Humoral and T‐cell response to SARS‐CoV‐2 vaccination in patients with rheumatoid arthritis
Carolina A Isnardi, Margarita Landi, Leonel Cruces, Pablo Maid, Claudia Calle Montoro, María A Alfaro, Brian M Roldán, Andrea B Gómez Vara, Pamela Giorgis, Roberto A Ezquer, María G Crespo Rocha, Camila R Reyes Gómez, María Á Correa, Osvaldo L Cerda, Marcos G Rosemffet, Virginia Carrizo Abarza, Santiago Catalan Pellet, Miguel Perandones, Cecilia Reimundes, Yesica Longueira, Gabriela Turk, María F Quiroga, Natalia Laufer, María C De La Vega, Gustavo Citera, Guillermo J. Pons‐Estel, Emilce E Schneeberger- Rheumatology
Objective
To assess the SARS‐CoV‐2‐specific humoral and T‐cell response after a two‐dose regimen of SARS‐CoV‐2 vaccine in patients with rheumatoid arthritis (RA).
Methods
In this observational study, patients with RA, ≥18 years old, vaccinated for SARS‐CoV‐2 according to the Argentine National Health Ministry´s vaccination strategy were included. Anti‐SARS‐CoV‐2 IgG antibodies (ELISA‐COVIDAR test), neutralizing activity (cytotoxicity in VERO cells) and specific T‐cell response (IFN‐γ ELISpot Assay) were assessed after the first and second dose.
Results
A total of 120 RA patients were included. Mostly, homologous regimens were used, including Gam‐COVID‐Vac (27.5%), ChAdOx1 (24.2%) and BBIBP‐CorV (22.5%). The most frequent combination was Gam‐COVID‐Vac/mRNA‐1273 (21.7%). After the second dose 81.7% presented anti‐SARS‐CoV‐2 antibodies, 70.0% neutralizing activity and 65.3% specific T‐cell response. The use of BBIBP‐CorV, treatment with abatacept (ABA) and rituximab (RTX) were associated with undetectable antibodies and no neutralizing activity after two doses. BBIBP‐CorV was also associated with the absence of T‐cell response. The total incidence of adverse events was 357.1 events/1000 doses, significantly lower with BBIBP‐CorV (166.7 events/1000 doses, p<0.02).
Conclusion
In this RA cohort vaccinated with homologous and heterologous regimens against COVID‐19, two out of ten patients did not develop IgG anti‐SARS‐CoV‐2, 70% presented neutralizing activity and 65% specific T‐cell response. The use of BBIBP‐CorV was associated with deficient humoral and cellular response, while treatment with ABA and RTX resulted in an impaired IgG anti‐SARS‐CoV‐2 formation and neutralizing activity.
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