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

Niels A.D Guchelaar,Jan A.M Van Laar,Maud A.W Hermans,Tim B Van Der Houwen,Sibel Atmaca,Maurits S Van Maaren,Zana Brkic,Paul L.A Van Daele,Virgil A.S.H Dalm,P Martin Van Hagen,Saskia M Rombach

doi:10.1016/j.jtauto.2021.100084

Niels A.D Guchelaar, Jan A.M Van Laar + Show 9 more

Open Access

https://doi.org/10.1016/j.jtauto.2021.100084

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Journal: Journal of Translational Autoimmunity	Publication Date: Jan 1, 2021
Citations: 5	License type: cc-by

Affiliation: Erasmus MC

Abstract

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

Highlights

An infection with SARS-CoV-2 causes symptoms of the respiratory tract, but increasing evidence shows that almost every organ system can be involved [1,2]
It may be suggested that immunocompromised patients, either due to a primary immunodeficiency or a secondary immunodeficiency caused by the usage of immunosuppressive drugs, are at increased risk for infection and a more severe disease course with SARS-CoV-2 [6]
Our cohort consists of 4497 patients that are attending the outpatient clinic of the department of Clinical Immunology at the Erasmus University Medical Center (Rotterdam, the Netherlands)

Summary

Introduction

An infection with SARS-CoV-2 causes symptoms of the respiratory tract, but increasing evidence shows that almost every organ system can be involved [1,2]. It may be suggested that immunocompromised patients, either due to a primary immunodeficiency or a secondary immunodeficiency caused by the usage of immunosuppressive drugs, are at increased risk for infection and a more severe disease course with SARS-CoV-2 [6]. To delineate the effect of an underlying immunological condition and/or immunosuppression on the course of COVID-19, we performed a descriptive study to investigate the incidence, disease course and SARS-CoV-2 antibody production in a cohort of patients with a primary or secondary immunodeficiency.

Results

Conclusion