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. 2022 Nov;74(11):1780-1785.
doi: 10.1002/acr.24716. Epub 2022 Aug 4.

Isolation, Behavioral Changes, and Low Seroprevalence of SARS-CoV-2 Antibodies in Patients With Systemic Lupus Erythematosus or Rheumatoid Arthritis

Christian Ammitzbøll  1 , Jakob Bøgh Andersen  1 , Signe Risbøl Vils  2 , Clara Elbaek Mistegaard  2 , Susan Mikkelsen  2 , Christian Erikstrup  2 , Marianne Kragh Thomsen  2 , Ellen-Margrethe Hauge  2 , Anne Troldborg  2
Affiliations

Isolation, Behavioral Changes, and Low Seroprevalence of SARS-CoV-2 Antibodies in Patients With Systemic Lupus Erythematosus or Rheumatoid Arthritis

Christian Ammitzbøll et al. Arthritis Care Res (Hoboken). 2022 Nov.

Abstract

Objective: Patients with chronic rheumatic diseases (CRDs), such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), require special attention during the COVID-19 pandemic as they are considered at risk of severe infections. Our objective was to assess the seroprevalence of SARS-CoV-2 in patients with SLE and RA and to assess patient behavior, disease-related symptoms, and mental health.

Methods: More than 900 participants were included: 405 patients with RA or SLE (CRD patients) and 513 blood donors. All participants had blood SARS-CoV-2 total antibodies measured (sensitivity 96.7%, specificity 99.5%) and answered a questionnaire concerning behavior, anxiety, and symptoms of depression (Patient Health Questionnaire 9). The CRD patients were further asked about physical activity, adherence to medication, and disease-related symptoms.

Results: CRD patients had a significantly lower seroprevalence of SARS-CoV-2 antibodies (n = 1 of 365, 0.3%) compared to blood donors (n = 10 of 513, 1.9%; P = 0.03). Almost 60% of patients were unable to exercise as usual, and increased pain and disease activity was experienced by 34% and 24% of patients, respectively. Almost 10% of patients reduced or discontinued their immunosuppressive treatments at their own initiative. Symptoms of moderate depression were present in 19% of patients compared to 6.8% of blood donors (P < 0.001).

Conclusion: Low seroprevalence in patients with CRDs indicates successful mitigation of exposure to SARS-CoV-2. However, this mitigation appears to occur at the expense of physical activity, experience of increased pain, disease activity, and symptoms of depression. There is a need for care providers to be aware of these negative side effects and for further studies to investigate the possible long-term consequences.

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Figures

Figure 1
Figure 1
Presence of SARS–CoV‐2 antibodies in chronic rheumatic disease patients (1 of 365, 0.3%) and blood donors (10 of 513, 1.9%). * P = 0.03.
See this image and copyright information in PMC

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