Effect of COVID Infection and COVID Vaccination on SLE Activity, Including Antiphospholipid Antibodies

Michelle Petri¹, Jessica Li² and Daniel Goldman¹, ¹Johns Hopkins University School of Medicine, Baltimore, MD, ²Johns Hopkins University, Baltimore, MD

Meeting: ACR Convergence 2021

Keywords: Autoantibody(ies), COVID-19, Disease Activity, Systemic lupus erythematosus (SLE)

Session Information

Date: Sunday, November 7, 2021

Title: SLE – Diagnosis, Manifestations, & Outcomes Poster II: Manifestations (0855–0896)

Session Type: Poster Session B

Session Time: 8:30AM-10:30AM

Background/Purpose: SLE patients may have a particular propensity to some viral infections including zoster and CMV. International studies have suggested that prednisone and rituximab may be risk factors for COVID in rheumatic disease patients. One study found that 50% of hospitalized patients (not SLE) made antiphospholipid antibodies. In this study we compared disease activity, and antiphospholipid antibodies both before and after COVID-19 infection and vaccination.

Methods: Patients enrolled in a lupus cohort had data on COVID-19 testing and vaccination status prior to May, 2021 collected. A positive RNA test was required to confirm COVID-19 infection. Dates of vaccination and vaccine source were recorded. All patients met ACR and/or SLICC criteria for SLE. The lupus activity index (0-3 visual acuity scale: LAI), SELENA SLE disease activity index (SLEDAI) and laboratory values were collected at each visit. To compare the pre and post COVID infection/vaccination, paired t-test was used for continuous variables and McNemar’s test was used for categorical variables.

Results: Out of 860 patients in the cohort, 65 patients had a positive COVID-19 RNA test. 38 of these patients had at least one visit within 6 months before and after the COVID date. Table 1 shows the effect of COVID-19 on disease activity and laboratory values. On average, the LAI-rash score was lower after COVID infection. Anticardiolipin (aCL) IgG and anticardiolipin IgM increase after COVID infection. 228 patients had COVID-19 vaccine: 10 had Johnson & Johnson; 94 had Moderna; 124 had Pfizer. 13 patients were positive for COVID-19 prior to vaccination. 98 patients had at least 1 visit within 6 months before vaccine and at least one visit after vaccine. Table 2 shows the effect of COVID-19 vaccination on disease activity and laboratory values.

Conclusion: : COVID infection did not lead to an increase in SLE activity. Instead there was a decrease in cutaneous activity (perhaps explained by quarantine). There was an increase in aCL IgG and IgM post infection, but COVID vaccination did not increase SLE activity and did not increase antiphospholipid antibody levels.

Table 1: Effect of COVID infection on disease activity and laboratory measurements

Table 2: Effect of COVID vaccination on disease activity and laboratory measurements

Disclosures: M. Petri, Alexion, 1, Amgen, 1, Astrazeneca, 1, 5, Aurinia, 5, 6, Eli Lilly, 5, Emergent Biosolutions, 1, Exagen, 5, Gilead Biosciences, 2, GSK, 1, 5, IQVIA, 1, Idorsia Pharmaceuticals, 2, Janssen, 1, 5, Merck EMD Serono, 1, Momenta Pharmaceuticals, 2, PPD Development, 1, Sanofi, 2, Thermofisher, 5, UCB Pharmaceuticals, 2; J. Li, None; D. Goldman, None.

To cite this abstract in AMA style:

Petri M, Li J, Goldman D. Effect of COVID Infection and COVID Vaccination on SLE Activity, Including Antiphospholipid Antibodies [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/effect-of-covid-infection-and-covid-vaccination-on-sle-activity-including-antiphospholipid-antibodies/. Accessed .

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