Investigation of the SARS-CoV-2 induced immune responses in rheumatoid arthritis and healthcare workers
Németh Dóra
Molecular Medicine Division
Dr. Várnai Péter
Országos Reumatológiai és Fizioterápiás Intézet Közösségi Központ, konferenciaterem
2026-11-13 09:00:00
Human molecular genetics and genetic diagnostics
Dr. Wiener Zoltán
Dr. Nagy György
Dr. Kiszel Petra
Dr. Kardos Zsófia
Dr. Vásárhelyi Barna
Dr. Nagy Eszter
Dr. Balog Attila
COVID-19 shows marked clinical heterogeneity driven by host-related factors, highlighting autoimmune patients and healthcare workers (HCWs) as key populations for immune studies. This study evaluated SARS-CoV-2-specific humoral and cell-mediated immune responses, along with their host-, and therapy-associated determinants, in rheumatoid arthritis (RA) patients, healthy control subjects and HCWs after SARS-CoV-2 infection and COVID-19 immunisation.
RA patients exhibited reduced anti-S antibody levels and SARS-CoV-2-specific T-cell responses compared with healthy individuals, with diminished immunity associated with older age, longer time since COVID-19 vaccination or SARS-CoV-2 infection and immunosuppressive therapies. TNF-α inhibitors and IL-6 inhibitor primarily reduced humoral immunity, while anti-CD20 therapy impaired both humoral and cellular responses, whereas methotrexate and low-dose glucocorticoid therapy showed no consistent independent effect. In HCWs, mRNA-based COVID-19 vaccination was safe and highly immunogenic; prior SARS-CoV-2 infection markedly enhanced antibody responses and booster vaccination increased antibody levels and was associated with milder disease despite limited protection against Omicron infection. Longitudinal analyses revealed that humoral immune responses in RA patients increased over time, whereas SARS-CoV-2-specific T-cell response remained relatively stable. In parallel, the co-circulation of multiple SARS-CoV-2 variants, potentially associated with attenuated clinical manifestations, may have contributed to the comparatively low incidence of severe COVID-19 in the general population.
In summary, this thesis suggests that SARS-CoV-2-specific immune responses in RA are influenced by host-related factors, prior infection, vaccination and immunosuppressive therapy and may remain adaptable over time despite evidence of impairment. When considered alongside data from HCWs, these findings are consistent with the safety and effectiveness of mRNA COVID-19 vaccination and highlight the potential value of individualized, risk-adapted vaccination strategies in these subgroups.
