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van Leeuwen LPM, Grobben M, GeurtsvanKessel CH, Ellerbroek PM, de Bree GJ, Potjewijd J, Rutgers A, Jolink H, van de Veerdonk FL, van Gils MJ, de Vries RD, Dalm VASH. Immunogenicity of COVID-19 booster vaccination in IEI patients and their one year clinical follow-up after start of the COVID-19 vaccination program. Front Immunol 2024; 15:1390022. [PMID: 38698851 PMCID: PMC11063285 DOI: 10.3389/fimmu.2024.1390022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/05/2024] [Indexed: 05/05/2024] Open
Abstract
Purpose Previous studies have demonstrated that the majority of patients with an inborn error of immunity (IEI) develop a spike (S)-specific IgG antibody and T-cell response after two doses of the mRNA-1273 COVID-19 vaccine, but little is known about the response to a booster vaccination. We studied the immune responses 8 weeks after booster vaccination with mRNA-based COVID-19 vaccines in 171 IEI patients. Moreover, we evaluated the clinical outcomes in these patients one year after the start of the Dutch COVID-19 vaccination campaign. Methods This study was embedded in a large prospective multicenter study investigating the immunogenicity of COVID-19 mRNA-based vaccines in IEI (VACOPID study). Blood samples were taken from 244 participants 8 weeks after booster vaccination. These participants included 171 IEI patients (X-linked agammaglobulinemia (XLA;N=11), combined immunodeficiency (CID;N=4), common variable immunodeficiency (CVID;N=45), isolated or undefined antibody deficiencies (N=108) and phagocyte defects (N=3)) and 73 controls. SARS-CoV-2-specific IgG titers, neutralizing antibodies, and T-cell responses were evaluated. One year after the start of the COVID-19 vaccination program, 334 study participants (239 IEI patients and 95 controls) completed a questionnaire to supplement their clinical data focusing on SARS-CoV-2 infections. Results After booster vaccination, S-specific IgG titers increased in all COVID-19 naive IEI cohorts and controls, when compared to titers at 6 months after the priming regimen. The fold-increases did not differ between controls and IEI cohorts. SARS-CoV-2-specific T-cell responses also increased equally in all cohorts after booster vaccination compared to 6 months after the priming regimen. Most SARS-CoV-2 infections during the study period occurred in the period when the Omicron variant had become dominant. The clinical course of these infections was mild, although IEI patients experienced more frequent fever and dyspnea compared to controls and their symptoms persisted longer. Conclusion Our study demonstrates that mRNA-based booster vaccination induces robust recall of memory B-cell and T-cell responses in most IEI patients. One-year clinical follow-up demonstrated that SARS-CoV-2 infections in IEI patients were mild. Given our results, we support booster campaigns with newer variant-specific COVID-19 booster vaccines to IEI patients with milder phenotypes.
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Affiliation(s)
- Leanne P. M. van Leeuwen
- Department of Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
- Travel Clinic, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Marloes Grobben
- Department of Medical Microbiology and Infection Prevention, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Pauline M. Ellerbroek
- Department of Internal Medicine, Infectious Diseases, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Judith Potjewijd
- Department of Internal Medicine, Division Clinical Immunology, Maastricht UMC, Maastricht, Netherlands
| | - Abraham Rutgers
- Department of Rheumatology and Clinical Immunology, UMC Groningen, Groningen, Netherlands
| | - Hetty Jolink
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
| | - Frank L. van de Veerdonk
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Nijmegen, Netherlands
| | - Marit J. van Gils
- Department of Medical Microbiology and Infection Prevention, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Rory D. de Vries
- Department of Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Virgil A. S. H. Dalm
- Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Immunology, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
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Lee CY, Kuo HW, Liu YL, Chuang JH, Chou JH. Population-Based Evaluation of Vaccine Effectiveness against SARS-CoV-2 Infection, Severe Illness, and Death, Taiwan. Emerg Infect Dis 2024; 30:478-489. [PMID: 38295401 PMCID: PMC10902541 DOI: 10.3201/eid3003.230893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Taiwan provided several COVID-19 vaccine platforms: mRNA (BNT162b2, mRNA-1273), adenoviral vector-based (AZD1222), and protein subunit (MVC-COV1901). After Taiwan shifted from its zero-COVID strategy in April 2022, population-based evaluation of vaccine effectiveness (VE) became possible. We conducted an observational cohort study of 21,416,151 persons to examine VE against SARS-CoV-2 infection, moderate and severe illness, and death during March 22, 2021-September 30, 2022. After adjusting for age and sex, we found that persons who completed 3 vaccine doses (2 primary, 1 booster) or received MVC-COV1901 as the primary series had the lowest hospitalization incidence (0.04-0.20 cases/100,000 person-days). We also found 95.8% VE against hospitalization for 3 doses of BNT162b2, 91.0% for MVC-COV1901, 81.8% for mRNA-1273, and 65.7% for AZD1222, which had the lowest overall VE. Our findings indicated that protein subunit vaccines provide similar protection against SARS-CoV-2---associated hospitalization as mRNA vaccines and can inform mix-and-match vaccine selection in other countries.
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Freund O, Harish A, Breslavsky A, Wand O, Zacks N, Bilenko N, Bar-Shai A. The humoral response to COVID-19 vaccinations can predict the booster effect on health care workers-toward personalized vaccinations? J Public Health (Oxf) 2024; 46:e78-e83. [PMID: 37872715 DOI: 10.1093/pubmed/fdad198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Waning immunity after the coronavirus disease 2019 (COVID-19) vaccinations creates the constant need of boosters. Predicting individual responses to booster vaccines can help in its timely administration. We hypothesized that the humoral response to the first two doses of the BNT162b2 vaccine can predict the response to the booster vaccine. METHODS A prospective cohort of hospital health care workers (HCW) that received three doses of the BNT162b2 vaccine. Participants completed serological tests at 1 and 6 months after the second vaccine dose and 1 month after the third. We analyzed predictive factors of antibody levels after the booster using multivariate regression analyses. RESULTS From 289 eligible HCW, 89 (31%) completed the follow-up. Mean age was 48 (±10) and 46 (52%) had daily interaction with patients. The mean (±standard deviation) antibody level 1 month after the second vaccine was 223 (±59) AU/ml, and 31 (35%) had a rapid antibody decline (>50%) in 6 months. Low antibody levels 1 month after the second vaccine and a rapid antibody decline were independent predictors of low antibody levels after the booster vaccine. CONCLUSIONS The characteristics of the humoral response to COVID-19 vaccinations show promise in predicting the humoral response to the booster vaccines.
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Affiliation(s)
- Ophir Freund
- The Institute of Pulmonary Medicine, Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alma Harish
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Anna Breslavsky
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ori Wand
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nadav Zacks
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Natalya Bilenko
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Medical Office of Southern District, Ministry of Health, Ashkelon, Israel
| | - Amir Bar-Shai
- The Institute of Pulmonary Medicine, Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Pulmonary Medicine, Barzilai Medical Center, Ashkelon, Israel
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Holdenrieder S, Dos Santos Ferreira CE, Izopet J, Theel ES, Wieser A. Clinical and laboratory considerations: determining an antibody-based composite correlate of risk for reinfection with SARS-CoV-2 or severe COVID-19. Front Public Health 2023; 11:1290402. [PMID: 38222091 PMCID: PMC10788057 DOI: 10.3389/fpubh.2023.1290402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/30/2023] [Indexed: 01/16/2024] Open
Abstract
Much of the global population now has some level of adaptive immunity to SARS-CoV-2 induced by exposure to the virus (natural infection), vaccination, or a combination of both (hybrid immunity). Key questions that subsequently arise relate to the duration and the level of protection an individual might expect based on their infection and vaccination history. A multi-component composite correlate of risk (CoR) could inform individuals and stakeholders about protection and aid decision making. This perspective evaluates the various elements that need to be accommodated in the development of an antibody-based composite CoR for reinfection with SARS-CoV-2 or development of severe COVID-19, including variation in exposure dose, transmission route, viral genetic variation, patient factors, and vaccination status. We provide an overview of antibody dynamics to aid exploration of the specifics of SARS-CoV-2 antibody testing. We further discuss anti-SARS-CoV-2 immunoassays, sample matrices, testing formats, frequency of sampling and the optimal time point for such sampling. While the development of a composite CoR is challenging, we provide our recommendations for each of these key areas and highlight areas that require further work to be undertaken.
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Affiliation(s)
- Stefan Holdenrieder
- Institute of Laboratory Medicine, German Heart Centre Munich, Technical University Munich, Munich, Germany
| | | | - Jacques Izopet
- Laboratory of Virology, Toulouse University Hospital and INFINITY Toulouse Institute for Infections and Inflammatory Diseases, INSERM UMR 1291 CNRS UMR 5051, University Toulouse III, Toulouse, France
| | - Elitza S. Theel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany
- German Centre for Infection Research (DZIF), Munich, Germany
- Faculty of Medicine, Max Von Pettenkofer Institute, LMU Munich, Munich, Germany
- Immunology, Infection and Pandemic Research, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Munich, Germany
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Agbarya A, Sarel I, Ziv-Baran T, Schwartz O, Shechtman Y, Kozlener E, Khoury R, Sheikh-Ahmad M, Saiegh L, Swaid F, Ahmad AA, Janzic U, Brenner R. Response Rate of the Third and Fourth Doses of the BNT162b2 Vaccine Administered to Cancer Patients Undergoing Active Anti-Neoplastic Treatments. Diseases 2023; 11:128. [PMID: 37873772 PMCID: PMC10594524 DOI: 10.3390/diseases11040128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/25/2023] Open
Abstract
The BNT162b2 vaccine is globally used for preventing morbidity and mortality related to COVID-19. Cancer patients have had priority for receiving the vaccine due to their diminished immunity. This study reports the response rate of administering the third and fourth vaccine doses to cancer patients receiving active anti-neoplastic treatment. A total of 142 patients received two doses of the mRNA-based BNT162b2 COVID-19 vaccine, while 76 and 25 patients received three and four doses, respectively. The efficacy of the humoral response following two vaccine doses was diminished in cancer patients, especially in the group of patients receiving chemotherapy. In a multivariate analysis, patients who received three and four BNT162b2 vaccine doses were more likely to have antibody titers in the upper tertile compared to patients who received two doses of the vaccine (odds ratio (OR) 7.62 (95% CI 1.38-42.12), p = 0.02 and 17.15 (95% CI 5.01-58.7), p < 0.01, respectively). Unlike the response after two doses, the third and fourth BNT162b2 vaccine booster doses had an increased efficacy of 95-100% in cancer patients while undergoing active treatment. This result could be explained by different mechanisms including the development of memory B cells.
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Affiliation(s)
- Abed Agbarya
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3109601, Israel
| | - Ina Sarel
- Edith Wolfson Medical Center, Oncology Institute, Holon 5822012, Israel;
| | - Tomer Ziv-Baran
- School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel;
| | - Orna Schwartz
- Microbiology and Immunology Laboratory, Edith Wolfson Medical Center, Holon 5822012, Israel;
| | - Yelena Shechtman
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Ella Kozlener
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Rasha Khoury
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Mohammad Sheikh-Ahmad
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Leonard Saiegh
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Forat Swaid
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Asala Abu Ahmad
- Bnai-Zion Medical Center, Oncology Institute, Haifa 3339419, Israel; (Y.S.); (E.K.); (R.K.); (M.S.-A.); (L.S.); (F.S.); (A.A.A.)
| | - Urska Janzic
- Department of Medical Oncology, University Clinic Golnik, 4202 Golnik, Slovenia;
| | - Ronen Brenner
- Edith Wolfson Medical Center, Oncology Institute, Holon 5822012, Israel;
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St. Germain R, Bossard EL, Corey L, Sholukh AM. Serum concentration of antigen-specific IgG can substantially bias interpretation of antibody-dependent phagocytosis assay readout. iScience 2023; 26:107527. [PMID: 37664583 PMCID: PMC10469534 DOI: 10.1016/j.isci.2023.107527] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 06/21/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Because virus neutralization cannot solely explain vaccine-induced, antibody-mediated protection, antibody effector functions are being considered as a potential correlate of protection (CoP). However, measuring effector functions at a fixed serum dilution for high throughput purposes makes it difficult to distinguish between the effect of serum antibody concentration and antibody properties such as epitopes, subclass, and glycosylation. To address this issue, we evaluated antibody-dependent cellular phagocytosis (ADCP) assay against SARS-CoV-2 spike. Adjustment of serum samples to the same concentration of antigen-specific IgG prior to the ADCP assay revealed concentration-independent differences in ADCP after mRNA vaccination in subjects with and without prior SARS-CoV-2 infection not detectable in assay performed with fixed serum dilution. Phagocytosis measured at different concentrations of spike-specific IgG strongly correlated with the area under the curve (AUC) indicating that ADCP assay can be performed at a standardized antibody concentration for the high throughput necessary for vaccine trial analyses.
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Affiliation(s)
- Russell St. Germain
- Vaccine and Infectious Diseases Division, Fred Hutch Cancer Research Center, Seattle, WA 98109, USA
| | - Emily L. Bossard
- Vaccine and Infectious Diseases Division, Fred Hutch Cancer Research Center, Seattle, WA 98109, USA
| | - Lawrence Corey
- Vaccine and Infectious Diseases Division, Fred Hutch Cancer Research Center, Seattle, WA 98109, USA
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA 98195, USA
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98195, USA
| | - Anton M. Sholukh
- Vaccine and Infectious Diseases Division, Fred Hutch Cancer Research Center, Seattle, WA 98109, USA
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Masson LC, Servian CDP, Jardim VH, Dos Anjos D, Dorta ML, Batalha-Carvalho JV, Moro AM, Romão PRT, Souza M, Fiaccadori FS, Fonseca SG. Heterologous Booster with BNT162b2 Induced High Specific Antibody Levels in CoronaVac Vaccinees. Vaccines (Basel) 2023; 11:1183. [PMID: 37514999 PMCID: PMC10383528 DOI: 10.3390/vaccines11071183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/21/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023] Open
Abstract
Immune responses after COVID-19 vaccination should be evaluated in different populations around the world. This study compared antibody responses induced by ChAdOx1 nCoV-19, CoronaVac, and BNT162b2 vaccines. Blood samples from vaccinees were collected pre- and post-vaccinations with the second and third doses. The study enrolled 78 vaccinees, of whom 62.8% were women, with the following median ages: 26 years-ChAdOx1 nCoV-19; 40 years-CoronaVac; 30 years-BNT162b2. Serum samples were quantified for anti-RBD IgG and anti-RBD IgA and anti-spike IgG by ELISA. After two vaccine doses, BNT162b2 vaccinees produced higher levels of anti-RBD IgA and IgG, and anti-spike IgG compared to ChAdOx1 nCoV-19 and CoronaVac vaccinees. The third dose booster with BNT162b2 induced higher levels of anti-RBD IgA and IgG, and anti-spike IgG in CoronaVac vaccinees. Individuals who reported a SARS-CoV-2 infection before or during the study had higher anti-RBD IgA and IgG production. In conclusion, two doses of the studied vaccines induced detectable levels of anti-RBD IgA and IgG and anti-spike IgG in vaccinees. The heterologous booster with BNT162b2 increased anti-RBD IgA and IgG and anti-spike IgG levels in CoronaVac vaccinees and anti-RBD IgA levels in ChAdOx1 nCoV-19 vaccinees. Furthermore, SARS-CoV-2 infection induced higher anti-RBD IgA and IgG levels in CoronaVac vaccinees.
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Affiliation(s)
- Letícia Carrijo Masson
- Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia 74605-050, GO, Brazil
| | - Carolina do Prado Servian
- Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia 74605-050, GO, Brazil
| | - Vitor Hugo Jardim
- Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia 74605-050, GO, Brazil
| | - Déborah Dos Anjos
- Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia 74605-050, GO, Brazil
| | - Miriam Leandro Dorta
- Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia 74605-050, GO, Brazil
| | | | - Ana Maria Moro
- Laboratório de Biofármacos, Instituto Butantan, São Paulo 05503-900, SP, Brazil
- Instituto de Investigação em Imunologia, Instituto Nacional de Ciência e Tecnologia (iii-INCT), Goiânia 74605-050, GO, Brazil
| | - Pedro Roosevelt Torres Romão
- Laboratório de Imunologia Celular e Molecular, Programa de Pós-Graduação em Ciências da Saúde, Programa de Pós-Graduação em Biociências, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90050-170, RS, Brazil
| | - Menira Souza
- Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia 74605-050, GO, Brazil
| | - Fabiola Souza Fiaccadori
- Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia 74605-050, GO, Brazil
| | - Simone Gonçalves Fonseca
- Departamento de Biociências e Tecnologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia 74605-050, GO, Brazil
- Instituto de Investigação em Imunologia, Instituto Nacional de Ciência e Tecnologia (iii-INCT), Goiânia 74605-050, GO, Brazil
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Cianci R, Franza L, Pignataro G, Massaro MG, Rio P, Tota A, Ocarino F, Sacco Fernandez M, Franceschi F, Gasbarrini A, Gambassi G, Candelli M. Effect of COVID-19 Vaccination on the In-Hospital Prognosis of Patients Admitted during Delta and Omicron Waves in Italy. Vaccines (Basel) 2023; 11:vaccines11020373. [PMID: 36851251 PMCID: PMC9965237 DOI: 10.3390/vaccines11020373] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/31/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
All-cause mortality related to the SARS-CoV-2 infection has declined from the first wave to subsequent waves, probably through vaccination programs and the availability of effective antiviral therapies. Our study aimed to evaluate the impact of the SARS-CoV-2 vaccination on the prognosis of infected patients. Overall, we enrolled 545 subjects during the Delta variant wave and 276 ones during the Omicron variant wave. Data were collected concerning vaccination status, clinical parameters, comorbidities, lung involvement, laboratory parameters, and pharmacological treatment. Outcomes were admission to the intensive care unit (ICU) and 30-day all-cause mortality. Overall, the final sample included 821 patients with a mean age of 62 ± 18 years [range 18-100], and 59% were men. Vaccinated patients during the Delta wave were 37% (over ¾ with two doses), while during the Omicron wave they were 57%. Vaccinated patients were older (68 vs. 57 years), and 62% had at least one comorbidity Admission to the ICU was 20%, and the mortality rate at 30 days was 14%. ICU admissions were significantly higher during the Delta wave than during Omicron (OR 1.9, 95% CI 1.2-3.1), while all-cause mortality did not differ. Unvaccinated patients had a higher risk of ICU admission (OR 2.0, 95% CI 1.3-3.1) and 30-day all-cause mortality (OR 1.7, 95% CI 1.3-2.7). Results were consistent for both Delta and Omicron variants. Overall, vaccination with at least two doses was associated with a reduced need for ICU admission. Even one shot of the vaccine was associated with a significantly reduced 30-day mortality.
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Affiliation(s)
- Rossella Cianci
- Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Laura Franza
- Emergency Medicine Unit, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
- Correspondence:
| | - Giulia Pignataro
- Emergency Medicine Unit, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Maria Grazia Massaro
- Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Pierluigi Rio
- Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Antonio Tota
- Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Francesca Ocarino
- Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Marta Sacco Fernandez
- Emergency Medicine Unit, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Francesco Franceschi
- Emergency Medicine Unit, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Giovanni Gambassi
- Department of Translational Medicine and Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Marcello Candelli
- Emergency Medicine Unit, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
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9
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Aaron Nathan Barksdale, Wood MG, Branecki CE, Zimmerman B, Lyden E, Nguyen TT, Hatfield A, Koepsell S, Langenfeld J, Zeger WG, Wadman MC. Incidence of unknown COVID-19 infection in a cohort of emergency physicians and advance practice providers. Am J Emerg Med 2023; 64:155-160. [PMID: 36563499 PMCID: PMC9749378 DOI: 10.1016/j.ajem.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION In United States, health care workers have been immersed in the COVID-19 pandemic since February 2020. Since availability of COVID-19 vaccines, there is limited literature investigating the incidence of unknown COVID-19 infections in physicians and Advanced Practitioner Providers (APPs) working in emergency departments (EDs). The primary objective is to determine the incidence unknown COVID-19 infection within a cohort of emergency physicians (EPs) and APPs. METHODS Prospective observational study at a tertiary academic center with emergency medicine residency and 64,000 annual ED visits. EPs/APPs providing care to ED patients over the prior 12 months were eligible. Serum samples were collected between May 1 and June 30, 2022. Analysis utilized Luminex xMAP® SARS-CoV-2 Multi-Antigen IgG Assay for antibodies to Nucleocapsid, Receptor-binding domain, and Spike subunit 1. Mean Fluorescent Intensity (MFI) ≥ 700 was considered positive. Subjects completed 12 question survey assessing demographics and previously confirmed COVID-19 infection. Fisher's exact test evaluated associations of demographics and clinical characteristics with confirmed COVID-19 status. Analyses performed using SAS, Version 9.4. P < 0.05 considered statistically significant. RESULTS Sixty-nine of 81 eligible subjects (85.2%) participated, 58.0% were male, 97.1% white, with mean age of 37. Eighteen subjects had MFI ≥ 700 strongly suggestive of prior infection, with 17.7% unknown. No statistically significant difference between age, gender, race, children in home, or household member with previously COVID-19 infection. CONCLUSION Unknown previous COVID-19 infection was less then expected in this cohort of EPs/APPs, and no association with individual characteristics, previously infected household member, or children in the home.
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Affiliation(s)
- Aaron Nathan Barksdale
- Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America,Corresponding author at: 981150 Nebraska Medical Center, Omaha, NE 68198-1150, United States of America
| | - Macy G. Wood
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Chad E. Branecki
- Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Brooklin Zimmerman
- Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Elizabeth Lyden
- Research Design and Analysis, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Thang T. Nguyen
- Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Andrew Hatfield
- Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Scott Koepsell
- Clinical Operations, Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Jason Langenfeld
- Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Wesley G. Zeger
- Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Michael C. Wadman
- Department of Emergency Medicine, University of Nebraska Medical Center, Omaha, NE, United States of America
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Kotsiou OS, Karakousis N, Papagiannis D, Matsiatsiou E, Avgeri D, Fradelos EC, Siachpazidou DI, Perlepe G, Miziou A, Kyritsis A, Gogou E, Vavougios GD, Kalantzis G, Gourgoulianis KI. The Comparative Superiority of SARS-CoV-2 Antibody Response in Different Immunization Scenarios. J Pers Med 2022; 12:jpm12111756. [PMID: 36573718 PMCID: PMC9698429 DOI: 10.3390/jpm12111756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 12/30/2022] Open
Abstract
Background: Both SARS-CoV-2 infection and/or vaccination result in the production of SARS-CoV-2 antibodies. We aimed to compare the antibody titers against SARS-CoV-2 in different scenarios for antibody production. Methods: A surveillance program was conducted in the municipality of Deskati in January 2022. Antibody titers were obtained from 145 participants while parallel recording their infection and/or vaccination history. The SARS-CoV-2 IgG II Quant method (Architect, Abbott, IL, USA) was used for antibody testing. Results: Advanced age (>56 years old) was associated with higher antibody titers. No significant differences were detected in antibody titers among genders, BMI, smoking status, comorbidities, vaccine brands, and months after the last dose. Hospitalization length and re-infection were predictors of antibody titers. The individuals who were fully or partially vaccinated and were also double infected had the highest antibody levels (25,017 ± 1500 AU/mL), followed by people who were fully vaccinated (20,647 ± 500 AU/mL) or/partially (15,808 ± 1800 AU/mL) vaccinated and were infected once. People who were only vaccinated had lower levels of antibodies (9946 ± 300 AU/mL), while the lowest levels among all groups were found in individuals who had only been infected (1124 ± 200 AU/mL). Conclusions: Every hit (infection or vaccination) gives an additional boost to immunization status.
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Affiliation(s)
- Ourania S. Kotsiou
- Faculty of Nursing, School of Health Sciences, University of Thessaly, GAIOPOLIS, 41110 Larissa, Greece
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110 Larissa, Greece
- Correspondence: or
| | - Nikolaos Karakousis
- Primary Healthcare, Internal Medicine Department, Amarousion, 15125 Athens, Greece
| | - Dimitrios Papagiannis
- Public Health & Vaccines Lab, Department of Nursing, School of Health Sciences, University of Thessaly, GAIOPOLIS, 41110 Larissa, Greece
| | - Elena Matsiatsiou
- Faculty of Nursing, School of Health Sciences, University of Thessaly, GAIOPOLIS, 41110 Larissa, Greece
| | - Dimitra Avgeri
- Faculty of Nursing, School of Health Sciences, University of Thessaly, GAIOPOLIS, 41110 Larissa, Greece
| | - Evangelos C. Fradelos
- Faculty of Nursing, School of Health Sciences, University of Thessaly, GAIOPOLIS, 41110 Larissa, Greece
| | - Dimitra I. Siachpazidou
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110 Larissa, Greece
| | - Garifallia Perlepe
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110 Larissa, Greece
| | - Angeliki Miziou
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110 Larissa, Greece
| | - Athanasios Kyritsis
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110 Larissa, Greece
| | - Eudoxia Gogou
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110 Larissa, Greece
| | - George D. Vavougios
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110 Larissa, Greece
| | - George Kalantzis
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110 Larissa, Greece
| | - Konstantinos I. Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110 Larissa, Greece
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