The effect of tocilizumab, anakinra and prednisolone on antibody response to SARS-CoV-2 in patients with COVID-19: A prospective cohort study with multivariate analysis of factors affecting the antibody response

Int J Infect Dis. 2021 Apr:105:756-762. doi: 10.1016/j.ijid.2021.03.031. Epub 2021 Mar 15.

Abstract

Objectives: Disease severity, previous medications and immunosuppressive agents could affect the antibody response against SARS-CoV-2. This study aimed to analyze variables affecting the humoral response to SARS-CoV-2.

Methods: This prospective cohort study included adult patients who recovered from COVID-19 and were admitted to a COVID-19 follow-up unit. Eight patient groups were defined in accordance with the results of thoracic computed tomography (CT), SARS-CoV-2 PCR test, and tocilizumab or anakinra use during active disease. Anti-S IgG antibodies were determined by ELISA in serum samples. Anti-S positive and negative cases were compared.

Results: A total of 518 patients were included in the study. SARS-CoV-2 IgG antibodies were positive in 82.8% of patients. SARS-CoV-2 PCR positivity, extent of lung involvement on CT, and time to antibody testing were independently associated with antibody positivity. Tocilizumab, anakinra or prednisolone use was not a factor affecting the antibody response. The rate of antibody response and sample/CO values among antibody-positive patients showed a linear relationship with the extent of lung involvement on CT.

Conclusions: The use of tocilizumab, anakinra and prednisolone for COVID-19 did not affect the antibody response against SARS-CoV-2. The main driver of antibody response among patients with COVID-19 was the extent of pulmonary involvement on CT.

Keywords: Anakinra; Antibody; Prednisolone; SARS-CoV-2; Tocilizumab.

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antibodies, Viral / blood*
  • Antibodies, Viral / immunology
  • COVID-19 Drug Treatment*
  • Cohort Studies
  • Drug Therapy, Combination
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin G / immunology
  • Interleukin 1 Receptor Antagonist Protein / therapeutic use*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prednisolone / therapeutic use*
  • Prospective Studies
  • SARS-CoV-2 / immunology*
  • Severity of Illness Index
  • Tomography, X-Ray Computed

Substances

  • Antibodies, Monoclonal, Humanized
  • Antibodies, Viral
  • Immunoglobulin G
  • Interleukin 1 Receptor Antagonist Protein
  • Prednisolone
  • tocilizumab