Background: Knowledge about COVID-19 infections is expanding, although knowledge about the disease course and antibody formation in patients with an auto-immune disease or immunodeficiency is not fully unraveled yet. It could be hypothesized that immunodeficient patients, due to immunosuppressive drugs or their disease, have a more severe disease course due to their immunocompromised state. However, it could also be hypothesized that some of the immunosuppressive drugs protect against a hyperinflammatory state. Methods: We collected data on the incidence of COVID-19, disease course and SARS-CoV-2 antibody formation in COVID-19 positive patients in a cohort of patients (n ​= ​4497) known at the Clinical Immunology outpatient clinic in a tertiary care hospital in the Netherlands. Results: In the first six months of the pandemic, 16 patients were identified with COVID-19, 14 by nasal swab PCR, and 2 patients by SARS-CoV-2 antibodies. Eight patients were admitted to the hospital. SARS-CoV-2 antibodies were measured in 8 patients and were detectable in all, including one patient on B-cell ablative therapy and one patient with Common Variable Immunodeficiency Disorder. Conclusion: This study indicates that the disease course differs among immunocompromised patients, independently of (dis)continuation of immunosuppressive drugs. Antibody production for SARS-CoV-2 in immunocompromised patients was shown. More research needs to be conducted to confirm these observations and guidelines regarding (dis)continuation of immunosuppressive drugs in COVID-19 positive immunocompromised patients should be developed.

Antibodies, COVID-19, Immunocompromised, Immunologic deficiency syndromes, Immunosuppressive agents,
Journal of Translational Autoimmunity
Department of Internal Medicine

Guchelaar, N.A.D. (Niels A.D.), van Laar, J.A.M, Hermans, M.A.W, van der Houwen, T.B. (Tim B.), Atmaca, S. (Sibel), van Maaren, M.S, … Rombach, S.M. (Saskia M.). (2021). Characteristics of COVID-19 infection and antibody formation in patients known at a tertiary immunology department. Journal of Translational Autoimmunity, 4. doi:10.1016/j.jtauto.2021.100084