COVID-19 antibody data reassuring for people with SLE
medwireNews: The majority of patients with systemic lupus erythematosus (SLE) and confirmed COVID-19 are able to produce a durable antibody response to the infection, despite the use of immunosuppressants, US research suggests.
Amit Saxena (New York University Grossman School of Medicine, USA) and co-investigators say: “Although a small subset of patients had negative testing on follow-up or lost antibody reactivity on serial examinations, no clear associated patterns were apparent.”
They add that the data provide “reassurance about the efficacy and durability of humoral immunity and possible protection against re-infection with SARS-CoV-2.”
Saxena and team studied 329 people with SLE (mean age 43 years, 94% women, 28% Hispanic) who were tested for SARS-CoV-2 immunoglobulin (Ig)G antibodies via commercially available immunoassays between April 29, 2020, and February 9, 2021.
Of these, 51 (16%) had a positive SARS-CoV-2 IgG antibody test.
Of 29 individuals with polymerase chain reaction (PCR)-confirmed COVID-19, 83% tested positive for SARS-CoV-2 IgG antibodies between 0 and 30 weeks after their positive PCR result. Nearly all (88%) of the people with antibodies were taking hydroxychloroquine, 63% were on immunosuppressants, and 29% were receiving glucocorticoids.
“Of particular clinical relevance, three patients had been treated with rituximab in the year before a positive SARS-CoV-2 [reverse transcription]-PCR test and all produced a positive SARS-CoV-2 antibody response with measurements at 0, 2, and 6 weeks, respectively,” Saxena et al note in The Lancet Rheumatology.
The researchers also report that one (6%) of 17 participants who had COVID-19 symptoms but a negative PCR test developed an antibody response, as did six (23%) of 26 patients who had COVID-19 symptoms but did not undergo PCR testing.
In addition, four (5%) of 83 patients who had neither COVID-19 symptoms nor PCR testing developed an antibody response.
Serial testing data were available for 23 people who were initially SARS-CoV-2 IgG positive. Of these, 26% became negative at a mean of 18.0 weeks. Reversion to IgG negativity was more likely in patients with initially lower IgG titers and in those who were cared for as outpatients; all six who required hospital admission retained IgG positivity.
Writing in a linked commentary, Martin Aringer (Technische Universität Dresden, Germany) stresses that “[i]t remains to be confirmed whether these SARS-CoV-2 antibodies are protective in patients with SLE.”
“However, at present there are no convincing arguments that patients with SLE who recover from COVID-19 should differ from other patients who recover from COVID-19, and the tests used generally correlated well with SARS-CoV-2 IgG antibodies,” he adds.
He concludes: “Although we do not have the complete picture yet, these initial findings should be reassuring for patients with SLE.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
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