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Brief report: can COVID-19 infection trigger rheumatoid arthritis-associated autoimmunity in individuals at risk for the disease? A nested cohort study

Published inFrontiers in medicine, vol. 10, 1201425
Publication date2023-07-07
First online date2023-07-07
Abstract

Objectives: To investigate the association between severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) infection and subsequent development of autoimmunity or pre-clinical manifestations associated with rheumatoid arthritis (RA) in at risk population.

Methods: This is a nested study within a prospective cohort of first-degree relatives of RA patients (RA-FDR). Participants are tested for RA-associated autoantibodies (anti-citrullinated peptide antibodies (ACPA)/rheumatoid factor (RF)) and clinical signs and symptoms suggestive of early disease. SARS-CoV-2 infections were self-reported between March 2020 and January 2023. All individuals with a pre-pandemic (sample 1) and a post-pandemic sample (sample 2) were included in the analysis. The exposure of interest was self-reported SARS-CoV-2 infection. The primary outcome was a clinically significant change in RA-associated autoantibody serum titers. Secondary outcomes included: becoming seropositive, becoming symptomatic, developing classifiable RA.

Results: Among 168 RA-FDRs, 109 reported a SARS-CoV-2 infection between sample 1 and sample 2. During this period, 2 RA-FDRs (1.2%) became anti-CCP2 seropositive, none became anti-CCP3 IgG positive, 6 (3.6%) became RF IgM seropositive, 1 became (0.6%) RF IgA seropositive, 19 (11.3%) became symptomatic and none developed classifiable RA. SARS-CoV-2 infection was not significantly associated with increases in RA autoantibody titers or with secondary outcomes.

Conclusion: We could not detect an association between SARS-CoV-2 infection and subsequent development of RA-associated autoimmunity, nor signs or symptoms of RA in an at risk population. These findings do not support the hypothesis that SARS-CoV-2 infections triggers the immune onset of RA.

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Keywords
  • COVID-19
  • RA-associated autoimmunity
  • SARS-CoV-2
  • First-degree relatives
  • Pre-clinical stages of RA
  • Rheumatoid arthritis
Citation (ISO format)
LAMACCHIA, Céline et al. Brief report: can COVID-19 infection trigger rheumatoid arthritis-associated autoimmunity in individuals at risk for the disease? A nested cohort study. In: Frontiers in medicine, 2023, vol. 10, p. 1201425. doi: 10.3389/fmed.2023.1201425
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ISSN of the journal2296-858X
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Technical informations

Creation09/11/2023 10:04:13 AM
First validation04/05/2024 11:26:12 AM
Update time04/05/2024 11:26:12 AM
Status update04/05/2024 11:26:12 AM
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