BACKGROUND: Knowledge about COVID-19 infections is expanding, although knowledge about the disease course and antibody formation in patients with an auto-immune disease or immunodeficiency is not fully unraveled yet. It could be hypothesized that immunodeficient patients, due to immunosuppressive drugs or their disease, have a more severe disease course due to their immunocompromised state. However, it could also be hypothesized that some of the immunosuppressive drugs protect against a hyperinflammatory state. METHODS: We collected data on the incidence of COVID-19, disease course and SARS-CoV-2 antibody formation in COVID-19 positive patients in a cohort of patients (n = 4497) known at the Clinical Immunology outpatient clinic in a tertiary care hospital in the Netherlands. RESULTS: In the first six months of the pandemic, 16 patients were identified with COVID-19, 14 by nasal swab PCR, and 2 patients by SARS-CoV-2 antibodies. Eight patients were admitted to the hospital. SARS-CoV-2 antibodies were measured in 8 patients and were detectable in all, including one patient on B-cell ablative therapy and one patient with Common Variable Immunodeficiency Disorder. CONCLUSION: This study indicates that the disease course differs among immunocompromised patients, independently of (dis)continuation of immunosuppressive drugs. Antibody production for SARS-CoV-2 in immunocompromised patients was shown. More research needs to be conducted to confirm these observations and guidelines regarding (dis)continuation of immunosuppressive drugs in COVID-19 positive immunocompromised patients should be developed.
BACKGROUND: Knowledge about COVID-19 infections is expanding, although knowledge about the disease course and antibody formation in patients with an auto-immune disease or immunodeficiency is not fully unraveled yet. It could be hypothesized that immunodeficient patients, due to immunosuppressive drugs or their disease, have a more severe disease course due to their immunocompromised state. However, it could also be hypothesized that some of the immunosuppressive drugs protect against a hyperinflammatory state. METHODS: We collected data on the incidence of COVID-19, disease course and SARS-CoV-2 antibody formation in COVID-19 positive patients in a cohort of patients (n = 4497) known at the Clinical Immunology outpatient clinic in a tertiary care hospital in the Netherlands. RESULTS: In the first six months of the pandemic, 16 patients were identified with COVID-19, 14 by nasal swab PCR, and 2 patients by SARS-CoV-2 antibodies. Eight patients were admitted to the hospital. SARS-CoV-2 antibodies were measured in 8 patients and were detectable in all, including one patient on B-cell ablative therapy and one patient with Common Variable Immunodeficiency Disorder. CONCLUSION: This study indicates that the disease course differs among immunocompromised patients, independently of (dis)continuation of immunosuppressive drugs. Antibody production for SARS-CoV-2 in immunocompromised patients was shown. More research needs to be conducted to confirm these observations and guidelines regarding (dis)continuation of immunosuppressive drugs in COVID-19 positive immunocompromised patients should be developed.
Authors: Edward Keystone; Roy Fleischmann; Paul Emery; Daniel E Furst; Ronald van Vollenhoven; Joan Bathon; Maxime Dougados; Andrew Baldassare; Gianfranco Ferraccioli; Andrew Chubick; James Udell; Matthew W Cravets; Sunil Agarwal; Simon Cooper; Fabio Magrini Journal: Arthritis Rheum Date: 2007-12
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Authors: Jessica J Manson; Colin Crooks; Meena Naja; Amanda Ledlie; Bethan Goulden; Trevor Liddle; Emon Khan; Puja Mehta; Lucia Martin-Gutierrez; Kirsty E Waddington; George A Robinson; Liliana Ribeiro Santos; Eve McLoughlin; Antonia Snell; Christopher Adeney; Ina Schim van der Loeff; Kenneth F Baker; Christopher J A Duncan; Aidan T Hanrath; B Clare Lendrem; Anthony De Soyza; Junjie Peng; Hajar J'Bari; Mandy Greenwood; Ellie Hawkins; Hannah Peckham; Michael Marks; Tommy Rampling; Akish Luintel; Bryan Williams; Michael Brown; Mervyn Singer; Joe West; Elizabeth C Jury; Matthew Collin; Rachel S Tattersall Journal: Lancet Rheumatol Date: 2020-08-21
Authors: Kristin M D'Silva; Naomi Serling-Boyd; Rachel Wallwork; Tiffany Hsu; Xiaoqing Fu; Ellen M Gravallese; Hyon K Choi; Jeffrey A Sparks; Zachary S Wallace Journal: Ann Rheum Dis Date: 2020-05-26 Impact factor: 27.973