We read with great interest the article published by D’Silva et al.1 The authors reported three patients with inadequate antibody response to SARS-CoV-2 infection, two of whom received rituximab (RTX). Presence of antispike or antinucleocapsid IgG antibodies is strongly associated with reduced reinfection rates following the COVID-19.2 RTX is an anti-CD 20 monoclonal antibody that depletes B cells. Both T cell-dependent and T cell-independent immune responses against various infections agents are drastically reduced up to 6 months following RTX infusion.3 4 Here we report the antibody response to SARS-CoV-2 infection in five patients with autoimmune rheumatic disease on RTX therapy.

In our centre 224 patients with autoimmune rheumatic diseases had RT-PCR proven COVID-19 infection between March 2020 and December 2020. Of these, five patients had received RTX therapy within 18 …