this patient group, particularly those taking methotrexate or CD20-targeted treatment.
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Affiliation(s)
- Filippo Fagni
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - David Simon
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - Verena Schoenau
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - Michael Sticherling
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Department of Dermatology, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - Markus F Neurath
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Department of Internal Medicine 1, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Friedrich-Alexander University Erlangen-Nuermberg, Erlangen, Germany
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Hasselbalch HC, Skov V, Kjær L, Ellervik C, Poulsen A, Poulsen TD, Nielsen CH. COVID-19 as a mediator of interferon deficiency and hyperinflammation: Rationale for the use of JAK1/2 inhibitors in combination with interferon. Cytokine Growth Factor Rev 2021; 60:28-45. [PMID: 33992887 PMCID: PMC8045432 DOI: 10.1016/j.cytogfr.2021.03.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/26/2021] [Accepted: 03/27/2021] [Indexed: 02/08/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) elicits an interferon (IFN) deficiency state, which aggravates the type I interferon deficiency and slow IFN responses, which associate with e.g. aging and obesity. Additionally, SARS-CoV-2 may also elicit a cytokine storm, which accounts for disease progression and ultimately the urgent need of ventilator support. Based upon several reports, it has been argued that early treatment with IFN-alpha2 or IFN-beta, preferentially in the early disease stage, may prohibit disease progression. Similarly, preliminary studies have shown that JAK1/2 inhibitor treatment with ruxolitinib or baricitinib may decrease mortality by dampening the deadly cytokine storm, which - in addition to the virus itself - also contributes to multi-organ thrombosis and multi-organ failure. Herein, we describe the rationale for treatment with IFNs (alpha2 or beta) and ruxolitinib emphasizing the urgent need to explore these agents in the treatment of SARS-CoV-2 - both as monotherapies and in combination. In this context, we take advantage of several safety and efficacy studies in patients with the chronic myeloproliferative blood cancers (essential thrombocythemia, polycythemia vera and myelofibrosis) (MPNs), in whom IFN-alpha2 and ruxolitinib have been used successfully for the last 10 (ruxolitinib) to 30 years (IFN) as monotherapies and most recently in combination as well. In the context of these agents being highly immunomodulating (IFN boosting immune cells and JAK1/2 inhibitors being highly immunosuppressive and anti-inflammatory), we also discuss if statins and hydroxyurea, both agents possessing anti-inflammatory, antithrombotic and antiviral potentials, might be inexpensive agents to be repurposed in the treatment of SARS-CoV-2.
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Affiliation(s)
- H C Hasselbalch
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark.
| | - V Skov
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - L Kjær
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - C Ellervik
- Department of Research, Production, Innovation, Region Zealand, Denmark; Department of Pathology, Harvard Medical School, Boston, MA, United States; Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, United States
| | - A Poulsen
- Department of Anestesiology and Intensive Care Unit, Zealand University Hospital, Roskilde, Denmark
| | - T D Poulsen
- Department of Anestesiology and Intensive Care Unit, Zealand University Hospital, Roskilde, Denmark
| | - C H Nielsen
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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38
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Salesi M, Shojaie B, Farajzadegan Z, Salesi N, Mohammadi E. TNF-α Blockers Showed Prophylactic Effects in Preventing COVID-19 in Patients with Rheumatoid Arthritis and Seronegative Spondyloarthropathies: A Case-Control Study. Rheumatol Ther 2021; 8:1-16. [PMID: 34316436 PMCID: PMC8299175 DOI: 10.1007/s40744-021-00342-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/23/2021] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The interaction between angiotensin-converting enzyme 2 (ACE2) and SARS-CoV-2 is a crucial factor in the viral infections leading to the release of inflammatory proteins, such as TNF-α. Thus, it is hypothesized that TNF-α blockers can prevent either COVID-19 incidence or its serious symptoms. TNF-α blockers are prescribed to treat various autoimmune disorders, including rheumatoid arthritis (RA) and seronegative spondyloarthropathies (SpA). Therefore, the objective of this work was to examine this hypothesis that TNF-α blockers can prevent COVID-19 incidence in patients with RA or SpA. METHODS A case-control study was conducted through interviews based on a structured questionnaire to investigate the frequency of COVID-19 incidence in 254 eligible patients with RA or SpA about whom 45% were under treatment with one type of TNF-α blockers including infliximab, adalimumab, and etanercept at least for 3 months during the COVID-19 pandemic. Interviews were carried out twice, at the beginning and the end of the study (June-December 2020). Patients with COVID-19 during the study or before that were considered as cases. The control group was patients without COVID-19 experience. Data were analyzed using descriptive statistics, and logistic regression was used to determine the relationships between COVID-19 incidence and independent variables. RESULTS A small percentage of patients treated with TNF-α blockers (5.22%, 6/115) experienced COVID-19, while a large percentage of patients with COVID-19 did not receive TNF-α blockers (27.34%, 38/139). According to odds ratio, adalimumab, infliximab, and etanercept decreased significantly the risk of developing COVID-19 up to 96.8, 95, and 80.3% (p < 0.05), respectively. Therefore, TNF-α blockers could probably decrease the chances of the COVID-19 incidence in patients with RA or SpA. CONCLUSIONS A direct and positive correlation between the use of TNF-α blockers and a reduction in the incidence of COVID-19 could suggest the prophylactic role of these drugs in preventing COVID-19 in patients with RA and SpA.
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Affiliation(s)
- Mansour Salesi
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrokh Shojaie
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ziba Farajzadegan
- Department of Community and Family Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Naghmeh Salesi
- Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Erfan Mohammadi
- Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
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39
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Bakasis AD, Mavragani CP, Boki KA, Tzioufas AG, Vlachoyiannopoulos PG, Stergiou IE, Skopouli FN, Moutsopoulos HM. COVID-19 infection among autoimmune rheumatic disease patients: Data from an observational study and literature review. J Autoimmun 2021; 123:102687. [PMID: 34311142 PMCID: PMC8282479 DOI: 10.1016/j.jaut.2021.102687] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 12/13/2022]
Abstract
The impact of SARS-CoV-2 infection in patients with autoimmune/auto-inflammatory rheumatic diseases (AARD) under immunomodulatory treatment has been a focus of interest during the COVID-19 pandemic. In this observational study, demographic data, disease related features and comorbidities, COVID-19 manifestations and outcome as well as antibody responses to SARS-CoV-2 were recorded among 77 consecutive patients with underlying AARD infected by SARS-CoV-2. Analysis of data was performed using univariate and multivariate models. Most patients (68.8%) had a mild COVID-19 course. The predominant clinical manifestations were fatigue (58.4%), low grade fever (45.4%) and upper respiratory tract symptoms (68.8%). About a quarter of patients required hospitalization (23.3%) and the mortality rate was 1.3%. Regarding COVID-19 severity, prior treatment with corticosteroids, mycophenolate mofetil or rituximab was more common in patients who developed a more serious disease course (60.0 vs 29.9%, p = 0.003, 40.0 vs 7.5%, p = 0.003, 10.0 vs 0.0%, p = 0.009, respectively). When disease related features and comorbidities were considered in multivariate models, older age and lung disease in the context of the AARD were found to be independent predictive factors for hospitalization (OR [95%]: 1.09 [1.03-1.15] and 6.43 [1.11-37.19]). Among COVID-19 related features, patients with shortness of breath and high-grade fever were more likely to get hospitalized (OR [95%]: 7.06 [1.36-36.57], 12.04 [2.96-48.86]), while anosmia was independently associated with lower hospitalization risk (OR [95%]: 0.09 [0.01-0.99]). Though the majority of AARD patients displayed a mild COVID-19 course, certain underlying disease features and COVID-19 related manifestations should prompt alertness for the physician to identify patients with AARD at high risk for severe COVID-19 and need for hospitalization.
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Affiliation(s)
- Athanasios-Dimitrios Bakasis
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Clio P Mavragani
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Institute for Autoimmune Systemic and Neurologic Diseases, Athens, Greece.
| | - Kyriaki A Boki
- Rheumatology Unit, Sismanoglio General Hospital, Athens, Greece
| | - Athanasios G Tzioufas
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Institute for Autoimmune Systemic and Neurologic Diseases, Athens, Greece
| | - Panayiotis G Vlachoyiannopoulos
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Institute for Autoimmune Systemic and Neurologic Diseases, Athens, Greece
| | - Ioanna E Stergiou
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Fotini N Skopouli
- Department of Nutrition and Clinical Dietetics, Harokopio University of Athens, Athens, Greece; Department of Medicine and Clinical Immunology, Euroclinic of Athens, Athens, Greece
| | - Haralampos M Moutsopoulos
- Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Medical Sciences/Immunology, Academy of Athens, Athens, Greece
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40
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Simon D, Tascilar K, Schmidt K, Manger B, Weckwerth L, Sokolova M, Bucci L, Fagni F, Manger K, Schuch F, Ronneberger M, Hueber A, Steffen U, Mielenz D, Herrmann M, Harrer T, Kleyer A, Krönke G, Schett G. Brief Report: Humoral and cellular immune responses to SARS-CoV-2 infection and vaccination in B cell depleted autoimmune patients. Arthritis Rheumatol 2021; 74:33-37. [PMID: 34196506 PMCID: PMC8427106 DOI: 10.1002/art.41914] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/29/2021] [Indexed: 12/04/2022]
Abstract
Objective B cell depletion is an established therapeutic principle in a wide range of autoimmune diseases. However, B cells are also critical for inducing protective immunity after infection and vaccination. We undertook this study to assess humoral and cellular immune responses after infection with or vaccination against SARS–CoV‐2 in patients with B cell depletion and controls who are B cell–competent. Methods Antibody responses (tested using enzyme‐linked immunosorbent assay) and T cell responses (tested using interferon‐γ enzyme‐linked immunospot assay) against the SARS–CoV‐2 spike S1 and nucleocapsid proteins were assessed in a limited number of previously infected (n = 6) and vaccinated (n = 8) autoimmune disease patients with B cell depletion, as well as previously infected (n = 30) and vaccinated (n = 30) healthy controls. Results As expected, B cell and T cell responses to the nucleocapsid protein were observed only after infection, while respective responses to SARS–CoV‐2 spike S1 were found after both infection and vaccination. A SARS–CoV‐2 antibody response was observed in all vaccinated controls (30 of 30 [100%]) but in none of the vaccinated patients with B cell depletion (0 of 8). In contrast, after SARS–CoV‐2 infection, both the patients with B cell depletion (spike S1, 5 of 6 [83%]; nucleocapsid, 3 of 6 [50%]) and healthy controls (spike S1, 28 of 30 [93%]; nucleocapsid, 28 of 30 [93%]) developed antibodies. T cell responses against the spike S1 and nucleocapsid proteins were found in both infected and vaccinated patients with B cell depletion and in the controls. Conclusion These data show that B cell depletion completely blocks humoral but not T cell SARS–CoV‐2 vaccination response. Furthermore, limited humoral immune responses are found after SARS–CoV‐2 infection in patients with B cell depletion.
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Affiliation(s)
- David Simon
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Katja Schmidt
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Bernhard Manger
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Leonie Weckwerth
- Division of Molecular Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Maria Sokolova
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Laura Bucci
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Filippo Fagni
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | | | | | - Axel Hueber
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Ulrike Steffen
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Dirk Mielenz
- Division of Molecular Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Martin Herrmann
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Thomas Harrer
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Gerhard Krönke
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
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Valor-Méndez L, Tascilar K, Simon D, Distler J, Kleyer A, Schett G, Rech J. Correspondence on 'Immunogenicity and safety of anti-SARS-CoV-2 mRNA vaccines in patients with chronic inflammatory conditions and immunosuppressive therapy in a monocentric cohort'. Ann Rheum Dis 2021; 80:e161. [PMID: 34187777 DOI: 10.1136/annrheumdis-2021-220898] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Larissa Valor-Méndez
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - David Simon
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Joerg Distler
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Arnd Kleyer
- Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Georg Schett
- Internal Medicine 3, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Juergen Rech
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
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42
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Berenguer J, Díez C, Martín-Vicente M, Micán R, Pérez-Elías MJ, García-Fraile LJ, Vidal F, Suárez-García I, Podzamczer D, Del Romero J, Pulido F, Iribarren JA, Gutiérrez F, Poveda E, Galera C, Izquierdo R, Asensi V, Portilla J, López JC, Arribas JR, Moreno S, González-García J, Resino S, Jarrín I. Prevalence and factors associated with SARS-CoV-2 seropositivity in the Spanish HIV Research Network Cohort. Clin Microbiol Infect 2021; 27:1678-1684. [PMID: 34186209 PMCID: PMC8267776 DOI: 10.1016/j.cmi.2021.06.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/08/2021] [Accepted: 06/12/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES We aimed to assess the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and factors associated with seropositivity and asymptomatic coronavirus disease 2019 (COVID-19) among people with HIV (PWH). METHODS This was a cross-sectional study carried out within the cohort of the Spanish HIV Research Network. Participants were consecutive PWH with plasma collected from 1st April to 30th September 2020. We determined SARS-CoV-2 antibodies (Abs) in plasma. Illness severity (NIH criteria) was assessed by a review of medical records and, if needed, participant interviews. Multivariable logistic regression analysis was used to identify predictors of seropositivity among the following variables: sex, age, country of birth, education level, comorbidities (hypertension, chronic heart disease, diabetes mellitus, non-AIDS-related cancer, chronic kidney disease, cirrhosis), route of HIV acquisition, prior AIDS, CD4+ cell count, HIV viral load, nucleoside/nucleotide reverse transcriptase inhibitor (N [t]RTI) backbone, type of third antiretroviral drug, and month of sample collection. RESULTS Of 1076 PWH (88.0% males, median age 43 years, 97.7% on antiretroviral therapy, median CD4+ 688 cells/mm3, 91.4% undetectable HIV viral load), SARS-CoV-2 Abs were detected in 91 PWH, a seroprevalence of 8.5% (95%CI 6.9-10.3%). Forty-five infections (45.0%) were asymptomatic. Variables independently associated with SARS-CoV-2 seropositivity were birth in Latin American countries versus Spain (adjusted odds ratio (aOR) 2.30, 95%CI 1.41-3.76, p 0.001), and therapy with tenofovir disoproxil fumarate plus emtricitabine (TDF/FTC) versus tenofovir alafenamide (TAF)/FTC as the N(t)RTI backbone (aOR 0.49, 95%CI 0.26-0.94, p 0.031). CONCLUSIONS Many SARS-CoV-2 infections among PWH were asymptomatic, and birth in Latin American countries increased the risk of SARS-CoV-2 seropositivity. Our analysis, adjusted by comorbidities and other variables, suggests that TDF/FTC may prevent SARS-CoV-2 infection among PWH.
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Affiliation(s)
- Juan Berenguer
- Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain.
| | - Cristina Díez
- Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | | | - Rafael Micán
- Hospital Universitario La Paz, IdiPaz, Madrid, Spain
| | | | | | - Francisco Vidal
- Hospital Universitari de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain
| | - Inés Suárez-García
- Hospital Universitario Infanta Sofía, FIIB HUIS HHEN, San Sebastián de los Reyes, Universidad Europea de Madrid, Spain
| | | | | | - Federico Pulido
- Hospital Universitario 12 Octubre, imas12, Universidad Complutense de Madrid, Madrid, Spain
| | - José A Iribarren
- Hospital Universitario Donostia, II BioDonostia, San Sebastián, Spain
| | - Félix Gutiérrez
- Hospital Universitario de Elche, Universidad Miguel Hernández, Elche, Spain
| | - Eva Poveda
- Galicia Sur Health Research Institute (IIS Galicia Sur)-Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, Spain
| | - Carlos Galera
- Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | - Víctor Asensi
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Juan C López
- Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | | | - Santiago Moreno
- Hospital Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | | | - Salvador Resino
- Centro Nacional de Microbiología (ISCIII), Majadahonda, Spain
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Choi YM, Jeong H, Park U, Cho NH, Kim BJ. A Hepatitis B Virus-Derived Peptide Can Inhibit Infection of Human Lung Cells with SARS-CoV-2 in a Type-1 Interferon-Dependent Manner. Viruses 2021; 13:v13071227. [PMID: 34202029 PMCID: PMC8310041 DOI: 10.3390/v13071227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/15/2021] [Accepted: 06/21/2021] [Indexed: 12/02/2022] Open
Abstract
The current COVID-19 pandemic has highlighted the urgent need to develop effective therapeutic strategies. We evaluated the in vitro antiviral effect against SARS-CoV-2 of a hepatitis B virus (HBV) hexamer peptide, Poly6, which is capable of eliciting an antiviral effect against human immunodeficiency virus -1 (HIV-1), as a novel HIV-1 integrase inhibitor, and a strong anticancer immune response in an IFN-I-dependent manner, as a novel potential adjuvant in anticancer immunotherapy. Here, we report that Poly6 exerts an anti-SARS-CoV-2 effect, with an estimated 50% inhibitory concentration of 2.617 µM, in the human bronchial epithelial cell line, Calu-3 but not in Vero-E6 cells, which are deficient in type 1 interferon (IFN-I) signaling. We proved via assays based on mRNA profiles, inhibitors, or blocking antibodies that Poly6 can exert an anti-SARS-CoV-2 effect in an IFN-I-dependent manner. We also found that Poly6 inhibits IL-6 production enhanced by SARS-CoV-2 in infected Calu-3 cells at both the transcription and the translation levels, mediated via IL-10 induction in an IFN-I-dependent manner. These results indicate the feasibility of Poly6 as an IFN-I-inducing COVID-19 drug with potent antiviral and anti-inflammatory activities.
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Affiliation(s)
- Yu-Min Choi
- Department of Microbiology and Immunology, College of Medicine, Seoul National University, Seoul 110799, Korea; (Y.-M.C.); (H.J.); (U.P.); (N.-H.C.)
- Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul 03080, Korea
| | - Hyein Jeong
- Department of Microbiology and Immunology, College of Medicine, Seoul National University, Seoul 110799, Korea; (Y.-M.C.); (H.J.); (U.P.); (N.-H.C.)
- Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul 03080, Korea
| | - Uni Park
- Department of Microbiology and Immunology, College of Medicine, Seoul National University, Seoul 110799, Korea; (Y.-M.C.); (H.J.); (U.P.); (N.-H.C.)
- Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul 03080, Korea
| | - Nam-Hyuk Cho
- Department of Microbiology and Immunology, College of Medicine, Seoul National University, Seoul 110799, Korea; (Y.-M.C.); (H.J.); (U.P.); (N.-H.C.)
- Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul 03080, Korea
| | - Bum-Joon Kim
- Department of Microbiology and Immunology, College of Medicine, Seoul National University, Seoul 110799, Korea; (Y.-M.C.); (H.J.); (U.P.); (N.-H.C.)
- Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul 03080, Korea
- Liver Research Institute, College of Medicine, Seoul National University, Seoul 03080, Korea
- Cancer Research Institute, College of Medicine, Seoul National University, Seoul 03080, Korea
- Seoul National University Medical Research Center (SNUMRC), Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-740-8315; Fax: +82-2-743-0881
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Schälter F, Dürholz K, Bucci L, Burmester G, Caporali R, Figuereido C, Cobra JF, Manger B, Zaiss MM, Schett G. Does methotrexate influence COVID-19 infection? Case series and mechanistic data. Arthritis Res Ther 2021; 23:166. [PMID: 34112217 PMCID: PMC8190723 DOI: 10.1186/s13075-021-02464-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 02/22/2021] [Indexed: 01/07/2023] Open
Abstract
Background To investigate whether methotrexate treatment may affect the susceptibility to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods Clinical assessment of symptoms, SARS-CoV-2 RNA, and anti-SARS-CoV-2 IgG in an initial case series of four families and confirmatory case series of seven families, within which one family member developed coronavirus disease 19 (COVID-19) and exposed another family member receiving methotrexate treatment; experimental part with methotrexate treatment of mice and organoids followed by the assessment of mRNA and protein expression of the SARS-CoV-2 receptor angiotensin-converting enzyme (ACE)-2. Results In the initial case series, three of four women on a joint ski trip developed COVID-19, while the fourth woman, under treatment with methotrexate, remained virus-free. Two of the three diseased women infected their husbands, while the third husband treated with methotrexate remained virus-free. In addition, 7 other families were identified in a follow-up case series, in which one member developed COVID-19, while the other, receiving methotrexate, remained healthy. Experimentally, when mice were treated with methotrexate, ACE2 expression significantly decreased in the lung, in the intestinal epithelium, and in intestinal organoids. Conclusion These clinical and experimental data indicate that methotrexate has certain protective effects on SARS-CoV-2 infection via downregulating ACE2.
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Affiliation(s)
- Fabian Schälter
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Kerstin Dürholz
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Laura Bucci
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Gerd Burmester
- Department of Rheumatology and Clinical Immunology, Charité, Berlin, Germany
| | - Roberto Caporali
- Department of Clinical Sciences and Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, University of Milan, G. Pini Hospital, Milan, Italy
| | - Camille Figuereido
- Cobra Clinic of Rheumatology and Research Center, São Paulo, Brazil.,Department of Rheumatology, University of Sao Paulo, São Paulo, Brazil
| | - Jaime Fogagnolo Cobra
- Cobra Clinic of Rheumatology and Research Center, São Paulo, Brazil.,Department of Rheumatology, University of Sao Paulo, São Paulo, Brazil
| | - Bernhard Manger
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Mario M Zaiss
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany. .,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.
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45
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Haberman RH, Herati RS, Simon D, Samanovic M, Blank RB, Tuen M, Koralov SB, Atreya R, Tascilar K, Allen JR, Castillo R, Cornelius AR, Rackoff P, Solomon G, Adhikari S, Azar N, Rosenthal P, Izmirly P, Samuels J, Golden B, Reddy S, Neurath M, Abramson SB, Schett G, Mulligan MJ, Scher JU. Methotrexate Hampers Immunogenicity to BNT162b2 mRNA COVID-19 Vaccine in Immune-Mediated Inflammatory Disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 34013285 DOI: 10.1101/2021.05.11.21256917] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective To investigate the humoral and cellular immune response to mRNA COVID-19 vaccines in patients with immune-mediated inflammatory diseases (IMIDs) on immunomodulatory treatment. Methods Established patients at NYU Langone Health with IMID (n=51) receiving the BNT162b2 mRNA vaccination were assessed at baseline and after second immunization. Healthy subjects served as controls (n=26). IgG antibody responses to the spike protein were analyzed for humoral response. Cellular immune response to SARS-CoV-2 was further analyzed using high-parameter spectral flow cytometry. A second independent, validation cohort of controls (n=182) and patients with IMID (n=31) from Erlangen, Germany were also analyzed for humoral immune response. Results Although healthy subjects (n=208) and IMID patients on biologic treatments (mostly on TNF blockers, n=37) demonstrate robust antibody responses (over 90%), those patients with IMID on background methotrexate (n=45) achieve an adequate response in only 62.2% of cases. Similarly, IMID patients do not demonstrate an increase in CD8+ T cell activation after vaccination. Conclusions In two independent cohorts of IMID patients, methotrexate, a widely used immunomodulator for the treatment of several IMIDs, adversely affected humoral and cellular immune response to COVID-19 mRNA vaccines. Although precise cut offs for immunogenicity that correlate with vaccine efficacy are yet to be established, our findings suggest that different strategies may need to be explored in patients with IMID taking methotrexate to increase the chances of immunization efficacy against SARS-CoV-2 as has been demonstrated for augmenting immunogenicity to other viral vaccines. KEY MESSAGES What is already known about this subject?: The impact of COVID-19 has been felt across the globe and new hope has arisen with the approval of mRNA vaccines against the SARS-CoV-2. Studies have shown immunogenicity and efficacy rates of over 90% in the immunocompetent adult population. However, there is a lack of knowledge surrounding the response of patients with immune-mediated inflammatory diseases (IMIDs) who may also be on immunomodulatory medications.Patients with IMID have been shown to have attenuated immune responses to seasonal influenza vaccination.What does this study add?: This study looks at the humoral and cellular immune response to two doses of BNT162b2 mRNA COVID-19 Vaccine in participants with IMID (on immunomodulators) compared with healthy controls.Individuals with IMID on methotrexate demonstrate up to a 62% reduced rate of adequate immunogenicity to the BNT162b2 mRNA vaccination. Those on anti-cytokine or non-methotrexate oral medications demonstrate similar levels of immunogenicity as healthy controls (greater than 90%).Similarly, vaccination did not induce an activated CD8+ T cell response in participants on background methotrexate, unlike healthy controls and patients with IMID not receiving methotrexate.How might this impact of clinical practice or future developments?: These results suggest that patients on methotrexate may need alternate vaccination strategies such as additional doses of vaccine, dose modification of methotrexate, or even a temporary discontinuation of this drug. Further studies will be required to explore the effect of these approaches on mRNA vaccine immunogenicity.
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Simon D, Tascilar K, Fagni F, Krönke G, Kleyer A, Meder C, Atreya R, Leppkes M, Kremer AE, Ramming A, Pachowsky ML, Schuch F, Ronneberger M, Kleinert S, Hueber AJ, Manger K, Manger B, Berking C, Sticherling M, Neurath MF, Schett G. SARS-CoV-2 vaccination responses in untreated, conventionally treated and anticytokine-treated patients with immune-mediated inflammatory diseases. Ann Rheum Dis 2021; 80:1312-1316. [PMID: 33958324 PMCID: PMC8103562 DOI: 10.1136/annrheumdis-2021-220461] [Citation(s) in RCA: 145] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/23/2021] [Accepted: 04/27/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To better understand the factors that influence the humoral immune response to vaccination against SARS-CoV-2 in patients with immune-mediated inflammatory diseases (IMIDs). METHODS Patients and controls from a large COVID-19 study, with (1) no previous history of COVID-19, (2) negative baseline anti-SARS-CoV-2 IgG test and (3) SARS-CoV-2 vaccination at least 10 days before serum collection were measured for anti-SARS-CoV-2 IgG. Demographic, disease-specific and vaccination-specific data were recorded. RESULTS Vaccination responses from 84 patients with IMID and 182 controls were analysed. While all controls developed anti-SARS-CoV-2 IgG, five patients with IMID failed to develop a response (p=0.003). Moreover, 99.5% of controls but only 90.5% of patients with IMID developed neutralising antibody activity (p=0.0008). Overall responses were delayed and reduced in patients (mean (SD): 6.47 (3.14)) compared with controls (9.36 (1.85); p<0.001). Estimated marginal means (95% CI) adjusted for age, sex and time from first vaccination to sampling were 8.48 (8.12-8.85) for controls and 6.90 (6.45-7.35) for IMIDs. Significantly reduced vaccination responses pertained to untreated, conventionally and anticytokine treated patients with IMID. CONCLUSIONS Immune responses against the SARS-CoV-2 are delayed and reduced in patients with IMID. This effect is based on the disease itself rather than concomitant treatment.
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Affiliation(s)
- David Simon
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Koray Tascilar
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Filippo Fagni
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Gerhard Krönke
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Arnd Kleyer
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Christine Meder
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Dermatology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Raja Atreya
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 1, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Moritz Leppkes
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 1, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Andreas E Kremer
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 1, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Andreas Ramming
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Milena L Pachowsky
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | | | | | - Axel J Hueber
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Section Rheumatology, Sozialstiftung Bamberg, Bamberg, Germany
| | - Karin Manger
- Rheumatology Practice Bamberg, Erlangen, Germany
| | - Bernhard Manger
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Carola Berking
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Dermatology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Michael Sticherling
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Dermatology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Markus F Neurath
- Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany .,Deutsches Zentrum fuer Immuntherapie (DZI), Friedrich-Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
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Weidinger C, Hegazy AN, Glauben R, Siegmund B. COVID-19-from mucosal immunology to IBD patients. Mucosal Immunol 2021; 14:566-573. [PMID: 33608656 PMCID: PMC7893623 DOI: 10.1038/s41385-021-00384-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 12/11/2020] [Accepted: 01/05/2021] [Indexed: 02/08/2023]
Abstract
Viral infections with SARS-CoV-2 can cause a multi-facetted disease, which is not only characterized by pneumonia and overwhelming systemic inflammatory immune responses, but which can also directly affect the digestive system and infect intestinal epithelial cells. Here, we review the current understanding of intestinal tropism of SARS-CoV-2 infection, its impact on mucosal function and immunology and summarize the effect of immune-suppression in patients with inflammatory bowel disease (IBD) on disease outcome of COVID-19 and discuss IBD-relevant implications for the clinical management of SARS-CoV-2 infected individuals.
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Affiliation(s)
- Carl Weidinger
- Department for Medicine (Gastroenterology, Infectious diseases, Rheumatology), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany,Clinician Scientist Program, Berlin Institute of Health, Berlin, Germany
| | - Ahmed Nabil Hegazy
- Department for Medicine (Gastroenterology, Infectious diseases, Rheumatology), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany,Clinician Scientist Program, Berlin Institute of Health, Berlin, Germany,Deutsches Rheumaforschungszentrum Berlin (DRFZ), An Institute of the Leibniz Association, Berlin, Germany
| | - Rainer Glauben
- Department for Medicine (Gastroenterology, Infectious diseases, Rheumatology), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - Britta Siegmund
- Department for Medicine (Gastroenterology, Infectious diseases, Rheumatology), Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
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48
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Gubatan J, Sinha SR, Habtezion A. Reply. Gastroenterology 2021; 160:1902-1903. [PMID: 33453234 PMCID: PMC7832550 DOI: 10.1053/j.gastro.2021.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 12/02/2022]
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49
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Ungaro RC, Kappelman MD, Rubin DT, Colombel JF. COVID-19 and Inflammatory Bowel Disease: Lessons Learned, Practical Recommendations, and Unanswered Questions. Gastroenterology 2021; 160:1447-1451. [PMID: 33387525 PMCID: PMC7832021 DOI: 10.1053/j.gastro.2020.12.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/22/2022]
Affiliation(s)
| | - Michael D Kappelman
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - David T Rubin
- University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, Illinois
| | - Jean-Frederic Colombel
- The Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York
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50
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Assessment, endoscopy, and treatment in patients with acute severe ulcerative colitis during the COVID-19 pandemic (PROTECT-ASUC): a multicentre, observational, case-control study. Lancet Gastroenterol Hepatol 2021; 6:271-281. [PMID: 33545083 PMCID: PMC7906670 DOI: 10.1016/s2468-1253(21)00016-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/23/2020] [Accepted: 12/23/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND There is a paucity of evidence to support safe and effective management of patients with acute severe ulcerative colitis during the COVID-19 pandemic. We sought to identify alterations to established conventional evidence-based management of acute severe ulcerative colitis during the early COVID-19 pandemic, the effect on outcomes, and any associations with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe COVID-19 outcomes. METHODS The PROTECT-ASUC study was a multicentre, observational, case-control study in 60 acute secondary care hospitals throughout the UK. We included adults (≥18 years) with either ulcerative colitis or inflammatory bowel disease unclassified, who presented with acute severe ulcerative colitis and fulfilled the Truelove and Witts criteria. Cases and controls were identified as either admitted or managed in emergency ambulatory care settings between March 1, 2020, and June 30, 2020 (COVID-19 pandemic period cohort), or between Jan 1, 2019, and June 30, 2019 (historical control cohort), respectively. The primary outcome was the proportion of patients with acute severe ulcerative colitis receiving rescue therapy (including primary induction) or colectomy. The study is registered with ClinicalTrials.gov, NCT04411784. FINDINGS We included 782 patients (398 in the pandemic period cohort and 384 in the historical control cohort) who met the Truelove and Witts criteria for acute severe ulcerative colitis. The proportion of patients receiving rescue therapy (including primary induction) or surgery was higher during the pandemic period than in the historical period (217 [55%] of 393 patients vs 159 [42%] of 380 patients; p=0·00024) and the time to rescue therapy was shorter in the pandemic cohort than in the historical cohort (p=0·0026). This difference was driven by a greater use of rescue and primary induction therapies with biologicals, ciclosporin, or tofacitinib in the COVID-19 pandemic period cohort than in the historical control period cohort (177 [46%] of 387 patients in the COVID-19 cohort vs 134 [36%] of 373 patients in the historical cohort; p=0·0064). During the pandemic, more patients received ambulatory (outpatient) intravenous steroids (51 [13%] of 385 patients vs 19 [5%] of 360 patients; p=0·00023). Fewer patients received thiopurines (29 [7%] of 398 patients vs 46 [12%] of 384; p=0·029) and 5-aminosalicylic acids (67 [17%] of 398 patients vs 98 [26%] of 384; p=0·0037) during the pandemic than in the historical control period. Colectomy rates were similar between the pandemic and historical control groups (64 [16%] of 389 vs 50 [13%] of 375; p=0·26); however, laparoscopic surgery was less frequently performed during the pandemic period (34 [53%] of 64] vs 38 [76%] of 50; p=0·018). Five (2%) of 253 patients tested positive for SARS-CoV-2 during hospital treatment. Two (2%) of 103 patients re-tested for SARS-CoV-2 during the 3-month follow-up were positive 5 days and 12 days, respectively, after discharge from index admission. Both recovered without serious outcomes. INTERPRETATION The COVID-19 pandemic altered practice patterns of gastroenterologists and colorectal surgeons in the management of acute severe ulcerative colitis but was associated with similar outcomes to a historical cohort. Despite continued use of high-dose corticosteroids and biologicals, the incidence of COVID-19 within 3 months was low and not associated with adverse COVID-19 outcomes. FUNDING None.
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