Differences in SARS ‐ CoV ‐2 Antigen Persistence in Individuals With Systemic Autoimmune Rheumatic Diseases Compared to the General Population: A RECOVER ‐Adult Cohort Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Individuals with systemic autoimmune rheumatic diseases (SARDs) are at risk for worse acute and post-acute COVID-19 outcomes, though whether individuals with SARDs have longer persistence of viral antigens after COVID-19 has not been studied. METHODS: This retrospective cohort study evaluated post-COVID-19 differences in SARS-CoV-2 antigen (spike, spike protein that contains the receptor-binding domain, and nucleocapsid) positivity between individuals with SARDs (COVID-19 and Rheumatic Diseases [RheumCARD]) and without SARDs (Researching COVID to Enhance Recovery [RECOVER]-Adult). SARS-CoV-2 antigens were measured in collected samples using a validated ultrasensitive single molecule array. This digital enzyme-linked immunosorbent assay used antibody-coated magnetic beads to capture antigen molecules, which were loaded into microwell arrays and detected through enzymatic cleavage of a fluorescent substrate. We used logistic regression to estimate unadjusted and adjusted (for age, sex, infection year, vaccination status, and COVID-19 treatment) odds ratios for SARS-CoV-2 antigen positivity at months 3 and 6 following COVID-19. RESULTS: Among 210 individuals with SARDs in RheumCARD and 348 individuals without SARDs in RECOVER-Adult, any SARS-CoV-2 antigen positivity was more common in those with SARDs (36.7% in RheumCARD vs 18.9% in RECOVER-Adult; P < 0.001). Those with SARDs had higher odds of nucleocapsid antigen positivity (adjusted odds ratio [aOR] 3.73, 95% confidence interval [CI] 1.28-10.85) or any antigen positivity (aOR 2.89, 95% CI 1.43-5.85) three months after COVID-19 infection and higher odds of nucleocapsid antigen positivity (aOR 6.62, 95% CI 1.09-40.30) six months after COVID-19 infection. CONCLUSION: Individuals with SARDs were more likely to have SARS-CoV-2 antigen positivity at months 3 and 6 following COVID-19 infection compared with individuals without SARDs, not explained by demographics, variant, vaccination, or treatment.
Source: Arthritis & Rheumatology
DOI: 10.1002/art.70205
Authors: Naomi J. Patel, Zoe Swank, Jiaqi Wang, Xiaosong Wang, Lauren A. O'Keeffe, Madison Negron, Liya S. Getachew, Louise L. Hansen, Grace Qian, Alene A. Saavedra, Kevin T. Mueller, Natalie A. Davis, Kathleen M. M. Vanni, Sandria Savage, Julie S. Lam, Zachary S. Wallace, David R. Walt, Jeffrey A. Sparks, RECOVER‐Adult
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,190
Awards: The Harvard Clinical and Translational Science Center, Immunologic and Clinical Sequelae after COVID-19 in Patients with Systemic Autoimmune Rheumatic Diseases, Joint Biology Consortium Resource-based Center, Rheumatoid Arthritis-associated Parenchymal Lung Disease: Clinical and Molecular Phenotypes, Rheumatoid Arthritis-Related Autoantibodies, Articular Inflammation, and RA-Associated Interstitial Lung Disease, VERITY: Value and Evidence in Rheumatology using bioInformaTics, and advanced analYtics
OpenAlex ID: W7157320000