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SARS-CoV-2 Antibody Isotypes in Systemic Lupus Erythematosus Patients Prior to Vaccination: Associations With Disease Activity, Antinuclear Antibodies, and Immunomodulatory Drugs During the First Year of the Pandemic.
- Source :
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Frontiers in immunology [Front Immunol] 2021 Aug 27; Vol. 12, pp. 724047. Date of Electronic Publication: 2021 Aug 27 (Print Publication: 2021). - Publication Year :
- 2021
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Abstract
- Objectives: Impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on individuals with arthritis has been highlighted whereas data on other rheumatic diseases, e.g., systemic lupus erythematosus (SLE), are scarce. Similarly to SLE, severe SARS-CoV-2 infection includes risks for thromboembolism, an unbalanced type I interferon response, and complement activation. Herein, SARS-CoV-2 antibodies in longitudinal samples collected prior to vaccination were analyzed and compared with SLE progression and antinuclear antibody (ANA) levels.<br />Methods: One hundred patients (83 women) with established SLE and a regular visit to the rheumatologist (March 2020 to January 2021) were included. All subjects donated blood and had done likewise prior to the pandemic. SARS-CoV-2 antibody isotypes (IgG, IgA, IgM) to the cell receptor-binding S1-spike outer envelope protein were detected by ELISA, and their neutralizing capacity was investigated. IgG-ANA were measured by multiplex technology.<br />Results: During the pandemic, 4% had PCR-confirmed infection but 36% showed SARS-CoV-2 antibodies of ≥1 isotype; IgA was the most common (30%), followed by IgM (9%) and IgG (8%). The antibodies had low neutralizing capacity and were detected also in prepandemic samples. Plasma albumin ( p = 0.04) and anti-dsDNA ( p = 0.003) levels were lower in patients with SARS-CoV-2 antibodies. Blood group, BMI, smoking habits, complement proteins, daily glucocorticoid dose, use of hydroxychloroquine, or self-reported coronavirus disease 2019 (COVID-19) symptoms (except fever, >38.5°C) did not associate with SARS-CoV-2 antibodies.<br />Conclusion: Our data from early 2021 indicate that a large proportion of Swedish SLE patients had serological signs of exposure to SARS-CoV-2 but apparently with a minor impact on the SLE course. Use of steroids and hydroxychloroquine showed no distinct effects, and self-reported COVID-19-related symptoms correlated poorly with all antibody isotypes.<br />Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.<br /> (Copyright © 2021 Sjöwall, Azharuddin, Frodlund, Zhang, Sandner, Dahle, Hinkula and Sjöwall.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Antibodies, Antinuclear blood
Antibodies, Antinuclear immunology
Antibodies, Viral blood
Female
Humans
Immunoglobulin Isotypes blood
Immunoglobulin Isotypes immunology
Immunosuppressive Agents therapeutic use
Lupus Erythematosus, Systemic drug therapy
Male
Middle Aged
SARS-CoV-2
Antibodies, Viral immunology
COVID-19 epidemiology
COVID-19 immunology
Lupus Erythematosus, Systemic complications
Lupus Erythematosus, Systemic immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1664-3224
- Volume :
- 12
- Database :
- MEDLINE
- Journal :
- Frontiers in immunology
- Publication Type :
- Academic Journal
- Accession number :
- 34512651
- Full Text :
- https://doi.org/10.3389/fimmu.2021.724047