Clinical and peculiar immunological manifestations of SARS-CoV-2 infection in systemic lupus erythematosus patients

Schioppo, Tommaso; Argolini, Lorenza Maria; Sciascia, Savino; Pregnolato, Francesca; Tamborini, Francesco; Miraglia, Paolo; Roccatello, Dario; Sinico, Renato Alberto; Caporali, Roberto; Moroni, Gabriella; Gerosa, Maria

doi:10.1093/rheumatology/keab611

Cited by 18 publications

(19 citation statements)

References 24 publications

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“…As shown above, the vaccine showed no direct association with flare, while SARS-CoV-2 infection was reported as an independent risk factor for RD flare in some studies ( 52 – 54 ). The flare rate of RD after SARS-CoV-2 infection presented a vastly higher flare risk than that after vaccination ( 52 – 58 ), with most flare rates being higher than 20% and some even higher than 40%. This may also encourage RD patients to receive the COVID-19 vaccination.…”

Section: The Flare Risk After Sars-cov-2 Infection Compared To the Fl...mentioning

confidence: 91%

The Flare of Rheumatic Disease After SARS-CoV-2 Vaccination: A Review

Xie

Liu

2022

Front. Immunol.

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As the coronavirus disease 2019 (COVID-19) pandemic continues worldwide, vaccination has been considered an effective measure to protect people from the COVID-19 and end the pandemic. However, for patients with rheumatic diseases (RD), concern for the induction of RD flare may combat the enthusiasm for vaccination. In general, current evidence doesn’t support the increased risk of disease flare after COVID-19 vaccination. However, the disease flare of RDs may be triggered by COVID-19 vaccinations, especially for patients with high disease activity. Most of these flares after vaccination are mild and need no treatment escalation. Considering the benefits and risks, RD patients are recommended to receive the COVID-19 vaccination but should be vaccinated when the RDs are in stable states.

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Section: The Flare Risk After Sars-cov-2 Infection Compared To the Fl...mentioning

confidence: 91%

The Flare of Rheumatic Disease After SARS-CoV-2 Vaccination: A Review

Xie

Liu

2022

Front. Immunol.

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“…Although patients with ADs -SLE within this group- have a higher prevalence of COVID-19 [ 25 ], there are some cohort studies which have shown no increase in SARS-CoV-2 risk of infection in these patients [ 26 ]. Studies reported an increased mortality rate in the patients with systemic autoimmune rheumatic diseases compared to the general population [ 27 ]; but this increase has not yet been determined whether it is solely due to COVID-19, or the delayed diagnosis and treatment of their pre-existing systemic autoimmune rheumatic diseases [ 28 ].…”

Section: Common Autoimmune Diseasesmentioning

confidence: 99%

“…The most common SARS-CoV-2 clinical manifestations in lupus patients are fever, anosmia and cough [ 26 ]. Patients with pre-existing lupus disease may have flares during the course of COVID-19, including worsening or different clinical signs, manifestations, and laboratory parameters indicating involvement of one or more organs [ 33 , 34 ].…”

Section: Common Autoimmune Diseasesmentioning

confidence: 99%

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A comprehensive review of COVID-19 symptoms and treatments in the setting of autoimmune diseases

Hamidi

Jabraeili-Siahroud

Taati-Alamdari

et al. 2023

Virol J

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After the first reporting of the index case of Severe Acute Respiratory Syndrome (SARS)-CoV-2-associated disease at the end of December 2019, the virus spread quickly throughout the world, prompting the WHO on 11 March 2020 to declare the disease a global pandemic. The coronavirus disease 2019 (COVID-19) pandemic, raises concerns for all people, mainly for susceptible population. People with pre-existing diseases, especially individuals with autoimmune disorders, are more at the risk of SARS-CoV-2 infection because of compromised immune system due to frequent use of immunosuppressive drugs and steroids. Patients with autoimmune diseases and their physicians have concerns about these patients’ healthcare, since they are at a higher risk for COVID-19 infection, may show severe complications of COVID-19, and may experience probable flares of their pre-existing disease. Even though there have been several studies discussing the relation between COVID-19 and various types of autoimmune diseases, it cannot be ascertained that all patients with autoimmune diseases experience more severe complications of COVID-19 and have more hospitalization or mortality rate. The situation depends on each patient’s condition, such as the type and the severity of the underlying autoimmune disease and the kind of treatment they receive. In the present review, we have discussed the effects of COVID-19 pandemic on patients with different autoimmune diseases and their relative concerns about their treatments. As a result, we have reviewed further considerations that should be taken into account for these patients during the pandemic or when they are infected with COVID-19.

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“…Although data are limited, a SARS-CoV-2 infection might trigger increased disease activity of the underlying IMID. [8][9][10][11] In this study we aimed to investigate long-term humoral immune responses and changes in disease activity after a polymerase chain reaction (PCR) or antigen test proven primary SARS-CoV-2 infection in unvaccinated IMID patients using different types of ISPs.…”

Section: Introductionmentioning

confidence: 99%

Primary SARS-CoV-2 infection in patients with immune-mediated inflammatory diseases: long-term humoral immune responses and effects on disease activity

Eftimov

Volkers

Stalman

et al. 2023

Preprint

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Background: Patients with immune-mediated inflammatory diseases (IMIDs) on immunosuppressants (ISPs) may have impaired long-term humoral immune responses and increased disease activity after SARS-CoV-2 infection. We aimed to investigate long-term humoral immune responses against SARS-CoV-2 and increased disease activity after a primary SARS-CoV-2 infection in unvaccinated IMID patients on ISPs. Methods: IMID patients on active treatment with ISPs and controls (i.e. IMID patients not on ISP and healthy controls) with a confirmed SARS-CoV-2 infection before first vaccination were included from an ongoing prospective cohort study (T2B! study). Clinical data on infections and increased disease activity were registered using electronic surveys and health records. A serum sample was collected before first vaccination to measure SARS-CoV-2 anti-receptor-binding domain (RBD) antibodies. Results: In total, 193 IMID patients on ISP and 113 controls were included. Serum samples from 185 participants were available, with a median time of 173 days between infection and sample collection. The rate of seropositive IMID patients on ISPs was 78% compared to 100% in controls (p<0.001). Seropositivity rates were lowest in patients on anti-CD20 (40.0%) and anti-tumor necrosis factor (TNF) agents (60.5%), as compared to other ISPs (p<0.001 and p<0.001, respectively). Increased disease activity after infection was reported by 68 of 260 patients (26.2%; 95% CI 21.2–31.8%), leading to ISP intensification in 6 out of these 68 patients (8.8%). Conclusion: IMID patients using ISPs showed reduced long-term humoral immune responses after primary SARS-CoV-2 infection, which was mainly attributed to treatment with anti-CD20 and anti-TNF agents. Increased disease activity after SARS-CoV-2 infection was reported commonly, but was mostly mild. Trial registration NL74974.018.20, Trial ID: NL8900. Registered on 9 September 2020.

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Clinical and peculiar immunological manifestations of SARS-CoV-2 infection in systemic lupus erythematosus patients

Cited by 18 publications

References 24 publications

The Flare of Rheumatic Disease After SARS-CoV-2 Vaccination: A Review

The Flare of Rheumatic Disease After SARS-CoV-2 Vaccination: A Review

A comprehensive review of COVID-19 symptoms and treatments in the setting of autoimmune diseases

Primary SARS-CoV-2 infection in patients with immune-mediated inflammatory diseases: long-term humoral immune responses and effects on disease activity

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