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Seroprevalence to SARS-CoV-2 in Patients with Rheumatic Diseases on Disease Modifying Antirheumatic Drugs and /or Immunosuppressive Medications from India: A Multicentric Study

16 Pages Posted: 17 Jan 2022

See all articles by Ramnath Misra

Ramnath Misra

KIIT University - Department of Clinical Immunology and Rheumatology

Debdutta Bhattacharya

Government of India - ICMR-Regional Medical Research Centre

Sakir Ahmed

KIIT University - Department of Clinical Immunology and Rheumatology

Sanjiv Amin

affiliation not provided to SSRN

Vineeta Shobha

affiliation not provided to SSRN

Alakendu Ghosh

affiliation not provided to SSRN

Sapan C Pandya

affiliation not provided to SSRN

Debaprasad Parai

Government of India - Department of Microbiology

Prasanta Padhan

KIIT University - Department of Clinical Immunology and Rheumatology

Subhadra Priyadarshini

affiliation not provided to SSRN

A Raj Kumar Patro

affiliation not provided to SSRN

Ambika Prasad Mohanty

affiliation not provided to SSRN

Sanghamitra Pati

Government of India - ICMR-Regional Medical Research Centre

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Abstract

Background: There is an uncertainty regarding the effect of the SARS-CoV-2 infection on patients with chronic rheumatic diseases who are on immunosuppressive drugs. Disease-modifying anti-rheumatic drugs (DMARDs) are immunomodulatory or immunosuppressive. In the current COVID-19 pandemic, it is not clear whether DMARDs are helpful or detrimental. This study was carried out to estimate the pre-vaccination seroprevalence of antibodies to SARS-CoV-2 in patients with a rheumatic disease on DMARDs and/or immunosuppressive drugs and compare them with family controls

Methods: A multicentric cross-sectional seroprevalence study were conducted in five different cities of India using convenient sampling. Patients with a diagnosis of rheumatic disease and on DMARDs were included. Relatives of the patients, preferably staying in the same household with no known rheumatic diseases served as controls. Serum IgG antibodies to SARS-CoV-2 Receptor-Binding Domain(RBD) of the spike protein was measured using electrochemiluminescence immunoassay(ECLIA) using the Roche Kit on Cobas system and IgG antibodies to nucleoprotein (NP) were assayed using chemiluminescent magnetic assay using Abott kit on ARCHITECT system.

Findings: Eight hundred ninety-five sera (cases=378 and controls=517) were assayed for detection of antibodies to SARS-CoV-2. IgG antibodies to either RBD and/or NP were positive in 135 (36%) cases as compared to 196 (38%) in controls.  The seroprevalence to RBD and NP varied between different cities but was not significantly different between cases and controls in Mumbai, Ahmedabad, Bengaluru and Bhubaneswar. However, the occurrence of IgG antibodies to RBD was significantly (p<0.05) lower in cases (28/65;43%) as compared to controls (423/65;65%) in Kolkata, where the positivity rate was lower in connective tissue disease group than in inflammatory arthritis group . 

Interpretation: Overall,  patients with rheumatic diseases on DMARDs have IgG antibodies to RBD and NP of SARS-CoV-2 at a comparable level with that of controls, but the level of antibodies to RBD is lower in patients  with connective tissue disease on immunosuppressive drugs in one centre.

Trial Registration: The study was registered in the Central Trial Registry of India with reference number CTRI/2020/11028967.

Funding: RM and SP; KIMS, Bhubaneswar & ICMR-RMRC, Bhubaneswar.

Declaration of Interest: None to declare.

Ethical Approval: This study was approved by the ethics committee at Kalinga Institute of Medical Science, Bhubaneswar which served as the nodal centre on behalf of all the participating centres [KIIT/KIMS/IEC/385/2020].

Suggested Citation

Misra, Ramnath and Bhattacharya, Debdutta and Ahmed, Sakir and Amin, Sanjiv and Shobha, Vineeta and Ghosh, Alakendu and Pandya, Sapan C and Parai, Debaprasad and Padhan, Prasanta and Priyadarshini, Subhadra and Patro, A Raj Kumar and Mohanty, Ambika Prasad and Pati, Sanghamitra, Seroprevalence to SARS-CoV-2 in Patients with Rheumatic Diseases on Disease Modifying Antirheumatic Drugs and /or Immunosuppressive Medications from India: A Multicentric Study (1/15/2022). Available at SSRN: https://ssrn.com/abstract=4011276 or http://dx.doi.org/10.2139/ssrn.4011276

Ramnath Misra (Contact Author)

KIIT University - Department of Clinical Immunology and Rheumatology ( email )

Debdutta Bhattacharya

Government of India - ICMR-Regional Medical Research Centre ( email )

CHANDRASEKHARPUR
BHUBANESWAR, 751023
India

HOME PAGE: http://www.rmrcbbsr.gov.in/covid_intro.php

Sakir Ahmed

KIIT University - Department of Clinical Immunology and Rheumatology ( email )

Bhubaneswar, 751024
India
00919706023644 (Phone)

Sanjiv Amin

affiliation not provided to SSRN

Vineeta Shobha

affiliation not provided to SSRN

Alakendu Ghosh

affiliation not provided to SSRN

Sapan C Pandya

affiliation not provided to SSRN

Debaprasad Parai

Government of India - Department of Microbiology ( email )

Chandrasekharpur
India

Prasanta Padhan

KIIT University - Department of Clinical Immunology and Rheumatology ( email )

Bhubaneswar, 751024
India

Subhadra Priyadarshini

affiliation not provided to SSRN

A Raj Kumar Patro

affiliation not provided to SSRN

Ambika Prasad Mohanty

affiliation not provided to SSRN

Sanghamitra Pati

Government of India - ICMR-Regional Medical Research Centre

CHANDRASEKHARPUR
BHUBANESWAR, 751023
India