COVID-19 in patients with immune-mediated inflammatory diseases: Scientific answers to changing medical challenges using a patient-interactive research platform

The COVID-19 pandemic raised major concerns for patients with immune-mediated inflammatory diseases (IMIDs), but simultaneously provided unique opportunities to investigate infection risk of IMID patients and effects of immunosuppressive treatment. At the Amsterdam Rheumatology and Immunology Center (ARC), we therefore set up a prospective cohort study to compare COVID-19 related outcomes between patients with rheumatic IMIDs and healthy controls. We designed a digital research platform that was complemented by serum collection via home finger pricks, in order to collect clinical and serological data remotely from over 3000 IMID patients and 1000 healthy controls. During the first six months of the pandemic, we observed that IMID patients were almost twice as likely to adhere to strict isolation measures compared to healthy controls, indicating that adherence to isolation measures would be an important factor to consider when interpreting incidence and hospitalization rates of SARS-CoV-2 infections. Subsequently, we were able to demonstrate that the risk of COVID-19 related hospitalization was comparable for IMID patients and healthy controls, except for patients treated with anti-CD20 therapy who showed a higher risk for developing severe COVID-19 manifestations. Near the end of 2020, it became clear that SARS-CoV-2 vaccinations would soon become available for the Dutch population, but this news was accompanied by hesitancy among people. We therefore investigated the perspective of IMID patients and healthy controls towards SARS-CoV-2 vaccination, and observed that vaccination willingness was similar for patients and controls. Hesitancy was mostly caused by concerns for adverse events, lack of long-term research and concerns for aggravation of underlying IMIDs, but this could for an important part be addressed by vaccine counseling by treating rheumatologists. As we had seen that concerns for adverse events were an important reason for hesitancy towards SARS-CoV-2