Humoral and cellular response in convalescent COVID-19 lupus patients
Copyright policy )Humoral and cellular response in convalescent COVID-19 lupus patients
AbstractIn SLE, underlying immune dysregulation and immunosuppression may increase the susceptibility to COVID-19 and impair the humoral and adaptive response. We aimed to characterize COVID-19 infection, identifying susceptibility and severity risk factors, assessing the presence of SARS-CoV-2 IgG antibodies and analyzing the cellular response. We established a prospective cohort of lupus patients to estimate the COVID-19 incidence compared to the reference general population. Data were collected via telephone interviews and medical record review. SARS-CoV-2 IgG antibodies were measured cross-sectionally as part of routine surveillance. Longitudinal changes in antibody titers and immunological profile from convalescent COVID-19 patients were evaluated at 6, 12 and 24 week after symptom onset. From immunological studies, PBMCs from convalescent patients were extracted and analyzed by flow cytometry and gene expression analysis. We included 725 patients, identifying 29 with PCR-confirmed COVID-19 infection and 16 with COVID-19-like symptoms without PCR-testing. Of the 29 confirmed cases, 7 had severe disease, 8 required hospital admission (27.6%), 4 intensive care, and 1 died. COVID-19 accumulated incidence was higher in lupus patients. Health care workers and anti-SSA/Ro52 antibody positivity were risk factors for COVID-19 susceptibility, and hypocomplementemia for severity. SARS-CoV-2 IgG antibodies were detected in 8.33% of patients. Three fourths of confirmed COVID-19 cases developed antibodies. High prednisone doses were associated with lack of antibody response. Antibody titers declined over time (39%). Convalescent patients at week 12 after symptom onset displayed a CD8+T cell reduction and predominant Th17 with a mild Th2 response, more pronounced in severe COVID-19 disease. Longitudinal immune response analysis showed a progressive sustained increase in CD8+ T and B memory cells with a decrease of Th17 signaling. Lupus patients are at higher risk of COVID-19 infection and new susceptibility and severity risk factors were identified. Lupus patients were able to mount humoral and cellular responses despite immunosuppressive therapy.
DISEASES::Immune System Diseases::Autoimmune Diseases::Lupus Erythematosus, Systemic, FENÓMENOS Y PROCESOS::fenómenos del sistema inmunitario::inmunidad::inmunidad adaptativa::inmunidad celular, Science, CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Viral, Translational immunology, PHENOMENA AND PROCESSES::Immune System Phenomena::Immunity::Adaptive Immunity::Immunity, Cellular, PHENOMENA AND PROCESSES::Immune System Phenomena::Immunity::Adaptive Immunity::Immunity, Humoral, Antibodies, Viral, COVID-19 (Malaltia), Article, Systemic lupus erythematosus, Immunitat cel·lular, Lupus eritematós sistèmic, DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections, Humans, ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus, Prospective Studies, ENFERMEDADES::enfermedades del sistema inmune::enfermedades autoinmunes::lupus eritematoso sistémico, SARS-CoV-2, Q, R, COVID-19, Immunity, Humoral, COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::proteínas sanguíneas::inmunoproteínas::inmunoglobulinas::anticuerpos::anticuerpos víricos, Immunoglobulin G, Medicine, FENÓMENOS Y PROCESOS::fenómenos del sistema inmunitario::inmunidad::inmunidad adaptativa::inmunidad humoral, Immunoglobulines
DISEASES::Immune System Diseases::Autoimmune Diseases::Lupus Erythematosus, Systemic, FENÓMENOS Y PROCESOS::fenómenos del sistema inmunitario::inmunidad::inmunidad adaptativa::inmunidad celular, Science, CHEMICALS AND DRUGS::Amino Acids, Peptides, and Proteins::Proteins::Blood Proteins::Immunoproteins::Immunoglobulins::Antibodies::Antibodies, Viral, Translational immunology, PHENOMENA AND PROCESSES::Immune System Phenomena::Immunity::Adaptive Immunity::Immunity, Cellular, PHENOMENA AND PROCESSES::Immune System Phenomena::Immunity::Adaptive Immunity::Immunity, Humoral, Antibodies, Viral, COVID-19 (Malaltia), Article, Systemic lupus erythematosus, Immunitat cel·lular, Lupus eritematós sistèmic, DISEASES::Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections, Humans, ENFERMEDADES::virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus, Prospective Studies, ENFERMEDADES::enfermedades del sistema inmune::enfermedades autoinmunes::lupus eritematoso sistémico, SARS-CoV-2, Q, R, COVID-19, Immunity, Humoral, COMPUESTOS QUÍMICOS Y DROGAS::aminoácidos, péptidos y proteínas::proteínas::proteínas sanguíneas::inmunoproteínas::inmunoglobulinas::anticuerpos::anticuerpos víricos, Immunoglobulin G, Medicine, FENÓMENOS Y PROCESOS::fenómenos del sistema inmunitario::inmunidad::inmunidad adaptativa::inmunidad humoral, Immunoglobulines
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