TY - JOUR
T1 - Revaccination of patients with systemic lupus erythematosus or rheumatoid arthritis without an initial COVID-19 vaccine response elicits seroconversion in half of the patients
AU - Ammitzbøll, Christian
AU - Thomsen, Marianne Kragh
AU - Andersen, Jakob Bøgh
AU - Jensen, Jens Magnus Bernth
AU - Bayarri-Olmos, Rafael
AU - Garred, Peter
AU - Hermansen, Marie-Louise From
AU - Johannsen, Anders Dahl
AU - Larsen, Mads Lamm
AU - Mistegaard, Clara Elbæk
AU - Mikkelsen, Susan
AU - Nielsen, Lena
AU - Olesen, Rikke
AU - Pérez-Alós, Laura
AU - Vils, Signe Risbøl
AU - Szabados, Fruzsina
AU - Søgaard, Ole Schmeltz
AU - Tolstrup, Martin
AU - Erikstrup, Christian
AU - Hauge, Ellen-Margrethe
AU - Troldborg, Anne
PY - 2024/1
Y1 - 2024/1
N2 - To investigate the effect of COVID-19 mRNA revaccination (two doses) on the antibody response in patients with rheumatic diseases (RD) who were initial vaccine non-responders. Further, to examine if B-cell levels or T-cell responses before revaccination predicted seroconversion. Methods From a RD cohort vaccinated with the standard two-dose COVID-19 vaccinations, we enrolled cases without detectable antibody responses (n=17) and controls with detectable antibody response (n=29). Blood donors (n=32) were included as additional controls. Samples were collected before and six weeks after completed revaccination. Total antibodies and specific IgG, IgA, and IgM against SARS-CoV-2 spike protein, SARS-CoV-2 neutralising antibodies, and SARS-CoV-2 reacting CD4+ and CD8+ T-cells were measured before and after revaccination. B-cells (CD19+CD45+) were quantified before revaccination. Results Forty-seven percent of cases had detectable neutralising antibodies after revaccination. However, antibody levels were significantly lower than in controls and blood donors. Revaccination induced an antibody class switch in cases with a decrease in IgM and increase in IgG. No significant difference was observed in T-cell responses before and after revaccination between the three groups. Only 29% of cases had measurable B-cells compared to 100% of controls and blood donors. Fifty percent of revaccinated cases who seroconverted had measurable B-cells before revaccination. Conclusion Forty-seven percent of initial non-responders seroconverted after two-dose revaccination but still had lower levels of SARS-CoV-2 antibodies compared with controls and blood donors. RD patients without a detectable serological response after the initial COVID-19 mRNA vaccine had a T-cell response similar to immunocompetent controls and blood donors.
AB - To investigate the effect of COVID-19 mRNA revaccination (two doses) on the antibody response in patients with rheumatic diseases (RD) who were initial vaccine non-responders. Further, to examine if B-cell levels or T-cell responses before revaccination predicted seroconversion. Methods From a RD cohort vaccinated with the standard two-dose COVID-19 vaccinations, we enrolled cases without detectable antibody responses (n=17) and controls with detectable antibody response (n=29). Blood donors (n=32) were included as additional controls. Samples were collected before and six weeks after completed revaccination. Total antibodies and specific IgG, IgA, and IgM against SARS-CoV-2 spike protein, SARS-CoV-2 neutralising antibodies, and SARS-CoV-2 reacting CD4+ and CD8+ T-cells were measured before and after revaccination. B-cells (CD19+CD45+) were quantified before revaccination. Results Forty-seven percent of cases had detectable neutralising antibodies after revaccination. However, antibody levels were significantly lower than in controls and blood donors. Revaccination induced an antibody class switch in cases with a decrease in IgM and increase in IgG. No significant difference was observed in T-cell responses before and after revaccination between the three groups. Only 29% of cases had measurable B-cells compared to 100% of controls and blood donors. Fifty percent of revaccinated cases who seroconverted had measurable B-cells before revaccination. Conclusion Forty-seven percent of initial non-responders seroconverted after two-dose revaccination but still had lower levels of SARS-CoV-2 antibodies compared with controls and blood donors. RD patients without a detectable serological response after the initial COVID-19 mRNA vaccine had a T-cell response similar to immunocompetent controls and blood donors.
KW - Autoimmune disease
KW - B-cell depleting therapy
KW - COVID-19
KW - Rheumatic diseases
KW - Rituximab
KW - Vaccine
KW - Antibodies, Neutralizing
KW - Immunoglobulin M
KW - Humans
KW - Immunoglobulin G
KW - Vaccination
KW - Antibodies, Viral
KW - Seroconversion
KW - Arthritis, Rheumatoid
KW - Spike Glycoprotein, Coronavirus
KW - SARS-CoV-2
KW - Immunization, Secondary
KW - COVID-19 Vaccines
KW - Lupus Erythematosus, Systemic
KW - COVID-19/prevention & control
KW - Rheumatic Diseases
U2 - 10.55563/clinexprheumatol/orpp04
DO - 10.55563/clinexprheumatol/orpp04
M3 - Journal article
C2 - 37877429
SN - 0392-856X
VL - 42
SP - 157
EP - 165
JO - Clinical and Experimental Rheumatology
JF - Clinical and Experimental Rheumatology
IS - 1
ER -