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SARS-CoV-2 Serologic Immune Response in Exogenously Immunosuppressed Patients
Megan L Zilla1, Christian Keetch1, Gretchen Mitchell1
1Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
The Journal of Applied Laboratory Medicine
|December 28, 2020
Summary
Solid organ transplant recipients on immunosuppression may experience delayed antibody responses and poorer outcomes following SARS-CoV-2 infection. Early interventions against COVID-19 are suggested for these vulnerable patients.
Area of Science:
- Immunology
- Virology
- Transplant Medicine
Background:
- Immunosuppressed individuals, including solid organ transplant recipients, are presumed to be at higher risk for severe SARS-CoV-2 infection.
- The antibody response to SARS-CoV-2 infection in immunosuppressed patient populations remains understudied.
Purpose of the Study:
- To investigate the anti-SARS-CoV-2 antibody response in patients undergoing exogenous immunosuppression.
- To compare antibody levels in solid organ transplant recipients and patients on inhaled steroids or etanercept versus controls.
Main Methods:
- Prospective follow-up of anti-SARS-CoV-2 antibody levels in COVID-19 patients.
- Study included solid organ transplant recipients, patients on inhaled fluticasone, etanercept, and a control group without exogenous immunosuppression.
Main Results:
- Solid organ transplant recipients on immunosuppression showed a delayed antibody response and poor outcomes.
- Inhaled steroids (fluticasone) and etanercept did not appear to predispose patients to delayed immune responses to SARS-CoV-2.
Conclusions:
- Solid organ transplant recipients on immunosuppression are at risk for delayed antibody response and adverse outcomes post-SARS-CoV-2 infection.
- These findings suggest that solid organ transplant recipients may benefit from early, targeted interventions for SARS-CoV-2.

