key: cord-0880910-kpy8zk08
authors: Smith, Jeffrey S.; Said, Jordan T.; Elman, Scott A.; Smith, Claire E.P.; Merola, Joseph F.
title: Seroconversion of SARS-CoV-2 infected patients on immunosuppression: a retrospective analysis
date: 2021-02-04
journal: J Am Acad Dermatol
DOI: 10.1016/j.jaad.2021.01.100
sha: 6591a61381dd6dac8f04923cd64bfc6ffaf69bb1
doc_id: 880910
cord_uid: kpy8zk08

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Patients on immunosuppression are at an increased risk of COVID-19 complications, in part due to the 2 propensity for immunosuppressive medications to interfere with pathogen-specific antibody seroconversion. 1 also had a reactive IgG serology. Of the patients that did not seroconvert, one patient was receiving rituximab, 25 prednisone, cyclophosphamide and eculizumab for antiphospholipid antibody syndrome, who ultimately died.

One patient was post lung transplant. The remaining two patients were taking oral prednisone. A While our retrospective analysis of seroconversion on immunosuppression is descriptive and contains a low 32 number of patients, to our knowledge this is the most comprehensive dataset on this topic to date. Limitations 33 are that the underlying disease requiring immunosuppressants inherently confounds interpretation, and that 34 hospitalized patients were more likely to receive requisite PCR and serology testing. We found that some Patients with a PCR-confirmed diagnosis of SARS-CoV-2 infection, with immunosuppression during a defined 7-day seroconversion window, and with an available serology study at least 7 days after diagnosis are graphed. For patients on multiple medications, a rank-order of immunosuppressant was applied (in descending order: rituximab, belimumab, tocilizumab, prednisone, methotrexate; see methods for details). Solid-organ transplant patients received a combination of mycophenolate mofetil, tacrolimus ± prednisone, and are graphed as a separate subgroup. Note that n refers to the number of patients in each category. 

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