COVID-19 vaccination in patients with rheumatic diseases leads to a high seroconversion rate and reduced self-imposed isolation and shielding behaviour

Christian Ammitzbøll; Marianne Kragh Thomsen; Jakob Bøgh Andersen; Lars Erik Bartels; Marie-Louise From Hermansen; Anders Dahl Johannsen; Clara Elbæk Mistegaard; Susan Mikkelsen; Signe Risbøl Vils; Christian Erikstrup; Ellen-Margrethe Hauge; Anne Troldborg

doi:10.1093/mr/roac069

COVID-19 vaccination in patients with rheumatic diseases leads to a high seroconversion rate and reduced self-imposed isolation and shielding behaviour

Christian Ammitzbøll, Marianne Kragh Thomsen, Jakob Bøgh Andersen, Lars Erik Bartels, Marie-Louise From Hermansen, Anders Dahl Johannsen, Clara Elbæk Mistegaard, Susan Mikkelsen, Signe Risbøl Vils, Christian Erikstrup, Ellen-Margrethe Hauge, Anne Troldborg

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

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Abstract

Objectives: We investigated the effect of a two-dose messenger ribonucleic acid (mRNA) vaccine on antibody levels against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and patient behaviour and shielding concerning fear of coronavirus disease 2019 (COVID-19) in patients with systemic lupus erythematosus or rheumatoid arthritis. Methods: Three hundred and three patients and 44 blood donors were included. All patients received two doses of an mRNA vaccine and had total antibodies against SARS-CoV-2 measured before vaccination and 2 and 9 weeks after the second vaccination. Further, patients answered an electronic questionnaire before and after vaccination concerning behaviour, anxiety, and symptoms of depression (Patient Health Questionnaire-9). Results: Significantly fewer patients (90%) had measurable antibodies against SARS-CoV-2 compared to blood donors (100%) after the second vaccination (P <. 001). Treatment with rituximab was the strongest predictor of an unfavourable vaccine response, as only 27% had measurable antibodies. Nearly all patients (97%) not treated with rituximab experienced seroconversion. Prednisone and methotrexate had a negative effect on seroconversion, but no effect of age or comorbidity was observed. Patients experienced significant improvement after vaccination in 10 out of 12 questions regarding behaviour and fear of COVID-19, while no change in Patient Health Questionnaire-9 or anxiety was observed. Conclusion: We find a very high seroconversion rate among rheumatic patients and reduced self-imposed isolation and shielding after COVID-19 vaccination.

Original language	English
Journal	Modern Rheumatology
Volume	33
Issue	4
Pages (from-to)	777–785
Number of pages	9
ISSN	1439-7595
DOIs	https://doi.org/10.1093/mr/roac069
Publication status	Published - 1 Jul 2023

Keywords

Antibodies
COVID-19 Vaccines/therapeutic use
COVID-19/prevention & control
Humans
Rheumatic Diseases/drug therapy
Rituximab
SARS-CoV-2
Seroconversion
Vaccination
COVID-19
systemic lupus erythematosus
SARS-CoV-2 antibodies
Rheumatoid arthritis
patient-reported outcome measures

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10.1093/mr/roac069

https://pmc.ncbi.nlm.nih.gov/articles/PMC9384499/pdf/roac069.pdf

Cite this

Ammitzbøll, C., Thomsen, M. K., Andersen, J. B., Bartels, L. E., Hermansen, M.-L. F., Johannsen, A. D., Mistegaard, C. E., Mikkelsen, S., Vils, S. R., Erikstrup, C., Hauge, E.-M., & Troldborg, A. (2023). COVID-19 vaccination in patients with rheumatic diseases leads to a high seroconversion rate and reduced self-imposed isolation and shielding behaviour. Modern Rheumatology, 33(4), 777–785. https://doi.org/10.1093/mr/roac069

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title = "COVID-19 vaccination in patients with rheumatic diseases leads to a high seroconversion rate and reduced self-imposed isolation and shielding behaviour",

abstract = "Objectives: We investigated the effect of a two-dose messenger ribonucleic acid (mRNA) vaccine on antibody levels against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and patient behaviour and shielding concerning fear of coronavirus disease 2019 (COVID-19) in patients with systemic lupus erythematosus or rheumatoid arthritis. Methods: Three hundred and three patients and 44 blood donors were included. All patients received two doses of an mRNA vaccine and had total antibodies against SARS-CoV-2 measured before vaccination and 2 and 9 weeks after the second vaccination. Further, patients answered an electronic questionnaire before and after vaccination concerning behaviour, anxiety, and symptoms of depression (Patient Health Questionnaire-9). Results: Significantly fewer patients (90%) had measurable antibodies against SARS-CoV-2 compared to blood donors (100%) after the second vaccination (P <. 001). Treatment with rituximab was the strongest predictor of an unfavourable vaccine response, as only 27% had measurable antibodies. Nearly all patients (97%) not treated with rituximab experienced seroconversion. Prednisone and methotrexate had a negative effect on seroconversion, but no effect of age or comorbidity was observed. Patients experienced significant improvement after vaccination in 10 out of 12 questions regarding behaviour and fear of COVID-19, while no change in Patient Health Questionnaire-9 or anxiety was observed. Conclusion: We find a very high seroconversion rate among rheumatic patients and reduced self-imposed isolation and shielding after COVID-19 vaccination.",

keywords = "Antibodies, COVID-19 Vaccines/therapeutic use, COVID-19/prevention & control, Humans, Rheumatic Diseases/drug therapy, Rituximab, SARS-CoV-2, Seroconversion, Vaccination, COVID-19, systemic lupus erythematosus, SARS-CoV-2 antibodies, Rheumatoid arthritis, patient-reported outcome measures",

author = "Christian Ammitzb{\o}ll and Thomsen, {Marianne Kragh} and Andersen, {Jakob B{\o}gh} and Bartels, {Lars Erik} and Hermansen, {Marie-Louise From} and Johannsen, {Anders Dahl} and Mistegaard, {Clara Elb{\ae}k} and Susan Mikkelsen and Vils, {Signe Risb{\o}l} and Christian Erikstrup and Ellen-Margrethe Hauge and Anne Troldborg",

year = "2023",

month = jul,

day = "1",

doi = "10.1093/mr/roac069",

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Ammitzbøll, C , Thomsen, MK , Andersen, JB, Bartels, LE, Hermansen, M-LF, Johannsen, AD, Mistegaard, CE , Mikkelsen, S, Vils, SR, Erikstrup, C , Hauge, E-M & Troldborg, A 2023, 'COVID-19 vaccination in patients with rheumatic diseases leads to a high seroconversion rate and reduced self-imposed isolation and shielding behaviour', Modern Rheumatology, vol. 33, no. 4, pp. 777–785. https://doi.org/10.1093/mr/roac069

COVID-19 vaccination in patients with rheumatic diseases leads to a high seroconversion rate and reduced self-imposed isolation and shielding behaviour. / Ammitzbøll, Christian ; Thomsen, Marianne Kragh ; Andersen, Jakob Bøgh et al.
In: Modern Rheumatology, Vol. 33, No. 4, 01.07.2023, p. 777–785.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - COVID-19 vaccination in patients with rheumatic diseases leads to a high seroconversion rate and reduced self-imposed isolation and shielding behaviour

AU - Ammitzbøll, Christian

AU - Thomsen, Marianne Kragh

AU - Andersen, Jakob Bøgh

AU - Bartels, Lars Erik

AU - Hermansen, Marie-Louise From

AU - Johannsen, Anders Dahl

AU - Mistegaard, Clara Elbæk

AU - Mikkelsen, Susan

AU - Vils, Signe Risbøl

AU - Erikstrup, Christian

AU - Hauge, Ellen-Margrethe

AU - Troldborg, Anne

PY - 2023/7/1

Y1 - 2023/7/1

N2 - Objectives: We investigated the effect of a two-dose messenger ribonucleic acid (mRNA) vaccine on antibody levels against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and patient behaviour and shielding concerning fear of coronavirus disease 2019 (COVID-19) in patients with systemic lupus erythematosus or rheumatoid arthritis. Methods: Three hundred and three patients and 44 blood donors were included. All patients received two doses of an mRNA vaccine and had total antibodies against SARS-CoV-2 measured before vaccination and 2 and 9 weeks after the second vaccination. Further, patients answered an electronic questionnaire before and after vaccination concerning behaviour, anxiety, and symptoms of depression (Patient Health Questionnaire-9). Results: Significantly fewer patients (90%) had measurable antibodies against SARS-CoV-2 compared to blood donors (100%) after the second vaccination (P <. 001). Treatment with rituximab was the strongest predictor of an unfavourable vaccine response, as only 27% had measurable antibodies. Nearly all patients (97%) not treated with rituximab experienced seroconversion. Prednisone and methotrexate had a negative effect on seroconversion, but no effect of age or comorbidity was observed. Patients experienced significant improvement after vaccination in 10 out of 12 questions regarding behaviour and fear of COVID-19, while no change in Patient Health Questionnaire-9 or anxiety was observed. Conclusion: We find a very high seroconversion rate among rheumatic patients and reduced self-imposed isolation and shielding after COVID-19 vaccination.

AB - Objectives: We investigated the effect of a two-dose messenger ribonucleic acid (mRNA) vaccine on antibody levels against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and patient behaviour and shielding concerning fear of coronavirus disease 2019 (COVID-19) in patients with systemic lupus erythematosus or rheumatoid arthritis. Methods: Three hundred and three patients and 44 blood donors were included. All patients received two doses of an mRNA vaccine and had total antibodies against SARS-CoV-2 measured before vaccination and 2 and 9 weeks after the second vaccination. Further, patients answered an electronic questionnaire before and after vaccination concerning behaviour, anxiety, and symptoms of depression (Patient Health Questionnaire-9). Results: Significantly fewer patients (90%) had measurable antibodies against SARS-CoV-2 compared to blood donors (100%) after the second vaccination (P <. 001). Treatment with rituximab was the strongest predictor of an unfavourable vaccine response, as only 27% had measurable antibodies. Nearly all patients (97%) not treated with rituximab experienced seroconversion. Prednisone and methotrexate had a negative effect on seroconversion, but no effect of age or comorbidity was observed. Patients experienced significant improvement after vaccination in 10 out of 12 questions regarding behaviour and fear of COVID-19, while no change in Patient Health Questionnaire-9 or anxiety was observed. Conclusion: We find a very high seroconversion rate among rheumatic patients and reduced self-imposed isolation and shielding after COVID-19 vaccination.

KW - Antibodies

KW - COVID-19 Vaccines/therapeutic use

KW - COVID-19/prevention & control

KW - Humans

KW - Rheumatic Diseases/drug therapy

KW - Rituximab

KW - SARS-CoV-2

KW - Seroconversion

KW - Vaccination

KW - COVID-19

KW - systemic lupus erythematosus

KW - SARS-CoV-2 antibodies

KW - Rheumatoid arthritis

KW - patient-reported outcome measures

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U2 - 10.1093/mr/roac069

DO - 10.1093/mr/roac069

M3 - Journal article

C2 - 35860843

SN - 1439-7595

VL - 33

SP - 777

EP - 785

JO - Modern Rheumatology

JF - Modern Rheumatology

IS - 4

ER -

COVID-19 vaccination in patients with rheumatic diseases leads to a high seroconversion rate and reduced self-imposed isolation and shielding behaviour

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