Abstract:
There is uncertainty regarding the effect of the SARS-CoV-2 infection on patients with autoimmune rheumatic diseases (AIRD) who are on immunosuppressive drugs. We did a multicity cross-sectional seroprevalence study conducted in five different cities in India before COVID-19 immunization. Patients with a diagnosis of AIRD and DMARDs were included. Relatives of the patients, preferably staying in the same household with no known rheumatic diseases served as controls. Serum IgG antibodies to SARS-CoV-2 Receptor Binding Domain (RBD) of the spike protein and nucleoprotein (NP) were assayed in eight hundred and eighty nine sera (subjects with disease = 379 and in subjects without disease = 510). IgG antibodies to either RBD and/or NP were positive in 135 (36%) subjects with AIRD as compared to 196 (38%) controls. The seroprevalence of anti-RBD and anti-NP varied between different cities but was not significantly different between subjects with and without disease in Mumbai, Ahmedabad, Bengaluru and Bhubaneswar. However, the occurrence of IgG antibodies to RBD was significantly (p < 0.05) lower in subjects with disease (28/65;43%) as compared to subjects without disease (42/65;65%) in Kolkata, where the positivity rate was lower in connective tissue disease group than in inflammatory arthritis group. Overall, patients with rheumatic diseases on DMARDs have IgG antibodies to RBD and NP of SARSCoV-2 at a comparable level with that of subjects without disease, but the level of antibodies to RBD is lower in patients with connective tissue disease on immunosuppressive drugs in one centre.
摘要:
SARS-CoV-2感染对使用免疫抑制药物的自身免疫性风湿性疾病(AIRD)患者的影响存在不确定性。在COVID-19免疫接种前,我们在印度五个不同城市进行了一项多因素横断面血清阳性率研究。包括诊断为AIRD和DMARDs的患者。患者的亲属,最好住在同一个家庭,没有已知的风湿性疾病作为对照。在八百八十九份血清(患有疾病的受试者=379,无疾病的受试者=510)中测定了针对刺突蛋白和核蛋白(NP)的SARS-CoV-2受体结合域(RBD)的血清IgG抗体。与196(38%)对照相比,135(36%)患有AIRD的受试者中针对RBD和/或NP的IgG抗体是阳性的。抗RBD和抗NP的血清阳性率在不同城市之间有所不同,但在孟买有和没有疾病的受试者之间没有显着差异。Ahmedabad,班加罗尔和布巴内斯瓦尔。然而,在加尔各答,与没有疾病的受试者(42/65;65%)相比,患有疾病的受试者(28/65;43%)的RBDIgG抗体的发生率显着(p<0.05)低。结缔组织疾病组的阳性率低于炎性关节炎组。总的来说,患有风湿性疾病的DMARDs患者对SARSCoV-2的RBD和NP的IgG抗体水平与没有疾病的受试者相当,但是,在一个中心,使用免疫抑制药物的结缔组织疾病患者的RBD抗体水平较低。