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  • Antibody response to SARS-CoV-2 in patients receiving glucocorticoids with or without tocilizumab for COVID-19-associated hyperinflammation

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Letter
Antibody response to SARS-CoV-2 in patients receiving glucocorticoids with or without tocilizumab for COVID-19-associated hyperinflammation
  1. Marlou T H F Janssen1,
  2. Sofia Ramiro2,3,
  3. Robert B M Landewé3,4,
  4. César Magro-Checa3,
  5. Rémy L M Mostard1
  1. 1 Pulmonology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands
  2. 2 Rheumatology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
  3. 3 Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, Limburg, The Netherlands
  4. 4 Amsterdam Rheumatology Center, AMC, Amsterdam, The Netherlands
  1. Correspondence to Marlou T H F Janssen, Pulmonology, Zuyderland Medical Centre Heerlen, 6419 PC Heerlen, The Netherlands; marl.janssen4{at}zuyderland.nl

https://doi.org/10.1136/annrheumdis-2021-220040

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    Several immune mechanisms resembling a hyperinflammatory state have been critically involved in the pathophysiology of severe COVID-19, motivating the use of immunomodulatory therapies in the management of these patients. Various studies have already suggested the efficacy of immunomodulatory medication of treatment for severe COVID-19.1–3 However, concerns have been raised about the impact of these therapies on immunity.4 5 We analysed the presence and levels of antibodies to SARS-CoV-2 in patients recovered from severe COVID-19-associated hyperinflammation after receiving no immunomodulatory therapy, and compared them to patients who received methylprednisolone alone or methylprednisolone followed by tocilizumab.

    Between March and May 2020, 197 patients were diagnosed with COVID-19-associated hyperinflammation in the Zuyderland Medical Centre. In order to meet the criteria for hyperinflammation, patients had to fulfil specific characteristics that have been previously reported in this journal.1

    Up to the 1st of April, patients were treated with standard of care. In April and May, patients were treated according to the COVID-19 high-intensity immunosuppression in cytokine storm syndrome (CHIC) protocol with immunomodulatory therapies. This protocol included …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors All authors were fully involved in the preparation of this article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests SR reports personal fees from AbbVie, personal fees from Eli Lilly, grants and personal fees from MSD, personal fees from Novartis, personal fees from Sanofi, personal fees from UCB, outside the submitted work. RBL reports personal fees from AbbVie, personal fees from Eli-Lilly, personal fees from Novartis, personal fees from Roche, personal fees from UCB, personal fees from Pfizer, personal fees from Jansen, outside the submitted work. RLMM reports personal fees from Roche, personal fees from Boehringer Ingelheim, personal fees from Galapagos, outside the submitted work.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.