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Villars H, Balardy L, Ghisolfi A, Blain H, Rolland Y. "Geriatric Team Health Care Pathways": An Organizational Innovation to Enhance Care Pathways of Long-Term Care Facilities' Residents in the French Region of Occitania. J Am Med Dir Assoc 2024; 25:104976. [PMID: 38583486 DOI: 10.1016/j.jamda.2024.02.014] [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: 12/03/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 04/09/2024]
Abstract
Born out of the COVID crisis, an innovative disposal called "Geriatric Team Healthcare Pathways" (GTHPs) has been implemented in the Occitania area in the south of France. GTHPs can be considered as geriatric "hotlines" providing expertise and knowledge to long-term care facility (LTCF) professionals, pursuing the general objective to promote a simplified, direct, and fair access to geriatric care for residents. This article highlights the history of their creation and their current use cases and operating modes for the year 2023, which includes a "quality of care approach" on good practices at a regional level (820 LTCFs), on topics such as the prevention of malnutrition and falls.
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Affiliation(s)
- Hélène Villars
- Geriatric Department Gerontopole Toulouse University Hospital, France-Hopital La Grave, Cité de la Santé Place Lange, Toulouse, France.
| | - Laurent Balardy
- Geriatric Department Gerontopole Toulouse University Hospital, France-Hopital La Grave, Cité de la Santé Place Lange, Toulouse, France
| | - Anne Ghisolfi
- Geriatric Department Gerontopole Toulouse University Hospital, France-Hopital La Grave, Cité de la Santé Place Lange, Toulouse, France
| | - Hubert Blain
- Geriatric Department Pôle de Gérontologie du CHU de Montpellier, Centre Antonin Balmes, Université de Montpellier, Montpellier, France
| | - Yves Rolland
- Geriatric Department Gerontopole Toulouse University Hospital, France-Hopital La Grave, Cité de la Santé Place Lange, Toulouse, France
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2
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Capelli N, Domitien Payet L, Alcocer Cordellat C, Pisoni A, Engelmann I, Van de Perre P, Jeziorski E, Tuaillon E. SARS-CoV-2 nucleocapsid antigen in plasma of children hospitalized for COVID-19 or with incidental detection of SARS-CoV-2 infection. J Med Virol 2024; 96:e29358. [PMID: 38180230 DOI: 10.1002/jmv.29358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/23/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
In hospitalized children, SARS-CoV-2 infection can present as either a primary reason for admission (patients admitted for COVID-19) or an incidental finding during follow-up (patients admitted with COVID-19). We conducted a nested case-control study within a cohort of pediatric patients with confirmed SARS-CoV-2 infection, to investigate the concentration of plasma nucleocapsid antigen (N-Ag) in children admitted for COVID-19 or with COVID-19. While reverse transcriptase polymerase chain reaction Ct values in nasopharyngeal swab were similar between the two groups, children admitted for COVID-19 had a higher rate of detectable N-Ag (12/18 (60.7%) versus 6/18 (33.3%), p = 0.0455) and a higher concentration of N-Ag (medians: 19.51 g/mL vs. 1.08 pg/mL, p = 0.0105). In children hospitalized for COVID-19, the youngest had higher concentration of N-Ag (r = -0.74, p = 0.0004). We also observed a lower prevalence of detectable spike antibodies in children hospitalized for COVID-19 compared to those hospitalized for other medical reasons (3/15 [20%] vs. 13/16 [81.25%], respectively, p = < 0.0011), but similar rates of IgG nucleocapsid antibodies (5/14 [35.7%] vs. 6/17 [35.3%], respectively, p = 0.99). Our findings indicate that N-Ag is associated with COVID-19-related hospitalizations in pediatric patients, and less frequently detected in children tested positive for SARS-CoV-2 but hospitalized for another medical reason. Further studies are needed to confirm the value of N-Ag in identifying COVID-19 disease infections in which SARS-CoV-2 is the main pathogen responsible for symptoms.
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Affiliation(s)
- Nicolas Capelli
- Pathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, Établissement Français du Sang, Montpellier, France
- Department of Virology, Montpellier University Hospital, Montpellier, France
| | - Léa Domitien Payet
- Pathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, Établissement Français du Sang, Montpellier, France
- Department of Virology, Montpellier University Hospital, Montpellier, France
| | - Carmen Alcocer Cordellat
- Pathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, Établissement Français du Sang, Montpellier, France
- Department of Virology, Montpellier University Hospital, Montpellier, France
| | - Amandine Pisoni
- Pathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, Établissement Français du Sang, Montpellier, France
- Department of Virology, Montpellier University Hospital, Montpellier, France
| | - Ilka Engelmann
- Pathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, Établissement Français du Sang, Montpellier, France
- Department of Virology, Montpellier University Hospital, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, Établissement Français du Sang, Montpellier, France
- Department of Virology, Montpellier University Hospital, Montpellier, France
| | - Eric Jeziorski
- Pathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, Établissement Français du Sang, Montpellier, France
- Department of General Pediatrics, Infectiology and Clinical Immunology, CEREMIA, Montpellier University Hospital, Montpellier, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic and Emerging Infections, Montpellier University, INSERM, Établissement Français du Sang, Montpellier, France
- Department of Virology, Montpellier University Hospital, Montpellier, France
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3
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Hartley GE, Edwards ESJ, O’Hehir RE, van Zelm MC. New insights into human immune memory from SARS-CoV-2 infection and vaccination. Allergy 2022; 77:3553-3566. [PMID: 36048132 PMCID: PMC9538469 DOI: 10.1111/all.15502] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/13/2022] [Accepted: 08/29/2022] [Indexed: 01/28/2023]
Abstract
Since early 2020, the world has been embroiled in an ongoing viral pandemic with SARS-CoV-2 and emerging variants resulting in mass morbidity and an estimated 6 million deaths globally. The scientific community pivoted rapidly, providing unique and innovative means to identify infected individuals, technologies to evaluate immune responses to infection and vaccination, and new therapeutic strategies to treat infected individuals. Never before has immunology been so critically at the forefront of combatting a global pandemic. It has now become evident that not just antibody responses, but formation and durability of immune memory cells following vaccination are associated with protection against severe disease from SARS-CoV-2 infection. Furthermore, the emergence of variants of concern (VoC) highlight the need for immunological markers to quantify the protective capacity of Wuhan-based vaccines. Thus, harnessing and modulating the immune response is key to successful vaccination and treatment of disease. We here review the latest knowledge about immune memory generation and durability following natural infection and vaccination, and provide insights into the attributes of immune memory that may protect from emerging variants.
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Affiliation(s)
- Gemma E. Hartley
- Allergy and Clinical Immunology Laboratory, Department of Immunology and Pathology, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Emily S. J. Edwards
- Allergy and Clinical Immunology Laboratory, Department of Immunology and Pathology, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia
| | - Robyn E. O’Hehir
- Allergy and Clinical Immunology Laboratory, Department of Immunology and Pathology, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia,Allergy, Asthma and Clinical Immunology ServiceAlfred HospitalMelbourneVictoriaAustralia
| | - Menno C. van Zelm
- Allergy and Clinical Immunology Laboratory, Department of Immunology and Pathology, Central Clinical SchoolMonash UniversityMelbourneVictoriaAustralia,Allergy, Asthma and Clinical Immunology ServiceAlfred HospitalMelbourneVictoriaAustralia
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4
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Streibl BI, Lahne H, Grahl A, Agsten P, Bichler M, Büchl C, Damzog M, Eberle U, Gärtner S, Hobmaier B, Margos G, Hoch M, Jungnick S, Jonas W, Katz K, Laubert L, Schutt B, Seidl C, Treis B, Weindl D, Zilch K, Wildner M, Liebl B, Ackermann N, Sing A, Fingerle V. Epidemiological and Serological Analysis of a SARS-CoV-2 Outbreak in a Nursing Home: Impact of SARS-CoV-2 Vaccination and Enhanced Neutralizing Immunity Following Breakthrough Infection. Microorganisms 2022; 10:microorganisms10091809. [PMID: 36144413 PMCID: PMC9505589 DOI: 10.3390/microorganisms10091809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/28/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Despite a vaccination rate of 82.0% (n = 123/150), a SARS-CoV-2 (Alpha) outbreak with 64.7% (n = 97/150) confirmed infections occurred in a nursing home in Bavaria, Germany. Objective: the aim of this retrospective cohort study was to examine the effects of the Corminaty vaccine in a real-life outbreak situation and to obtain insights into the antibody response to both vaccination and breakthrough infection. Methods: the antibody status of 106 fully vaccinated individuals (54/106 breakthrough infections) and epidemiological data on all 150 residents and facility staff were evaluated. Results: SARS-CoV-2 infections (positive RT-qPCR) were detected in 56.9% (n = 70/123) of fully vaccinated, compared to 100% (n = 27/27) of incompletely or non-vaccinated individuals. The proportion of hospitalized and deceased was 4.1% (n = 5/123) among fully vaccinated and therewith lower compared to 18.5% (n = 5/27) hospitalized and 11.1% (n = 3/27) deceased among incompletely or non-vaccinated. Ct values were significantly lower in incompletely or non-vaccinated (p = 0.02). Neutralizing antibodies were detected in 99.1% (n = 105/106) of serum samples with significantly higher values (p < 0.001) being measured post-breakthrough infection. α-N-antibodies were detected in 37.7% of PCR positive but not in PCR negative individuals. Conclusion: Altogether, our data indicate that SARS-CoV-2 vaccination does provide protection against infection, severe disease progression and death with regards to the Alpha variant. Nonetheless, it also shows that infection and transmission are possible despite full vaccination. It further indicates that breakthrough infections can significantly enhance α-S- and neutralizing antibody responses, indicating a possible benefit from booster vaccinations.
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Affiliation(s)
- Barbara I. Streibl
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
- Correspondence: (B.I.S.); (V.F.)
| | - Heidi Lahne
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Andreas Grahl
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Philipp Agsten
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Magdalena Bichler
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | | | | | - Ute Eberle
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | | | - Bernhard Hobmaier
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Gabriele Margos
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Martin Hoch
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Sabrina Jungnick
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Walter Jonas
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Katharina Katz
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | | | | | - Cornelia Seidl
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Bianca Treis
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Daniel Weindl
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Karen Zilch
- Health Office Neumarkt, 92318 Neumarkt, Germany
| | - Manfred Wildner
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Bernhard Liebl
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Nikolaus Ackermann
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Andreas Sing
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
| | - Volker Fingerle
- Public Health Microbiology Unit, Bavarian Health and Food Safety Authority, 85764 Oberschleißheim, Germany
- Correspondence: (B.I.S.); (V.F.)
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Dyer AH, Fallon A, Noonan C, Dolphin H, O'Farrelly C, Bourke NM, O'Neill D, Kennelly SP. Managing the Impact of COVID-19 in Nursing Homes and Long-Term Care Facilities: An Update. J Am Med Dir Assoc 2022; 23:1590-1602. [PMID: 35922016 PMCID: PMC9250924 DOI: 10.1016/j.jamda.2022.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/26/2022]
Abstract
Older adults in nursing homes are at greatest risk of morbidity and mortality from SARS-CoV-2 infection. Nursing home residents constituted one-third to more than half of all deaths during the early waves of the COVID-19 pandemic. Following this, widespread adaptation of infection prevention and control measures and the supply and use of personal protective equipment resulted in a significant decrease in nursing home infections and deaths. For nursing homes, the most important determinant of experiencing a SARS-CoV-2 outbreak in the first instance appears to be community-transmission levels (particularly with variants of concern), although nursing home size and quality, for-profit status, and sociodemographic characteristics are also important. Use of visitation bans, imposed to reduce the impact of COVID-19 on residents, must be delicately balanced against their impact on resident, friend or family, and staff well-being. The successful rollout of primary vaccination has resulted in a sharp decrease in morbidity and mortality from SARS-CoV-2 in nursing homes. However, emerging evidence suggests that vaccine efficacy may wane over time, and the use of a third or additional vaccine "booster" doses in nursing home residents restores protection afforded by primary vaccination. Ongoing monitoring of vaccine efficacy in terms of infection, morbidity, and mortality is crucial in this vulnerable group in informing ongoing SARS-CoV-2 vaccine boosting strategies. Here, we detail the impact of SARS-CoV-2 on nursing home residents and discuss important considerations in the management of nursing home SARS-CoV-2 outbreaks. We additionally examine the use of testing strategies, nonpharmacologic outbreak control measures and vaccination strategies in this cohort. Finally, the impact of SARS-CoV-2 on the sector is reflected on as we emphasize the need for adoption of universal standards of medical care and integration with wider public health infrastructure in nursing homes in order to provide a safe and effective long-term care sector.
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Affiliation(s)
- Adam H Dyer
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Aoife Fallon
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Claire Noonan
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland
| | - Helena Dolphin
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland
| | - Cliona O'Farrelly
- Comparative Immunology, School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Dublin, Ireland; School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Nollaig M Bourke
- Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland; Inflammageing Research Group, Trinity Translational Medicine Institute, Dublin, Ireland
| | - Desmond O'Neill
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sean P Kennelly
- Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Discipline of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
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6
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Tuaillon E, Pisoni A, Veyrenche N, Rafasse S, Niel C, Gros N, Muriaux D, Picot MC, Aouinti S, Van de Perre P, Bousquet J, Blain H. Antibody response after first and second BNT162b2 vaccination to predict the need for subsequent injections in nursing home residents. Sci Rep 2022; 12:13749. [PMID: 35962053 PMCID: PMC9373891 DOI: 10.1038/s41598-022-18041-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 08/04/2022] [Indexed: 11/21/2022] Open
Abstract
We explored antibody response after first and second BNT162b2 vaccinations, to predict the need for subsequent injections in nursing home (NH) residents. 369 NH residents were tested for IgG against SARS-CoV-2 Receptor-Binding Domain (RBD-IgG) and nucleoprotein-IgG (SARS-CoV-2 IgG II Quant and SARS-CoV-2 IgG Alinity assays, Abbott Diagnostics). In NH residents with prior SARS-CoV-2 infection, the first dose elicited high RBD-IgG levels (≥ 4160 AU/mL) in 99/129 cases (76.9%), with no additional antibody gain after the second dose in 74 cases (74.7%). However, a low RBD-IgG level (< 1050 AU/mL) was observed in 28 (21.7%) residents. The persistence of nucleoprotein-IgG and a longer interval between infection and the first dose were associated with a higher RBD-IgG response (p < 0.0001 and p = 0.0013, respectively). RBD-IgG below 50 AU/mL after the first dose predicted failure to reach the antibody concentration associated with a neutralizing effect after the second dose (≥ 1050 AU/mL). The BNT162b2 vaccine elicited a strong humoral response after the first dose in a majority of NH residents with prior SARS-CoV-2 infection. However, about one quarter of these residents require a second injection. Consideration should be given to immunological monitoring in NH residents to optimize the vaccine response in this vulnerable population.
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Affiliation(s)
- Edouard Tuaillon
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, INSERM, Établissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France.
| | - Amandine Pisoni
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, INSERM, Établissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France
| | - Nicolas Veyrenche
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, INSERM, Établissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France
| | - Sophia Rafasse
- CEMIPAI, University of Montpellier, UAR3725 CNRS, Montpellier, France
| | - Clémence Niel
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, INSERM, Établissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France
| | - Nathalie Gros
- CEMIPAI, University of Montpellier, UAR3725 CNRS, Montpellier, France
| | - Delphine Muriaux
- CEMIPAI, University of Montpellier, UAR3725 CNRS, Montpellier, France
| | | | - Safa Aouinti
- Clinical Research and Epidemiology Unit, University Hospital, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic and Emerging Infections, University Montpellier, INSERM, Établissement Français du Sang, Antilles University, CHU Montpellier, Montpellier, France
| | - Jean Bousquet
- Department of Dermatology and Allergy, Charité, Univeersitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Comprehensive Allergy Center, Berlin, Germany.,University Hospital, Montpellier, France
| | - Hubert Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier University, Montpellier, France
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Gattinger P, Tulaeva I, Borochova K, Kratzer B, Trapin D, Kropfmüller A, Pickl WF, Valenta R. Omicron: A SARS-CoV-2 variant of real concern. Allergy 2022; 77:1616-1620. [PMID: 35188670 PMCID: PMC9111213 DOI: 10.1111/all.15264] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Pia Gattinger
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Inna Tulaeva
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- Laboratory for Immunopathology Department of Clinical Immunology and Allergy Sechenov First Moscow State Medical University Moscow Russia
| | - Kristina Borochova
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Bernhard Kratzer
- Institute of Immunology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Doris Trapin
- Institute of Immunology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Anna Kropfmüller
- Österreichische Gesundheitskasse Klinikum Peterhof Baden Austria
| | - Winfried F. Pickl
- Institute of Immunology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- Karl Landsteiner University of Health Sciences Krems Austria
| | - Rudolf Valenta
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- Laboratory for Immunopathology Department of Clinical Immunology and Allergy Sechenov First Moscow State Medical University Moscow Russia
- Karl Landsteiner University of Health Sciences Krems Austria
- NRC Institute of Immunology FMBA of Russia Moscow Russia
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8
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Meyer M, Constancias F, Worth C, Meyer A, Muller M, Boussuge A, Kaltenbach G, Schmitt E, Chayer S, Velay A, Vogel T, Fafi-Kremer S, Karcher P. Humoral immune response after COVID-19 infection or BNT162b2 vaccine among older adults: evolution over time and protective thresholds. GeroScience 2022; 44:1229-1240. [PMID: 35394604 PMCID: PMC8990277 DOI: 10.1007/s11357-022-00546-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/11/2022] [Indexed: 01/09/2023] Open
Abstract
The objectives of this study were to assess the
dynamics of the SARS-CoV-2 anti-RBD-IgG response over time among older people after
COVID-19 infection or vaccination and its comparison with indicative levels of protection.
Geriatric patients with SARS-CoV-2 serological test results were included and
divided into three groups. A vaccine group (n
= 34), a group of natural COVID-19 infection (n = 32), and a group who contracted
COVID-19 less than 15 days after the first injection (n = 17). Eighty-three patients were
included; the median age with IQR was 87 (81–91) years. In the
vaccine group at 1 month since the first vaccination, the median titer of anti-RBD-IgG
was 620 (217–1874) BAU/ml with 87% of patients above the theoretical protective threshold
of 141 BAU/ml according to Dimeglio et al. (J Infec. 84(2):248–88, [7]). Seven months after the first
vaccination, this titer decreased to 30 (19–58) BAU/ml with
9.5% of patients > 141 BAU/ml. In the natural COVID-19 infection group, at 1 month
since the date of first symptom onset, the median titer was 798 (325–1320) BAU/ml with
86.7% of patients > 141 BAU/ml and fell to 88 (37–385) with 42.9% of patients > 141
BAU/ml at 2 months. The natural infection group was vaccinated 3 months after the infection.
Five months after the vaccination cycle, the median titer was 2048 (471–4386) BAU/ml with
83.3% of patients > 141 BAU/ml. This supports the clinical results describing the
decrease in vaccine protection over time and suggests that vaccination after infection can
maintain significantly higher antibody titer levels for a prolonged period of time.
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Affiliation(s)
- Maxence Meyer
- Department of Geriatric, University Hospitals of Strasbourg, 83 rue Himmerich, 67000, Strasbourg, France.
| | | | - Claudia Worth
- Nuffield Department of Rheumatology, Orthopaedics and Musculosckeletal Sciences, University of Oxford, Oxford, UK
| | - Anita Meyer
- COVID Vaccination Center, Offenburg, Germany
| | - Marion Muller
- Department of Geriatric, University Hospitals of Strasbourg, 83 rue Himmerich, 67000, Strasbourg, France
| | - Alexandre Boussuge
- Department of Geriatric, University Hospitals of Strasbourg, 83 rue Himmerich, 67000, Strasbourg, France
| | - Georges Kaltenbach
- Department of Geriatric, University Hospitals of Strasbourg, 83 rue Himmerich, 67000, Strasbourg, France
| | - Elise Schmitt
- Department of Geriatric, University Hospitals of Strasbourg, 83 rue Himmerich, 67000, Strasbourg, France
| | - Saïd Chayer
- Department of Clinical Research and Innovations, University Hospitals of Strasbourg, Strasbourg, France
| | - Aurélie Velay
- Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,INSERM, UMR_S1109, LabEx TRANSPLANTEX, Research Center for Immunology and Hematology, Faculty of Medicine, University Hospital Federation (FHU) OMICARE, Federation of Translational Medicine of Strasbourg (FMTS), University of Strasbourg, Strasbourg, France
| | - Thomas Vogel
- Department of Geriatric, University Hospitals of Strasbourg, 83 rue Himmerich, 67000, Strasbourg, France
| | - Samira Fafi-Kremer
- Laboratoire de Virologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,INSERM, UMR_S1109, LabEx TRANSPLANTEX, Research Center for Immunology and Hematology, Faculty of Medicine, University Hospital Federation (FHU) OMICARE, Federation of Translational Medicine of Strasbourg (FMTS), University of Strasbourg, Strasbourg, France
| | - Patrick Karcher
- Department of Geriatric, University Hospitals of Strasbourg, 83 rue Himmerich, 67000, Strasbourg, France
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9
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Gattinger P, Kratzer B, Tulaeva I, Niespodziana K, Ohradanova‐Repic A, Gebetsberger L, Borochova K, Garner‐Spitzer E, Trapin D, Hofer G, Keller W, Baumgartner I, Tancevski I, Khaitov M, Karaulov A, Stockinger H, Wiedermann U, Pickl W, Valenta R. Vaccine based on folded RBD-PreS fusion protein with potential to induce sterilizing immunity to SARS-CoV-2 variants. Allergy 2022; 77:2431-2445. [PMID: 35357709 PMCID: PMC9111473 DOI: 10.1111/all.15305] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 12/28/2022]
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is responsible for the ongoing global COVID‐19 pandemic. One possibility to control the pandemic is to induce sterilizing immunity through the induction and maintenance of neutralizing antibodies preventing SARS‐CoV‐2 from entering human cells to replicate in. Methods We report the construction and in vitro and in vivo characterization of a SARS‐CoV‐2 subunit vaccine (PreS‐RBD) based on a structurally folded recombinant fusion protein consisting of two SARS‐CoV‐2 Spike protein receptor‐binding domains (RBD) fused to the N‐ and C‐terminus of hepatitis B virus (HBV) surface antigen PreS to enable the two unrelated proteins serving as immunologic carriers for each other. Results PreS‐RBD, but not RBD alone, induced a robust and uniform RBD‐specific IgG response in rabbits. Currently available genetic SARS‐CoV‐2 vaccines induce mainly transient IgG1 responses in vaccinated subjects whereas the PreS‐RBD vaccine induced RBD‐specific IgG antibodies consisting of an early IgG1 and sustained IgG4 antibody response in a SARS‐CoV‐2 naive subject. PreS‐RBD‐specific IgG antibodies were detected in serum and mucosal secretions, reacted with SARS‐CoV‐2 variants, including the omicron variant of concern and the HBV receptor‐binding sites on PreS of currently known HBV genotypes. PreS‐RBD‐specific antibodies of the immunized subject more potently inhibited the interaction of RBD with its human receptor ACE2 and their virus‐neutralizing titers (VNTs) were higher than median VNTs in a random sample of healthy subjects fully immunized with registered SARS‐CoV‐2 vaccines or in COVID‐19 convalescent subjects. Conclusion The PreS‐RBD vaccine has the potential to serve as a combination vaccine for inducing sterilizing immunity against SARS‐CoV‐2 and HBV by stopping viral replication through the inhibition of cellular virus entry.
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Affiliation(s)
- Pia Gattinger
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Bernhard Kratzer
- Center for Pathophysiology, Infectiology and Immunology Institute of Immunology Medical University of Vienna Vienna Austria
| | - Inna Tulaeva
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- Laboratory for Immunopathology Department of Clinical Immunology and Allergology Sechenov First Moscow State Medical University Moscow Russia
| | - Katarzyna Niespodziana
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- Karl Landsteiner University of Health Sciences Krems Austria
| | - Anna Ohradanova‐Repic
- Center for Pathophysiology, Infectiology and Immunology Institute for Hygiene and Applied Immunology Medical University of Vienna Vienna Austria
| | - Laura Gebetsberger
- Center for Pathophysiology, Infectiology and Immunology Institute for Hygiene and Applied Immunology Medical University of Vienna Vienna Austria
| | - Kristina Borochova
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Erika Garner‐Spitzer
- Institute of Specific Prophylaxis and Tropical Medicine Medical University of Vienna Vienna Austria
| | - Doris Trapin
- Center for Pathophysiology, Infectiology and Immunology Institute of Immunology Medical University of Vienna Vienna Austria
| | - Gerhard Hofer
- Department of Materials and Environmental Chemistry University of Stockholm Stockholm Sweden
| | - Walter Keller
- Institute of Molecular Biosciences, BioTechMed Graz University of Graz Graz Austria
| | | | - Ivan Tancevski
- Department of Internal Medicine II Medical University of Innsbruck Innsbruck Austria
| | - Musa Khaitov
- NRC Institute of Immunology FMBA of Russia Moscow Russia
- Pirogov Russian National Research Medical University Moscow Russia
| | - Alexander Karaulov
- Laboratory for Immunopathology Department of Clinical Immunology and Allergology Sechenov First Moscow State Medical University Moscow Russia
| | - Hannes Stockinger
- Center for Pathophysiology, Infectiology and Immunology Institute for Hygiene and Applied Immunology Medical University of Vienna Vienna Austria
| | - Ursula Wiedermann
- Institute of Specific Prophylaxis and Tropical Medicine Medical University of Vienna Vienna Austria
| | - Winfried F. Pickl
- Center for Pathophysiology, Infectiology and Immunology Institute of Immunology Medical University of Vienna Vienna Austria
- Karl Landsteiner University of Health Sciences Krems Austria
| | - Rudolf Valenta
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- Laboratory for Immunopathology Department of Clinical Immunology and Allergology Sechenov First Moscow State Medical University Moscow Russia
- Karl Landsteiner University of Health Sciences Krems Austria
- NRC Institute of Immunology FMBA of Russia Moscow Russia
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10
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Dyer AH, Noonan C, McElheron M, Batten I, Reddy C, Connolly E, Pierpoint R, Murray C, Leonard A, Higgins C, Reilly P, Boran G, Phelan T, McCormack W, O'Neill D, Fallon A, Brady G, O'Farrelly C, Bourke NM, Kennelly SP. Previous SARS-CoV-2 Infection, Age, and Frailty Are Associated With 6-Month Vaccine-Induced Anti-Spike Antibody Titer in Nursing Home Residents. J Am Med Dir Assoc 2022; 23:434-439. [PMID: 35219507 PMCID: PMC8748020 DOI: 10.1016/j.jamda.2021.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Older nursing home residents make up the population at greatest risk of morbidity and mortality from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. No studies have examined the determinants of long-term antibody responses post vaccination in this group. DESIGN Longitudinal cohort study. SETTING AND PARTICIPANTS Residents from 5 nursing homes assessed before vaccination, and 5 weeks and 6 months post vaccination, with the BNT162b2 messenger RNA SARS-CoV-2 vaccine. METHODS Comprehensive clinical assessment was performed, including assessment for comorbidity, frailty, and SARS-CoV-2 infection history. Serum nucleocapsid and anti-spike receptor binding domain (RBD) antibodies were analyzed at all timepoints. An in vitro angiotensin-converting enzyme (ACE2) receptor-spike RBD neutralization assay assessed serum neutralization capacity. RESULTS Of 86 participants (81.1 ± 10.8 years; 65% female), just under half (45.4%; 39 of 86) had evidence of previous SARS-CoV-2 infection. All participants demonstrated a significant antibody response to vaccination at 5 weeks and a significant decline in this response by 6 months. SARS-CoV-2 infection history was the strongest predictor of antibody titer (log-transformed) at both 5 weeks [β: 3.00; 95% confidence interval (CI): 2.32-3.70; P < .001] and 6 months (β: 3.59; 95% CI: 2.89-4.28; P < .001). Independent of SARS-CoV-2 infection history, both age in years (β: -0.05; 95% CI: -0.08 to -0.02; P < .001) and frailty (β: -0.22; 95% CI: -0.33 to -0.11; P < .001) were associated with a significantly lower antibody titer at 6 months. Anti-spike antibody titers at both 5 weeks and 6 months significantly correlated with in vitro neutralization capacity. CONCLUSIONS AND IMPLICATIONS In older nursing home residents, SARS-CoV-2 infection history was the strongest predictor of anti-spike antibody titers at 6 months, whereas age and frailty were independently associated with lower titers at 6 months. Antibody titers significantly correlated with in vitro neutralization capacity. Although older SARS-CoV-2 naïve nursing home residents may be particularly vulnerable to breakthrough SARS-CoV-2 infection, the relationship between antibody titers, SARS-CoV-2 infection, and clinical outcomes remains to be fully elucidated in this vulnerable population.
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Affiliation(s)
- Adam H Dyer
- Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Inflammaging Research Group, Trinity Translational Medicine Institute, St James's Hospital Campus, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland.
| | - Claire Noonan
- Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland
| | - Matt McElheron
- Inflammaging Research Group, Trinity Translational Medicine Institute, St James's Hospital Campus, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Isabella Batten
- Inflammaging Research Group, Trinity Translational Medicine Institute, St James's Hospital Campus, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Conor Reddy
- Inflammaging Research Group, Trinity Translational Medicine Institute, St James's Hospital Campus, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Emma Connolly
- Inflammaging Research Group, Trinity Translational Medicine Institute, St James's Hospital Campus, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Rachel Pierpoint
- Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland
| | - Caroline Murray
- Departments of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland
| | - Ann Leonard
- Departments of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland; Clinical Biochemistry Unity, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Catriona Higgins
- Departments of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland
| | - Phyllis Reilly
- Departments of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland
| | - Gerard Boran
- Departments of Clinical Chemistry and Laboratory Medicine, Tallaght University Hospital, Dublin, Ireland; Clinical Biochemistry Unity, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Thomas Phelan
- Clinical Medicine, Trinity Translational Medicine Institute, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - William McCormack
- Clinical Medicine, Trinity Translational Medicine Institute, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Desmond O'Neill
- Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Aoife Fallon
- Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland
| | - Gareth Brady
- Clinical Medicine, Trinity Translational Medicine Institute, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Cliona O'Farrelly
- Comparative Immunology Research Group, Trinity Biomedical Sciences Institute, Dublin, Ireland
| | - Nollaig M Bourke
- Inflammaging Research Group, Trinity Translational Medicine Institute, St James's Hospital Campus, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Sean P Kennelly
- Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland; Inflammaging Research Group, Trinity Translational Medicine Institute, St James's Hospital Campus, Dublin, Ireland; Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
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11
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Hollstein MM, Münsterkötter L, Schön MP, Bergmann A, Husar TM, Abratis A, Eidizadeh A, Schaffrinski M, Zachmann K, Schmitz A, Holsapple JS, Stanisz‐Bogeski H, Schanz J, Fischer A, Groß U, Leha A, Zautner AE, Schnelle M, Erpenbeck L. Interdependencies of cellular and humoral immune responses in heterologous and homologous SARS-CoV-2 vaccination. Allergy 2022; 77:2381-2392. [PMID: 35124800 PMCID: PMC9111248 DOI: 10.1111/all.15247] [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: 12/23/2021] [Revised: 01/17/2022] [Accepted: 01/23/2022] [Indexed: 12/27/2022]
Abstract
Background Homologous and heterologous SARS‐CoV‐2 vaccinations yield different spike protein‐directed humoral and cellular immune responses. This study aimed to explore their currently unknown interdependencies. Methods COV‐ADAPT is a prospective, observational cohort study of 417 healthcare workers who received vaccination with homologous ChAdOx1 nCoV‐19, homologous BNT162b2 or with heterologous ChAdOx1 nCoV‐19/BNT162b2. We assessed humoral (anti‐spike‐RBD‐IgG, neutralizing antibodies, and avidity) and cellular (spike‐induced T‐cell interferon‐γ release) immune responses in blood samples up to 2 weeks before (T1) and 2–12 weeks following secondary immunization (T2). Results Initial vaccination with ChAdOx1 nCoV‐19 resulted in lower anti‐spike‐RBD‐IgG compared with BNT162b2 (70 ± 114 vs. 226 ± 279 BAU/ml, p < .01) at T1. Booster vaccination with BNT162b2 proved superior to ChAdOx1 nCoV‐19 at T2 (anti‐spike‐RBD‐IgG: ChAdOx1 nCoV‐19/BNT162b2 2387 ± 1627 and homologous BNT162b2 3202 ± 2184 vs. homologous ChAdOx1 nCoV‐19 413 ± 461 BAU/ml, both p < .001; spike‐induced T‐cell interferon‐γ release: ChAdOx1 nCoV‐19/BNT162b2 5069 ± 6733 and homologous BNT162b2 4880 ± 7570 vs. homologous ChAdOx1 nCoV‐19 1152 ± 2243 mIU/ml, both p < .001). No significant differences were detected between BNT162b2‐boostered groups at T2. For ChAdOx1 nCoV‐19, no booster effect on T‐cell activation could be observed. We found associations between anti‐spike‐RBD‐IgG levels (ChAdOx1 nCoV‐19/BNT162b2 and homologous BNT162b2) and T‐cell responses (homologous ChAdOx1 nCoV‐19 and ChAdOx1 nCoV‐19/BNT162b2) from T1 to T2. Additionally, anti‐spike‐RBD‐IgG and T‐cell response were linked at both time points (all groups combined). All regimes yielded neutralizing antibodies and increased antibody avidity at T2. Conclusions Interdependencies between humoral and cellular immune responses differ between common SARS‐CoV‐2 vaccination regimes. T‐cell activation is unlikely to compensate for poor humoral responses.
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Affiliation(s)
- Moritz M. Hollstein
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Lennart Münsterkötter
- Institute of Medical Microbiology and Virology University Medical Center Göttingen Göttingen Germany
| | - Michael P. Schön
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
- Lower Saxony Institute of Occupational Dermatology University Medical Center Göttingen Göttingen Germany
| | - Armin Bergmann
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Thea M. Husar
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Anna Abratis
- Institute for Clinical Chemistry University Medical Center Göttingen Göttingen Germany
| | - Abass Eidizadeh
- Institute for Clinical Chemistry University Medical Center Göttingen Göttingen Germany
| | - Meike Schaffrinski
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Karolin Zachmann
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Anne Schmitz
- Department of Dermatology University of Münster Münster Germany
| | | | - Hedwig Stanisz‐Bogeski
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
| | - Julie Schanz
- Institute for Clinical Chemistry University Medical Center Göttingen Göttingen Germany
- Department of Hematology and Medical Oncology University Medical Center Göttingen Göttingen Germany
| | - Andreas Fischer
- Institute for Clinical Chemistry University Medical Center Göttingen Göttingen Germany
- Division Vascular Signaling and Cancer German Cancer Research Center (DKFZ) Heidelberg Germany
| | - Uwe Groß
- Institute of Medical Microbiology and Virology University Medical Center Göttingen Göttingen Germany
| | - Andreas Leha
- Department of Medical Statistics University Medical Center Göttingen Göttingen Germany
| | - Andreas E. Zautner
- Institute of Medical Microbiology and Virology University Medical Center Göttingen Göttingen Germany
- Institute of Medical Microbiology and Hospital Hygiene Medical Faculty Otto‐von‐Guericke University Magdeburg Magdeburg Germany
| | - Moritz Schnelle
- Institute for Clinical Chemistry University Medical Center Göttingen Göttingen Germany
| | - Luise Erpenbeck
- Department of Dermatology, Venereology and Allergology University Medical Center Göttingen Göttingen Germany
- Department of Dermatology University of Münster Münster Germany
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12
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Strong Decay of SARS-CoV-2 Spike Antibodies after 2 BNT162b2 Vaccine Doses and High Antibody Response to a Third Dose in Nursing Home Residents. J Am Med Dir Assoc 2022; 23:750-753. [PMID: 35311651 PMCID: PMC8864102 DOI: 10.1016/j.jamda.2022.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 12/21/2022]
Abstract
Objectives To measure the antibody decay after 2 BNT162b2 doses and the antibody response after a third vaccine dose administered 6 months after the second one in nursing home residents with and without prior COVID-19. Design Cohort study. Setting and Participants Four hundred-eighteen residents from 18 nursing homes. Methods Blood receptor-binding domain (RBD)-IgG (IgG II Quant assay, Abbott Diagnostics; upper limit: 5680 BAU) and nucleocapsid-IgG (Abbott Alinity) were measured 21‒28 days after the second BNT162b2 dose, as well as 1‒3 days before and 21‒28 days after the third vaccine dose. RBD-IgG levels of ≥592 BAU/mL were considered as high antibody response. Residents with prior positive quantitative reverse transcription polymerase chain reaction on a nasopharyngeal swab or with N-IgG levels above 0.8 S/CO were considered as prior COVID-19 residents. Results In prior COVID-19 residents (n = 122), RBD-IgG median levels decreased by 82% in 167 days on average. In the same period, the number of residents with a high antibody response decreased from 88.5% to 54.9% (P < .0001) and increased to 97.5% after the third vaccine dose (P = .02 vs the first measure). In residents without prior COVID-19 (n = 296), RBD-IgG median levels decreased by 89% in 171 days on average. The number of residents with a high antibody response decreased from 29.4% to 1.7% (P < .0001) and increased to 88.4% after the third vaccine dose (P < .0001 vs the first measure). Conclusions and Implications The strong and rapid decay of RBD-IgG levels after the second BNT162b2 dose in all residents and the high antibody response after the third dose validate the recommendation of a third vaccine dose in residents less than 6 months after the second dose, prioritizing residents without prior COVID-19. The slope of RBD-IgG decay after the third BNT162b2 dose and the protection level against SARS-CoV-2 B.1.1.529 (omicron) and other variants of concern provided by the high post-boost vaccination RBD-IgG response require further investigation in residents.
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