Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia; College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia.
College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia; Department of Critical Care, Dr Sulaiman Al Habib Medical Group, Riyadh, Kingdom of Saudi Arabia.
J Infect Public Health. 2022 Jun;15(6):685-688. doi: 10.1016/j.jiph.2022.05.005. Epub 2022 May 13.
Rheumatic diseases patients receiving Rituximab had severe COVID-19 disease. Although they had impaired humoral immune responses following COVID-19 vaccine, they had preserved cellular immune responses. Waning of COVID-19 antibody responses was observed within six months post vaccination among immunocompromised patients. Recent reports showed fatal outcome of breakthrough SARS-CoV-2 infections among vaccinated high-risk rheumatic diseases patients receiving Rituximab. SAR-CoV-2 serological tests were not performed.
Evaluation of COVID-19 vaccine humoral responses and breakthrough infections among low risk fully vaccinated rheumatic patients during the Delta Variant Era.
A case series of 19 fully vaccinated patients with rheumatic diseases were followed to determine post vaccine SARS-CoV-2 neutralizing antibody titers and to monitor the development of breakthrough infections up to eight months post vaccine at our tertiary care center in Jeddah, Saudi Arabia from 1st April until 30th November 2021.
The mean age of patients was 49 years old. 10% of patients were receiving Rituximab. 73% of patients had positive SARS-CoV-2 serological testing post second vaccine. Two mild breakthrough COVID-19 infections were diagnosed six months post second dose of vaccine. Patients were less than 65 years, did not receive Rituximab, did not have interstitial lung diseases and had positive post vaccine serological testing.
We demonstrated high SARS-CoV-2 neutralizing antibodies seroprevalence and self-limiting breakthrough infections in low risk rheumatic diseases patients during the Delta Era. Future studies are needed to study the outcome of rheumatic diseases patients in the Era of Omicron in view of viral immune escape responses.
接受利妥昔单抗治疗的风湿性疾病患者患有严重的 COVID-19 疾病。尽管他们在 COVID-19 疫苗接种后出现了体液免疫反应受损，但仍保留了细胞免疫反应。免疫功能低下的患者在接种疫苗后六个月内观察到 COVID-19 抗体反应减弱。最近的报告显示，接受利妥昔单抗治疗的接种高危风湿性疾病患者突破性 SARS-CoV-2 感染的致命后果。未进行 SAR-CoV-2 血清学检测。
评估在 Delta 变体时代，低风险完全接种疫苗的风湿性疾病患者 COVID-19 疫苗的体液反应和突破性感染。
对 19 名接受利妥昔单抗治疗的风湿性疾病患者进行了病例系列研究，以确定疫苗接种后 SARS-CoV-2 中和抗体滴度，并在沙特阿拉伯吉达的我们的三级护理中心监测突破性感染的发展，时间从 2021 年 4 月 1 日至 11 月 30 日。
患者的平均年龄为 49 岁。10%的患者正在接受利妥昔单抗治疗。73%的患者在第二次疫苗接种后 SARS-CoV-2 血清学检测呈阳性。在第二次疫苗接种后六个月诊断出两例轻度突破性 COVID-19 感染。患者年龄小于 65 岁，未接受利妥昔单抗治疗，无间质性肺病，且疫苗接种后血清学检测呈阳性。
我们在 Delta 时代证明了低危风湿性疾病患者 SARS-CoV-2 中和抗体血清阳性率高且突破性感染自行限制。鉴于病毒免疫逃逸反应，未来需要研究 Omicron 时代风湿性疾病患者的结局。
