SARS-CoV-2 Serologic Immune Response in Exogenously Immunosuppressed Patients

J Appl Lab Med. 2021 Mar 1;6(2):486-490. doi: 10.1093/jalm/jfaa232.

Abstract

Background: While it is presumed that immunosuppressed patients, such as solid organ transplant recipients on immunosuppression, are at greater risk from SARS-CoV-2 infection than the general population, the antibody response to infection in this patient population has not been studied.

Methods: In this report, we follow the anti-SARS-CoV-2 antibody levels in patients with COVID-19 who are undergoing exogenous immunosuppression. Specifically, we studied the antibody response of 3 solid organ transplant recipient patients, 3 patients who take daily inhaled fluticasone, and a patient on etanercept and daily inhaled fluticasone, and compared them to 5 patients not on exogenous immunosuppression.

Results: We found that the solid organ transplant patients on full immunosuppression are at risk of having a delayed antibody response and poor outcome. We did not find evidence that inhaled steroids or etanercept predispose patients to delayed immune response to SARS-CoV-2.

Conclusion: The data presented here suggest that solid organ transplant recipients may be good candidates for early targeted intervention against SARS-CoV-2.

Publication types

  • Comparative Study

MeSH terms

  • Administration, Inhalation
  • Adult
  • Aged
  • Antibodies, Viral / blood*
  • Antibodies, Viral / immunology
  • Antibodies, Viral / isolation & purification
  • COVID-19 / blood
  • COVID-19 / diagnosis
  • COVID-19 / immunology*
  • COVID-19 / virology
  • COVID-19 Serological Testing / statistics & numerical data
  • Calcineurin Inhibitors / adverse effects
  • Etanercept / adverse effects
  • Female
  • Fluticasone / administration & dosage
  • Fluticasone / adverse effects
  • Humans
  • Immunocompromised Host*
  • Immunosuppressive Agents / adverse effects*
  • Male
  • Middle Aged
  • Organ Transplantation / adverse effects
  • SARS-CoV-2 / immunology*
  • SARS-CoV-2 / isolation & purification
  • Spike Glycoprotein, Coronavirus / immunology
  • Transplant Recipients / statistics & numerical data
  • Young Adult

Substances

  • Antibodies, Viral
  • Calcineurin Inhibitors
  • Immunosuppressive Agents
  • Spike Glycoprotein, Coronavirus
  • spike protein, SARS-CoV-2
  • Fluticasone
  • Etanercept