Severely impaired humoral response against SARS-CoV-2 variants of concern following two doses of BNT162b2 vaccine in patients with systemic lupus erythematosus (SLE)
“…In the present study, we first confirmed the results of previous studies showing a B cell defect that impairs immune protection following anti-SARS-CoV-2 vaccine in SLE patients [ 17 ] . Second, we showed that BNT162b2 mRNA induces a short-term in vivo activation of the pDCs that contributes to the immune response against SARS-CoV-2 vaccine.…”
Section: Discussionsupporting
confidence: 90%
“…1 A). Those data confirmed the poor immune protection conferred by 2 doses of BNT162b2 vaccines in SLE patients, even though they were not treated with immunosuppressive drugs [ 17 ], Fig. 1 SARS-CoV-2-specific immune responses following vaccination Anti-Spike IgG blood titer measured in BAU/mL by ELISA in SLE patients (in blue) compared to HV (in red).…”
Section: Resultssupporting
confidence: 55%
“…Among SLE patients, the absolute count of circulating anti-Spike specific B cells measured by flow cytometry increased overtime and appeared maximal 6 months after the first vaccine shot (5 [ [4] , [5] , [6] , [7] , [8] , [9] , [10] ].10–5/mL anti-S specific B cells at T0 vs 16 [6–29] at M6, p = 0.009). Consistent with the poor humoral response, the absolute count of anti-S specific B cells was significantly lower in SLE patients as compared to HV at M1 (5 [ [4] , [5] , [6] , [7] , [8] , [9] , [10] ].10–5/mL anti-S specific B cells in SLE vs 14 [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] ].10–5/mL in HV; p = 0.004), M3 (11 [ [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] ].10–5/mL vs 30 [18–53].10–5/mL, p = 0.008) and M6 (16 [6–29].10–5/mL vs 27 [25–82].10–5/mL, p = 0.02) ( Fig. 1 B).…”
“…In the present study, we first confirmed the results of previous studies showing a B cell defect that impairs immune protection following anti-SARS-CoV-2 vaccine in SLE patients [ 17 ] . Second, we showed that BNT162b2 mRNA induces a short-term in vivo activation of the pDCs that contributes to the immune response against SARS-CoV-2 vaccine.…”
Section: Discussionsupporting
confidence: 90%
“…1 A). Those data confirmed the poor immune protection conferred by 2 doses of BNT162b2 vaccines in SLE patients, even though they were not treated with immunosuppressive drugs [ 17 ], Fig. 1 SARS-CoV-2-specific immune responses following vaccination Anti-Spike IgG blood titer measured in BAU/mL by ELISA in SLE patients (in blue) compared to HV (in red).…”
Section: Resultssupporting
confidence: 55%
“…Among SLE patients, the absolute count of circulating anti-Spike specific B cells measured by flow cytometry increased overtime and appeared maximal 6 months after the first vaccine shot (5 [ [4] , [5] , [6] , [7] , [8] , [9] , [10] ].10–5/mL anti-S specific B cells at T0 vs 16 [6–29] at M6, p = 0.009). Consistent with the poor humoral response, the absolute count of anti-S specific B cells was significantly lower in SLE patients as compared to HV at M1 (5 [ [4] , [5] , [6] , [7] , [8] , [9] , [10] ].10–5/mL anti-S specific B cells in SLE vs 14 [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] ].10–5/mL in HV; p = 0.004), M3 (11 [ [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] ].10–5/mL vs 30 [18–53].10–5/mL, p = 0.008) and M6 (16 [6–29].10–5/mL vs 27 [25–82].10–5/mL, p = 0.02) ( Fig. 1 B).…”
“…ARD patients are generally at higher risk for COVID-19-related worse outcomes, probably due to lessened vaccine efficacy and weaker anti-viral immune response of ARD patients receiving these therapies. [ 7 , 15 , [18] , [19] , [20] ] For instance, a review by Grainger et al concluded that there is an increased risk of COVID-19-related hospitalization and mortality among ARD patients. [3] Of note, an existing ARD of RA or SLE was associated with a higher risk for hospitalization and death.…”
“…Recently, Saxena et al reported a lower rate of COVID-19 breakthrough infection after receiving an additional vaccination dose in patients with SLE; however, the study did not assess the risk of severe sequelae of COVID-19 (eg, hospitalisation and death) and did not include the healthy individuals as a comparison group. 23 Despite the indirect evidence regarding immunogenicity, [24][25][26][27] there is still a paucity of data on the effect of COVID-19 vaccination, especially its long-term effect, on the risk of SARS-CoV-2 breakthrough infection and its related sequelae among patients with SLE. Therefore, knowledge gaps exist regarding the efficacy or effectiveness of vaccination in the face of waning immunity, as well as the need for additional vaccination and preventive measures in patients with SLE.…”
Section: How This Study Might Affect Research Practice or Policymentioning
ObjectiveTo compare the risk of SARS-CoV-2 infection and its related severe sequelae between patients with systemic lupus erythematosus (SLE) and the general population according to COVID-19 vaccination status.MethodsWe performed cohort studies using data from The Health Improvement Network to compare the risks of SARS-CoV-2 infection and severe sequelae between patients with SLE and the general population. Individuals aged 18–90 years with no previously documented SARS-CoV-2 infection were included. We estimated the incidence rates and HRs of SARS-CoV-2 infection and severe sequelae between patients with SLE and the general population according to COVID-19 vaccination status using exposure score overlap weighted Cox proportional hazards model.ResultsWe identified 3245 patients with SLE and 1 755 034 non-SLE individuals from the unvaccinated cohort. The rates of SARS-CoV-2 infection, COVID-19 hospitalisation, COVID-19 death and combined severe outcomes per 1000 person-months were 10.95, 3.21, 1.16 and 3.86 among patients with SLE, and 8.50, 1.77, 0.53 and 2.18 among general population, respectively. The corresponding adjusted HRs were 1.28 (95% CI: 1.03 to 1.59), 1.82 (95% CI: 1.21 to 2.74), 2.16 (95% CI: 1.00 to 4.79) and 1.78 (95% CI: 1.21 to 2.61). However, no statistically significant differences were observed between vaccinated patients with SLE and vaccinated general population over 9 months of follow-up.ConclusionWhile unvaccinated patients with SLE were at higher risk of SARS-CoV-2 infection and its severe sequelae than the general population, no such difference was observed among vaccinated population. The findings indicate that COVID-19 vaccination provides an adequate protection to most patients with SLE from COVID-19 breakthrough infection and its severe sequelae.
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