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比较两批未接种疫苗队列中类风湿关节炎、银屑病关节炎和脊柱关节炎患者与对照者的 SARS-CoV-2 体液免疫反应。

Comparison of SARS-COV-2 humoral response between rheumatoid arthritis, psoriatic arthritis and spondyloarthritis patients and controls in two unvaccinated cohorts.

机构信息

Department of Rheumatology, Toulouse University Hospital, Centre d'Investigation Clinique de Toulouse CIC1436, Inserm, Paul Sabatier University, Toulouse, France.

CHU Toulouse, Hôpital Purpan, Virology Laboratory, Toulouse; INSERM UMR1291 - CNRS UMR5051, Toulouse Institute for Infectious and Inflammatory Diseases (INFINITy), Toulouse, France.

出版信息

Clin Exp Rheumatol. 2024 Nov;42(11):2141-2149. doi: 10.55563/clinexprheumatol/48440j. Epub 2024 Oct 17.

Abstract

OBJECTIVES

To compare the humoral response after a SARS-CoV-2 infection in an inflammatory rheumatic disease population with a healthy control population in a case-control study.

METHODS

Cases: between March and September 2021, all consecutive unvaccinated patients followed for rheumatoid arthritis (RA), spondyloarthritis (SpA) or psoriatic arthritis (PsA) in 16 hospitals in France were systematically screened with a SARS-CoV-2 serological test. Patients with a positive test were included in the COVID-RIC-2 cohort.

CONTROLS

between June and July 2020, healthcare professionals working in the Toulouse University Hospital were screened with a SARS-CoV-2 serological test. Those with a positive test were included in the COVID-BIOTOUL cohort and matched to those from COVID-RIC-2 by age, sex and time-sampling on infection date.

ANALYSES

total SARS-CoV-2 antibody titres were centrally measured and compared.

RESULTS

95 patients from COVID-RIC-2 (mean age 49 years, 76% females, median delay of COVID infection: 149 days) including 48 RA, 33 SpA and 14 PsA were compared to 95 matched controls. Globally, there was no significant difference of SARS-CoV-2 antibody titres between both populations: 155 Binding Antibody Units (BAU) (IQR:7-376) in COVID-RIC-2 vs. 120 BAU (IQR:35-320) in COVID-BIOTOUL. There was a trend towards higher antibody titres in patients from COVID-RIC-2 with severe COVID-19 symptoms. In COVID-RIC-2, there was no impact of age, sex, time-sampling or underlying disease on antibody titres and patients taking glucocorticoids, abatacept or rituximab trended toward having lower antibody titres after COVID-19 infection.

CONCLUSIONS

This study provides reassuring data on humoral response after COVID-19 infection in patients treated with disease-modifying anti-rheumatic drugs.

摘要

目的

在一项病例对照研究中,比较炎症性风湿病患者和健康对照组在 SARS-CoV-2 感染后的体液反应。

方法

病例:2021 年 3 月至 9 月期间,法国 16 家医院连续筛查所有未接种疫苗的类风湿关节炎(RA)、脊柱关节炎(SpA)或银屑病关节炎(PsA)患者,进行 SARS-CoV-2 血清学检测。检测结果阳性的患者纳入 COVID-RIC-2 队列。

对照组

2020 年 6 月至 7 月期间,在图卢兹大学医院工作的医护人员进行 SARS-CoV-2 血清学检测。检测结果阳性的患者纳入 COVID-BIOTOUL 队列,并按感染日期的年龄、性别和时间进行匹配。

分析

中心测量并比较了总 SARS-CoV-2 抗体滴度。

结果

COVID-RIC-2 队列包括 95 例患者(平均年龄 49 岁,76%为女性,COVID 感染的中位延迟时间为 149 天),其中 48 例为 RA,33 例为 SpA,14 例为 PsA,与 95 例匹配的对照组进行比较。总体而言,两组人群的 SARS-CoV-2 抗体滴度无显著差异:COVID-RIC-2 队列为 155 结合抗体单位(BAU)(IQR:7-376),COVID-BIOTOUL 队列为 120 BAU(IQR:35-320)。COVID-RIC-2 队列中 COVID-19 症状严重的患者抗体滴度有升高趋势。在 COVID-RIC-2 队列中,年龄、性别、时间采样或基础疾病对抗体滴度无影响,服用糖皮质激素、阿巴西普或利妥昔单抗的患者 COVID-19 感染后抗体滴度有下降趋势。

结论

本研究为接受疾病修饰抗风湿药物治疗的患者 COVID-19 感染后的体液反应提供了令人安心的数据。

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