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Günther F, Einhauser S, Peterhoff D, Wiegrebe S, Niller HH, Beileke S, Steininger P, Burkhardt R, Küchenhoff H, Gefeller O, Überla K, Heid IM, Wagner R. Higher Infection Risk among Health Care Workers and Lower Risk among Smokers Persistent across SARS-CoV-2 Waves-Longitudinal Results from the Population-Based TiKoCo Seroprevalence Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16996. [PMID: 36554876 PMCID: PMC9779618 DOI: 10.3390/ijerph192416996] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
SARS-CoV-2 seroprevalence was reported as substantially increased in medical personnel and decreased in smokers after the first wave in spring 2020, including in our population-based Tirschenreuth Study (TiKoCo). However, it is unclear whether these associations were limited to the early pandemic and whether the decrease in smokers was due to reduced infection or antibody response. We evaluated the association of occupation and smoking with period-specific seropositivity: for the first wave until July 2020 (baseline, BL), the low infection period in summer (follow-up 1, FU1, November 2020), and the second/third wave (FU2, April 2021). We measured binding antibodies directed to SARS-CoV-2 nucleoprotein (N), viral spike protein (S), and neutralizing antibodies at BL, FU1, and FU2. Previous infection, vaccination, smoking, and occupation were assessed by questionnaires. The 4181 participants (3513/3374 at FU1/FU2) included 6.5% medical personnel and 20.4% current smokers. At all three timepoints, new seropositivity was higher in medical personnel with ORs = 1.99 (95%-CI = 1.36-2.93), 1.41 (0.29-6.80), and 3.17 (1.92-5.24) at BL, FU1, and FU2, respectively, and nearly halved among current smokers with ORs = 0.47 (95%-CI = 0.33-0.66), 0.40 (0.09-1.81), and 0.56 (0.33-0.94). Current smokers compared to never-smokers had similar antibody levels after infection or vaccination and reduced odds of a positive SARS-CoV-2 result among tested. Our data suggest that decreased seroprevalence among smokers results from fewer infections rather than reduced antibody response. The persistently higher infection risk of medical staff across infection waves, despite improved means of protection over time, underscores the burden for health care personnel.
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Affiliation(s)
- Felix Günther
- Department of Mathematics, Stockholm University, Albanovägen 28, 11419 Stockholm, Sweden
| | - Sebastian Einhauser
- Institute of Medical Microbiology and Hygiene, Molecular Microbiology (Virology), University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - David Peterhoff
- Institute of Medical Microbiology and Hygiene, Molecular Microbiology (Virology), University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Simon Wiegrebe
- Department of Genetic Epidemiology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Geschwister-Scholl-Platz 1, 80539 Munich, Germany
| | - Hans Helmut Niller
- Institute of Medical Microbiology and Hygiene, Molecular Microbiology (Virology), University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Stephanie Beileke
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schlossgarten 4, 91054 Erlangen, Germany
| | - Philipp Steininger
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schlossgarten 4, 91054 Erlangen, Germany
| | - Ralph Burkhardt
- Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Helmut Küchenhoff
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Geschwister-Scholl-Platz 1, 80539 Munich, Germany
| | - Olaf Gefeller
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Waldstr. 6, 91054 Erlangen, Germany
| | - Klaus Überla
- Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schlossgarten 4, 91054 Erlangen, Germany
| | - Iris M. Heid
- Department of Genetic Epidemiology, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Ralf Wagner
- Institute of Medical Microbiology and Hygiene, Molecular Microbiology (Virology), University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
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Pani A, Romandini A, Schianchi A, Senatore M, Gagliardi OM, Gazzaniga G, Agliardi S, Conti T, Schenardi PA, Maggi M, D'Onghia S, Panetta V, Renica S, Molteni SN, Vismara C, Campisi D, Bertuzzi M, Giroldi S, Zoppini L, Moreno M, Merli M, Bosio M, Puoti M, Scaglione F. Antibody Response to COVID-19 Booster Vaccination in Healthcare Workers. Front Immunol 2022; 13:872667. [PMID: 35720366 PMCID: PMC9205631 DOI: 10.3389/fimmu.2022.872667] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/21/2022] [Indexed: 11/20/2022] Open
Abstract
Objective To evaluate the mean increase of anti-S IgG antibody titer between the basal, pre-booster level to the titer assessed 14 days after the booster dose of BNT162b2. Patients and Methods The RENAISSANCE study is an observational, longitudinal, prospective, population-based study, conducted on healthcare workers of Niguarda Hospital in Milan, Italy who received a BNT162b2 booster dose at least 180 days after their second dose or after positivity for SARS-CoV-2 and accepted to take part in the study. The RENAISSANCE study was conducted from January 1, 2021 through December 28, 2021. Findings 1,738 subjects were enrolled among healthcare workers registered for the booster administration at our hospital. Overall, 0.4% of subjects were seronegative at the pre-booster evaluation, and 1 subject had a titer equal to 50 AU/ml: none of the evaluated subjects was seronegative after the booster dose. Thus, the efficacy of the booster in our population was universal. Mean increase of pre- to post-booster titer was more significant in subjects who never had SARS-CoV-2 (44 times CI 95% 42-46) compared to those who had it, before (33 times, CI 95% 13-70) or after the first vaccination cycle (12 times, CI 95% 11-14). Differently from sex, age and pre-booster titers affected the post-booster antibody response. Nevertheless, the post-booster titer was very similar in all subgroups, and independent of a prior exposure to SARS-CoV-2, pre-booster titer, sex or age. Conclusion Our study shows a potent universal antibody response of the booster dose of BNT162b2, regardless of pre-booster vaccine seronegativity.
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Affiliation(s)
- Arianna Pani
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy
| | - Alessandra Romandini
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy
| | - Alice Schianchi
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy
| | - Michele Senatore
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy.,Chemical-Clinical Analysis Unit, Laboratory Medicine Department, Niguarda Hospital, Milan, Italy
| | - Oscar M Gagliardi
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy
| | - Gianluca Gazzaniga
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy
| | - Stefano Agliardi
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy
| | - Tommaso Conti
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy
| | - Paolo A Schenardi
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy
| | - Matteo Maggi
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy
| | - Stefano D'Onghia
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy
| | - Valentina Panetta
- Biostatistics Office, L'altrastatistica srl - Consultancy & Training, Rome, Italy
| | - Silvia Renica
- Microbiology Unit, Laboratory Medicine Department, Niguarda Hospital, Milan, Italy
| | | | - Chiara Vismara
- Microbiology Unit, Laboratory Medicine Department, Niguarda Hospital, Milan, Italy
| | - Daniela Campisi
- Microbiology Unit, Laboratory Medicine Department, Niguarda Hospital, Milan, Italy
| | - Michaela Bertuzzi
- Quality & Risk Control in Data Management, Azienda Socio Sanitaria Territoriale (ASST) Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Simona Giroldi
- Socio-sanitary Direction, Azienda Socio Sanitaria Territoriale (ASST) Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Laura Zoppini
- Socio-sanitary Direction, Azienda Socio Sanitaria Territoriale (ASST) Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Mauro Moreno
- Healthcare Management Department, Azienda Socio Sanitaria Territoriale (ASST) Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Merli
- Infectious Diseases Unit, Azienda Socio Sanitaria Territoriale (ASST) Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Bosio
- Healthcare Management Department, Azienda Socio Sanitaria Territoriale (ASST) Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Massimo Puoti
- Infectious Diseases Unit, Azienda Socio Sanitaria Territoriale (ASST) Grande Ospedale Metropolitano Niguarda, Milan, Italy.,School of Medicine and Surgery, Università degli Studi di Milano Bicocca, Milan, Italy
| | - Francesco Scaglione
- Oncology and Hemato-Oncology Department, Università degli Studi di Milano, Milan, Italy.,Chemical-Clinical Analysis Unit, Laboratory Medicine Department, Niguarda Hospital, Milan, Italy
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Ferrara P, Gianfredi V, Tomaselli V, Polosa R. The Effect of Smoking on Humoral Response to COVID-19 Vaccines: A Systematic Review of Epidemiological Studies. Vaccines (Basel) 2022; 10:303. [PMID: 35214761 PMCID: PMC8880575 DOI: 10.3390/vaccines10020303] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/10/2022] [Accepted: 02/14/2022] [Indexed: 02/06/2023] Open
Abstract
While the role of active smoking on response to vaccines is yet to be fully understood, some real-world studies have outlined a possible link between smoking and humoral response to COVID-19 vaccines. Thus, the present rapid systematic review aimed at summarizing the current epidemiological evidence on this association. Following PRISMA and WHO guidelines on rapid systematic reviews, we systematically reviewed published literature on this topic and discussed the findings according to the aim of analysing smoking and its impact on humoral response to COVID-19 postvaccination antibody titres. The search strategy yielded a total of 23 articles. The sample size amongst the studies ranged between 74 and 3475 participants (median, 360), with the proportion of smokers being between 4.2% and 40.8% (median, 26.0%). The studies included in this review analysis investigated the dynamics of antibody response to different type of COVID-19 vaccines. In 17 out of 23 studies, current smokers showed much lower antibody titres or more rapid lowering of the vaccine-induced IgG compared with nonsmokers. This rapid systematic review indicates that active smoking negatively impacts humoral response to COVID-19 vaccines, although the pathophysiologic mechanisms for this association have not been entirely suggested. The results advocate targeted policies to promote tailored health promotion initiatives, which can increase risk perception and ensure appropriate protection measures to be taken to avoid the health consequences of COVID-19 in smokers.
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Affiliation(s)
- Pietro Ferrara
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- Center for Public Health Research, University of Milan, Bicocca, 20900 Monza, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
- CAPHRI Care and Public Health Research Institute, Maastricht University, 6211 LK Maastricht, The Netherlands
| | - Venera Tomaselli
- Department of Political and Social Sciences, University of Catania, 95131 Catania, Italy;
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, 95131 Catania, Italy;
| | - Riccardo Polosa
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, 95131 Catania, Italy;
- Department of Clinical and Experimental Medicine, University of Catania, 95131 Catania, Italy
- Institute of Internal Medicine, AOU “Policlinico-V. Emanuele”, 95131 Catania, Italy
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Beard K, Sriwastava S. Insight in booster COVID-19 vaccine and disease modifying therapy in multiple sclerosis. J Neurol Sci 2021; 430:120034. [PMID: 34688988 PMCID: PMC8523307 DOI: 10.1016/j.jns.2021.120034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/07/2021] [Accepted: 10/15/2021] [Indexed: 01/04/2023]
Affiliation(s)
- Katherine Beard
- School of Medicine, West Virginia University, United States of America,Department of Neurology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America
| | - Shitiz Sriwastava
- School of Medicine, West Virginia University, United States of America,Department of Neurology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States of America,West Virginia Clinical and Translational Science Institute, United States of America,Corresponding author at: Department of Neurology, Rockefeller Neuroscience Institute, West Virginia University School of Medicine, Morgantown, WV 26506, United States of America
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Estimates and Determinants of SARS-Cov-2 Seroprevalence and Infection Fatality Ratio Using Latent Class Analysis: The Population-Based Tirschenreuth Study in the Hardest-Hit German County in Spring 2020. Viruses 2021; 13:v13061118. [PMID: 34200766 PMCID: PMC8230374 DOI: 10.3390/v13061118] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 02/08/2023] Open
Abstract
SARS-CoV-2 infection fatality ratios (IFR) remain controversially discussed with implications for political measures. The German county of Tirschenreuth suffered a severe SARS-CoV-2 outbreak in spring 2020, with particularly high case fatality ratio (CFR). To estimate seroprevalence, underreported infections, and IFR for the Tirschenreuth population aged ≥14 years in June/July 2020, we conducted a population-based study including home visits for the elderly, and analyzed 4203 participants for SARS-CoV-2 antibodies via three antibody tests. Latent class analysis yielded 8.6% standardized county-wide seroprevalence, a factor of underreported infections of 5.0, and 2.5% overall IFR. Seroprevalence was two-fold higher among medical workers and one third among current smokers with similar proportions of registered infections. While seroprevalence did not show an age-trend, the factor of underreported infections was 12.2 in the young versus 1.7 for ≥85-year-old. Age-specific IFRs were <0.5% below 60 years of age, 1.0% for age 60–69, and 13.2% for age 70+. Senior care homes accounted for 45% of COVID-19-related deaths, reflected by an IFR of 7.5% among individuals aged 70+ and an overall IFR of 1.4% when excluding senior care home residents from our computation. Our data underscore senior care home infections as key determinant of IFR additionally to age, insufficient targeted testing in the young, and the need for further investigations on behavioral or molecular causes of the fewer infections among current smokers.
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Petráš M, Oleár V, Molitorisová M, Dáňová J, Čelko AM, Nováková E, Štefkovičová M, Krištúfková Z, Malinová J, Králová Lesná I. Factors Influencing Persistence of Diphtheria Immunity and Immune Response to a Booster Dose in Healthy Slovak Adults. Vaccines (Basel) 2019; 7:vaccines7040139. [PMID: 31591336 PMCID: PMC6963617 DOI: 10.3390/vaccines7040139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 09/20/2019] [Accepted: 10/01/2019] [Indexed: 11/19/2022] Open
Abstract
We assessed the long-term persistence of humoral immunity against diphtheria in adults with childhood vaccination and the immunogenicity of a booster dose considering demographic, behavioural and vaccinating factors. We conducted a trial in 200 healthy Slovak adults aged 24–65 years, immunised against diphtheria in childhood and against tetanus at regular 10–15 year intervals, and receiving a dose of a tetanus-diphtheria toxoid vaccine. The response was determined by ELISA antibody concentrations of paired sera before and at 4 weeks post-vaccination. A seroprotection rate of 21% (95% confidence interval, CI 15.6–27.3%) was found in adults up to 59 years since the last vaccination with seroprotective levels of antibodies against diphtheria ≥0.1 IU/mL and a geometric mean concentration of 0.05 IU/mL. Conversely, seropositive levels ≥0.01 IU/mL were observed in 98% of adults (95% CI 95–99.5%). Booster-induced seroprotection was achieved in 78% of adults (95% CI 71.6–83.5%) clearly depending on pre-booster antibody levels correlating with age and time since the last vaccination. Moreover, only 54.2% of smokers and 53.3% of patients on statins exhibited seroprotection. Booster vaccination against diphtheria was unable to confer seroprotection in all recipients of only childhood vaccination.
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Affiliation(s)
- Marek Petráš
- Preventive Medicine, Third Faculty of Medicine, Charles University in Prague, 100 00 Prague, Czech Republic; (J.D.); (A.M.Č.)
- Correspondence: ; Tel.: +420-774-738-727
| | - Vladimir Oleár
- Faculty of Healthcare, Alexander Dubček University of Trenčín, 911 50 Trenčín, Slovakia; (V.O.); (M.Š.)
| | - Milica Molitorisová
- Faculty of Pharmacy, Comenius University in Bratislava, 832 32 Bratislava, Slovakia;
| | - Jana Dáňová
- Preventive Medicine, Third Faculty of Medicine, Charles University in Prague, 100 00 Prague, Czech Republic; (J.D.); (A.M.Č.)
| | - Alexander M. Čelko
- Preventive Medicine, Third Faculty of Medicine, Charles University in Prague, 100 00 Prague, Czech Republic; (J.D.); (A.M.Č.)
| | - Elena Nováková
- Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 036 01 Martin, Slovakia;
| | - Mária Štefkovičová
- Faculty of Healthcare, Alexander Dubček University of Trenčín, 911 50 Trenčín, Slovakia; (V.O.); (M.Š.)
| | - Zuzana Krištúfková
- Faculty of Public Health, Slovak Medical University in Bratislava, 831 01 Bratislava, Slovakia;
| | - Jana Malinová
- Preventive Medicine, Third Faculty of Medicine, Charles University in Prague, 100 00 Prague, Czech Republic; (J.D.); (A.M.Č.)
| | - Ivana Králová Lesná
- Laboratory for Atherosclerosis Research, Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, 140 21 Prague, Czech Republic;
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