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
dx.doi.org/10.1016/j.jtauto.2021.100084, hdl.handle.net/1765/134843
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