P057 What is the course of SARS-CoV-2 infection in people with autoimmune conditions on immunomodulators in comparison to people without autoimmune disease?

Background/AimsThe pathogenesis and outcomes of COVID-19 in patients withautoimmune disease remains poorly understood. We aimed toevaluate clinical features and antibody mediated immunity againstsevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) insubjects with autoimmune disease, compared to those without.MethodsPatients who developed COVID-19 were identified through the auditdepartment/clinician identification. In total, there were 48 subjects withautoimmune disease and confirmed COVID-19. Of these patients, 6had sadly died. In recruited patients, clinical data regarding COVID-19symptoms, treatment and outcomes were collected. Blood was takenfor quantitative serology testing against SARS-CoV-2 using theMologic test kit. A binary logistic regression was used to compareserology results in subjects with and without autoimmune diagnoses.ResultsOur sample included 103 participants. 26 subjects with autoimmunedisease and confirmed COVID-19 were recruited, the most commondiagnoses being rheumatoid arthritis (27%), psoriatic arthritis (19%)and inflammatory bowel disease (15%). 21 of 28 participants were onimmunomodulatory medications including 16 on conventional synthetic disease modifying anti-rheumatic drugs (DMARDs), four onbiologic DMARDs and one on tacrolimus. We age- and gendermatched these subjects to 26 without autoimmune disease withconfirmed SARS-CoV-2 infection. 17 further subjects reported viralsymptoms during the COVID-19 pandemic but had negative serology.30 subjects had rheumatic conditions but denied symptoms suggestive of COVID-19. 4 of the asymptomatic patients tested positive forCOVID-19 on serology. 23 stored serum samples, obtained before2019, were all negative for antibodies against SARS-CoV-2. In patientswith confirmed COVID-19, clinical features and serology werecompared in those with and without autoimmune disease. Logisticregression showed a significant impact of COVID-19 severity onantibody titres in people with and without autoimmune disease(p = 0.003 and <0.001 respectively). In both mild and severe disease, autoimmunity had no effect on antibody titres (p = 0.253 and 0.119respectively).ConclusionPeople with and without autoimmune disease presented with similarsymptoms of COVID-19. In our sample, subjects with autoimmunedisease were less likely to be hospitalised or require respiratorysupport. Serology revealed no difference in antibody titres againstSARS-CoV-2 in participants with and without autoimmune disease.