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Tunheim G, Fossum E, Robertson AH, Rø GØI, Chopra A, Vaage JT, Vikse EL, Kran AMB, Magnus P, Trogstad L, Mjaaland S, Hungnes O, Lund-Johansen F. Characterization of the SARS-CoV-2 antibody landscape in Norway in the late summer of 2022: high seroprevalence in all age groups with patterns of primary Omicron infection in children and hybrid immunity in adults. BMC Infect Dis 2024; 24:841. [PMID: 39164637 PMCID: PMC11334563 DOI: 10.1186/s12879-024-09670-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 07/25/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND According to Norwegian registries, 91% of individuals ≥ 16 years had received ≥ 1 dose of COVID-19 vaccine by mid-July 2022, whereas less than 2% of children < 12 years were vaccinated. Confirmed COVID-19 was reported for 27% of the population, but relaxation of testing lead to substantial underreporting. We have characterized the humoral immunity to SARS-CoV-2 in Norway in the late summer of 2022 by estimating the seroprevalence and identifying antibody profiles based on reactivity to Wuhan or Omicron-like viruses in a nationwide cross-sectional collection of residual sera, and validated our findings using cohort sera. METHODS 1,914 anonymized convenience sera and 243 NorFlu-cohort sera previously collected from the Oslo-area with reported infection and vaccination status were analyzed for antibodies against spike, the receptor-binding domain (RBD) of the ancestral Wuhan strain and Omicron BA.2 RBD, and nucleocapsid (N). Samples were also tested for antibodies inhibiting RBD-ACE2 interaction. Neutralization assays were performed on subsets of residual sera against B.1, BA.2, XBB.1.5 and BQ.1.1. RESULTS The national seroprevalence estimate from vaccination and/or infection was 99.1% (95% CrI 97.0-100.0%) based on Wuhan (spike_W and RBD_W) and RBD_BA2 antibodies. Sera from children < 12 years had 2.2 times higher levels of antibodies against RBD_BA2 than RBD_W and their seroprevalence estimate showed a 14.4 percentage points increase when also including anti-RBD_BA2 antibodies compared to Wuhan-antibodies alone. 50.3% (95% CI 45.0-55.5%) of residual sera from children and 38.1% (95% CI 36.0-40.4%) of all residual sera were positive for anti-N-antibodies. By combining measurements of binding- and ACE2-RBD-interaction-inhibiting antibodies, reactivity profiles indicative of infection and vaccination history were identified and validated using cohort sera. Residual sera with a profile indicative of hybrid immunity were able to neutralize newer Omicron variants XBB.1.5 and BQ.1.1. CONCLUSIONS By late summer of 2022, most of the Norwegian population had antibodies to SARS-CoV-2, and almost all children had been infected. Antibody profiles indicated that children mostly had experienced a primary Omicron infection, while hybrid immunity was common among adults. The finding that sera displaying hybrid immunity could neutralize newer Omicron variants indicates that Wuhan-like priming of the immune response did not have a harmful imprinting effect and that infections induce cross-reacting antibodies against future variants.
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Affiliation(s)
- Gro Tunheim
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway.
| | - Even Fossum
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Anna Hayman Robertson
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | | | - Adity Chopra
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - John T Vaage
- Department of Immunology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Elisabeth Lea Vikse
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Anne-Marte Bakken Kran
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Per Magnus
- Center for Fertility and Health, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Lill Trogstad
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Siri Mjaaland
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Olav Hungnes
- Division of Infection Control, Norwegian Institute of Public Health (NIPH), Oslo, Norway
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Lam LK, Tan JT, Ooi PH, Zhang R, Chan KH, Mao X, Hung IFN, Seto WK, Yuen MF, Cheung KS. Effect of metabolic dysfunction-associated steatotic liver disease on BNT162b2 immunogenicity against the severe acute respiratory syndrome coronavirus 2 omicron variant. J Gastroenterol Hepatol 2024. [PMID: 39152762 DOI: 10.1111/jgh.16716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/21/2024] [Accepted: 07/30/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND AND AIM We aimed to investigate the effect of metabolic dysfunction-associated steatotic liver disease (MASLD) on three-dose BNT162b2 immunogenicity to the omicron variant. METHODS Adult recipients of three doses of BNT162b2 were prospectively recruited between May and December 2021. The serology of the neutralizing antibody by live virus microneutralization (vMN) to the omicron variant was measured at baseline, day 180, and day 360 after the first dose. The primary outcome was seroconversion (vMN titer ≥ 10) at day 360. Exposure of interest was MASLD, defined as hepatic steatosis (controlled attenuation parameter ≥ 248 dB/m on transient elastography) plus at least one of five cardiometabolic risk factors. Subjects with prior COVID-19 were excluded. A multivariable logistic regression model was used to derive the adjusted odds ratio of seroconversion with MASLD by adjusting for age, sex, antibiotic use, and proton pump inhibitor use. RESULTS One hundred forty-eight BNT162b2 recipients (male: 48 [32.4%]; median age: 51.0 years [interquartile range, IQR: 44.5-57.3]) were recruited. The median time from the first dose to the third dose was 8.5 months (IQR: 7.9-8.9). MASLD subjects had a lower seroconversion rate than non-MASLD ones (89.6% vs 99.0%; P = 0.007). MASLD was the only independent risk factor for seroconversion (adjusted odds ratio: 0.051, 95% confidence interval: 0.002-0.440). Subgroup analysis of immunogenicity at 4 months after the third dose shows significantly lower vMN titer (13.06 [IQR: 7.69-22.20] vs 33.49 [IQR: 24.05-46.53]; P = 0.004) and seroconversion rate (76.9% vs 97.4%; P = 0.016) in MASLD than non-MASLD subjects, but not within 4 months from the third dose (vMN titer: 46.87 [IQR: 33.12-66.02] vs 41.86 [IQR: 34.47-50.91], P = 0.240; seroconversion rate: 94.3% vs 100%, P = 0.131). CONCLUSION Metabolic dysfunction-associated steatotic liver disease was a risk factor for poorer immunogenicity to the omicron variant, with a more pronounced waning effect compared among three-dose BNT162b2 recipients.
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Affiliation(s)
- Lok Ka Lam
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Jing Tong Tan
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Poh Hwa Ooi
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Ruiqi Zhang
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Kwok Hung Chan
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Xianhua Mao
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Ivan F N Hung
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
| | - Wai Kay Seto
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- State Key Laboratory of Liver Research, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Man Fung Yuen
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- State Key Laboratory of Liver Research, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Ka Shing Cheung
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
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Miyashita N, Nakamori Y, Ogata M, Fukuda N, Yamura A, Ito T. Aspiration pneumonia after SARS-CoV-2 Omicron infection frequently induced physical functional decline in Japan. J Med Microbiol 2024; 73. [PMID: 39207830 DOI: 10.1099/jmm.0.001872] [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: 09/04/2024] Open
Abstract
Introduction. Nursing and healthcare-associated pneumonia (NHCAP) mainly occurs in older people whose physical functions have declined, and it is the most common type of pneumonia in Japan, a super-ageing society. In older people who meet NHCAP criteria, respiratory tract infections are often accompanied by aspiration pneumonia.Gap statement. The SARS-CoV-2 Omicron variant frequently causes aspiration pneumonia and has induced a decline in physical function.Aim. To clarify functional outcomes at 1 year after hospital discharge in SARS-CoV-2 Omicron-related NHCAP cases.Methodology. We compared the functional outcomes between 259 patients with primary SARS-CoV-2 pneumonia and 223 patients with aspiration pneumonia.Results. Functional decline rates for calculating the Barthel index at the time of hospital discharge were higher in the aspiration pneumonia group than the primary SARS-CoV-2 pneumonia group [114 patients (51.6%) vs 70 patients (27.0%), P<0.0001]. Of 114 patients with aspiration pneumonia who had a decline in physical function at the time of hospital discharge, 91 (79.8%) still showed functional decline 1 year later. In contrast, 9.3% of patients had functional decline at 1 year after hospital discharge in the primary SARS-CoV-2 pneumonia group, which was significantly lower than in the aspiration pneumonia group.Conclusions. The Omicron variant showed decreased infectivity in the lungs and was less pathogenic compared with the Delta and former variants. However, physicians should recommend SARS-CoV-2 vaccination and non-pharmaceutical interventions, depending on the presence or absence of applicable criteria for NHCAP, even when the predominant strain is the Omicron variant.
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Affiliation(s)
- Naoyuki Miyashita
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Hirakata, Japan
| | - Yasushi Nakamori
- Department of Emergency Medicine, Kansai Medical University Medical Center, Hirakata, Japan
| | - Makoto Ogata
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Hirakata, Japan
| | - Naoki Fukuda
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Hirakata, Japan
| | - Akihisa Yamura
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Hirakata, Japan
| | - Tomoki Ito
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, Hirakata, Japan
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Tiwari AK, Aggarwal G, Kale P, Yadav N, Kumar V, Singh G, Cheirmaraj K, Krishnan K. Determination of optimum levels of binding antibody units (BAU) of new quantitative chemiluminescent immuno-assay (CLIA) in COVID-19 vaccinated volunteer blood donors. Transfus Apher Sci 2024; 63:103937. [PMID: 38678985 DOI: 10.1016/j.transci.2024.103937] [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: 07/11/2023] [Revised: 03/23/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND For assessment of COVID-19 vaccine efficacy, neutralization activity of anti-SARS-CoV-2 antibody is measured. This study was undertaken to determine optimum levels of binding antibody units (BAU/ml) in new quantitative chemiluminescent assay (CLIA) that corresponded to neutralizing potential (30% inhibition) of sVNT assay. METHODS Ninety-one blood samples were analyzed by CLIA and sVNT assays. Test samples (n = 75) were collected from blood donors post-2nd vaccination dose, while control samples (n = 16) were archived pre-COVID donor samples. Correlation between CLIA and sVNT was calculated and receiver operating characteristic (ROC) curve was drawn and analyzed. RESULTS Results indicated excellent correlation between 57.5 BAU/ml on CLIA and 30%inhibition on sVNT assay. ROC curve analysis revealed that the area under the curve (AUC) was 0.971. DISCUSSION The present study determined that 57.5 BAU/ml on CLIA corresponded to 30% inhibition on sVNT assay. Periodic quantitative analysis.
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Affiliation(s)
- Aseem Kumar Tiwari
- Department of Transfusion Medicine Medanta-The Medicity, Sector-38, Gurgaon, India.
| | - Geet Aggarwal
- Department of Transfusion Medicine Medanta-The Medicity, Sector-38, Gurgaon, India
| | - Pratibha Kale
- Department of Clinical Microbiology Institute of Liver and Biliary Sciences, New Delhi, India
| | - Neeti Yadav
- Department of Transfusion Medicine Medanta-The Medicity, Sector-38, Gurgaon, India
| | - Virendra Kumar
- Department of Microbiology College of Life Sciences, Jiwaji University Gwalior, India
| | - Gargi Singh
- Medanta Institute of Education and Research Medanta-The Medicity, Sector-38, Gurgaon, India
| | - K Cheirmaraj
- Independent Laboratory Consultant, Chennai, Tamil Nadu, India
| | - K Krishnan
- Laboratory Medicine, Thane West, Mumbai 400606, India
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Hirano H. Anti-spike protein IgG antibody responses up to 3 months after the third dose of the BNT162b2 mRNA vaccine in medical care workers. J Gen Fam Med 2024; 25:140-145. [PMID: 38707702 PMCID: PMC11065147 DOI: 10.1002/jgf2.688] [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: 10/03/2023] [Revised: 01/30/2024] [Accepted: 03/06/2024] [Indexed: 05/07/2024] Open
Abstract
Background This study aimed to assess the changes in anti-spike protein IgG antibody titer over time following mRNA vaccination (BNT162b2) against severe acute respiratory syndrome coronavirus 2. Methods We monitored IgG levels in 23 medical care workers (MCWs) for up to 3 months after administering the third dose of BNT162b2. Blood samples were periodically collected from all participants. Results Following the third dose, the median antibody titer increased to 252 and 327% compared with antibody levels at 1 and 3 months after the second dose, respectively. Additionally, compared with 1 month after the second dose, the median antibody titer decreased to 30.2 and 9.8% at 3 and 6 months, respectively, and to 39.1% at 3 months, compared with 1 month after the third dose. Conclusion Antibody levels declined quickly after the second dose but declined more slowly after the third dose, showing a booster effect. This study provides insights into the immunogenicity of booster doses and time intervals for booster vaccination strategies.
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Affiliation(s)
- Harukazu Hirano
- Koyo Seikyo ClinicFukui Health Cooperative Association (FHCA)FukuiJapan
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Miyashita N, Nakamori Y, Ogata M, Fukuda N, Yamura A, Ishiura Y, Ito T. Invalidity of JRS atypical pneumonia prediction score in Omicron variant of COVID-19 pneumonia. Respir Investig 2024; 62:384-387. [PMID: 38452443 DOI: 10.1016/j.resinv.2024.02.010] [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: 08/01/2023] [Revised: 01/31/2024] [Accepted: 02/17/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND We evaluated whether the Japanese Respiratory Society (JRS) atypical pneumonia prediction score can be adapted for the diagnosis of COVID-19 pneumonia due to Omicron BA.1, BA.2, and BA.5 subvariants. METHODS We enrolled a total of 547 patients with community-acquired COVID-19 pneumonia. Of the COVID-19 pneumonia patients, 198 cases were the Omicron BA.1 subvariant, 127 cases were the Omicron BA.2 subvariant, and 222 cases were the Omicron BA.5 subvariant. Patients with extremely severe pneumonia were excluded and finally 524 patients were analyzed. RESULTS Rates of conformity for the six predictors were identical among the three Omicron groups, and high rates of conformity were observed in the following predictors: adventitious sounds; etiological agent; and a peripheral WBC count. The sensitivities of the diagnosis of atypical pneumonia in patients with COVID-19 pneumonia based on four or more predictors were 49.0% in the BA.1 subvariant group, 58.1% in the BA.2 subvariant group, and 51.0% in the BA.5 subvariant group. The diagnostic sensitivities for Omicron BA.1, BA.2, and BA.5 subvariant groups were 96.6%, 100%, and 96.4% for non-elderly (aged <60 years) patients and 28.4%, 29.7%, and 34.2% for elderly (aged ≥60 years) patients, respectively. CONCLUSIONS In Omicron variant of COVID-19, the JRS atypical pneumonia prediction score is a useful tool for distinguishing between COVID-19 pneumonia and bacterial pneumonia only in patients aged <60 years.
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Affiliation(s)
- Naoyuki Miyashita
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
| | - Yasushi Nakamori
- Department of Emergency Medicine, Kansai Medical University Medical Center, 10-15 Bunen-cho, Moriguchi, Osaka, 570-8507, Japan
| | - Makoto Ogata
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Naoki Fukuda
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Akihisa Yamura
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Yoshihisa Ishiura
- First Department of Internal Medicine, Division of Respiratory Medicine, Oncology and Allergology, Kansai Medical University Medical Center, 10-15 Bunen-cho, Moriguchi, Osaka, 570-8507, Japan
| | - Tomoki Ito
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
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Miyashita N, Nakamori Y, Ogata M, Fukuda N, Yamura A, Ishiura Y, Ito T. Is the JRS atypical pneumonia prediction score useful in detecting COVID-19 pneumonia under nursing or healthcare settings? Respir Investig 2024; 62:187-191. [PMID: 38185019 DOI: 10.1016/j.resinv.2023.12.017] [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: 08/04/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND SARS-CoV-2 causes frequent outbreaks in elderly care facilities that meet the criteria for nursing and healthcare-associated pneumonia (NHCAP). We evaluated whether the Japanese Respiratory Society (JRS) atypical pneumonia prediction score could be adapted to the diagnosis of nursing and healthcare acquired COVID-19 (NHA-COVID-19) with pneumonia. METHODS We analyzed 516 pneumonia patients with NHA-COVID-19 and compared them with 1505 pneumonia patients with community-associated COVID-19 (CA-COVID-19). NHA-COVID-19 patients were divided into six groups; 80 cases had the ancestral strain, 76 cases had the Alfa variant, 30 cases had the Delta variant, 120 cases had the Omicron subvariant BA.1, 53 cases had the Omicron subvariant BA.2, and 157 cases had the Omicron subvariant BA.5. RESULTS The sensitivities of the diagnosis of atypical pneumonia in patients with NHA-COVID-19 based on four or more predictors were 22.8 % in the ancestral strain group, 32.0 % in the Alfa variant group, 34.5 % in the Delta variant group, 23.1 % in the BA.1 subvariant group, 32.7 % in the BA.2 subvariant group, and 30.4 % in the BA.5 subvariant group. The diagnostic sensitivity for the presumptive diagnosis of atypical pneumonia was significantly lower for NHA-COVID-19 than for CA-COVID-19 (28.2 % vs 64.1 %, p < 0.0001). CONCLUSIONS Our present study demonstrated that the JRS atypical pneumonia prediction score is not a useful tool in elderly patients even if there is a lot of atypical pneumonia in the NHCAP group. The caution is necessary that JRS atypical pneumonia prediction score was not fully applied to prediction for NHA-COVID-19 pneumonia.
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Affiliation(s)
- Naoyuki Miyashita
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan.
| | - Yasushi Nakamori
- Department of Emergency Medicine, Kansai Medical University Medical Center, 10-15 Bunen-cho, Moriguchi, Osaka, 570-8507, Japan
| | - Makoto Ogata
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Naoki Fukuda
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Akihisa Yamura
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
| | - Yoshihisa Ishiura
- First Department of Internal Medicine, Division of Respiratory Medicine, Oncology and Allergology, Kansai Medical University Medical Center, 10-15 Bunen-cho, Moriguchi, Osaka, 570-8507, Japan
| | - Tomoki Ito
- First Department of Internal Medicine, Division of Respiratory Medicine, Infectious Disease and Allergology, Kansai Medical University, 2-3-1 Shin-machi, Hirakata, Osaka, 573-1191, Japan
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Picchianti-Diamanti A, Navarra A, Aiello A, Laganà B, Cuzzi G, Salmi A, Vanini V, Maggi F, Meschi S, Matusali G, Notari S, Agrati C, Salemi S, Di Rosa R, Passarini D, Di Gioia V, Sesti G, Conti F, Spinelli FR, Corpolongo A, Chimenti MS, Ferraioli M, Sebastiani GD, Benucci M, Li Gobbi F, Santoro AP, Capri A, Puro V, Nicastri E, Goletti D. Older Age, a High Titre of Neutralising Antibodies and Therapy with Conventional DMARDs Are Associated with Protection from Breakthrough Infection in Rheumatoid Arthritis Patients after the Booster Dose of Anti-SARS-CoV-2 Vaccine. Vaccines (Basel) 2023; 11:1684. [PMID: 38006015 PMCID: PMC10675674 DOI: 10.3390/vaccines11111684] [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: 09/18/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Objectives: We aimed to analyse the incidence and severity of breakthrough infections (BIs) in rheumatoid arthritis (RA) patients after a COronaVIrus Disease 2019 (COVID-19) vaccination booster dose. Methods: We enrolled 194 RA patients and 1002 healthcare workers (HCWs) as controls. Clinical, lifestyle and demographic factors were collected at the time of the third dose, and immunogenicity analyses were carried out in a subgroup of patients at 4-6 weeks after the third dose. Results: BIs were experienced by 42% patients (82/194) with a median time since the last vaccination of 176 days. Older age (>50 years; aHR 0.38, 95% CI: 0.20-0.74), receiving conventional synthetic disease modifying antirheumatic drugs (csDMARDs) (aHR 0.52, 95%CI: 0.30-0.90) and having a titre of neutralising antibodies >20 (aHR 0.36, 95% CI: 0.12-1.07) were identified as protective factors. Conversely, anti-IL6R treatment and anti-CD20 therapy increased BI probability. BIs were mostly pauci-symptomatic, but the hospitalisation incidence was significantly higher than in HCWs (8.5% vs. 0.19%); the main risk factor was anti-CD20 therapy. Conclusions: Being older than 50 years and receiving csDMARDs were shown to be protective factors for BI, whereas anti-IL6R or anti-CD20 therapy increased the risk. Higher neutralising antibody titres were associated with a lower probability of BI. If confirmed in a larger population, the identification of a protective cut-off would allow a personalised risk-benefit therapeutic management of RA patients.
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Affiliation(s)
- Andrea Picchianti-Diamanti
- Department of Clinical and Molecular Medicine, “Sapienza” University, S. Andrea University Hospital, 00189 Rome, Italy; (A.P.-D.); (B.L.); (S.S.); (R.D.R.); (D.P.); (V.D.G.); (G.S.)
| | - Assunta Navarra
- Epidemiology Department, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy;
| | - Alessandra Aiello
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (A.A.); (G.C.); (A.S.); (V.V.)
| | - Bruno Laganà
- Department of Clinical and Molecular Medicine, “Sapienza” University, S. Andrea University Hospital, 00189 Rome, Italy; (A.P.-D.); (B.L.); (S.S.); (R.D.R.); (D.P.); (V.D.G.); (G.S.)
| | - Gilda Cuzzi
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (A.A.); (G.C.); (A.S.); (V.V.)
| | - Andrea Salmi
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (A.A.); (G.C.); (A.S.); (V.V.)
| | - Valentina Vanini
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (A.A.); (G.C.); (A.S.); (V.V.)
- Unità Operativa Semplice (UOS) Professioni Sanitarie Tecniche, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy
| | - Fabrizio Maggi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (F.M.); (S.M.); (G.M.)
| | - Silvia Meschi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (F.M.); (S.M.); (G.M.)
| | - Giulia Matusali
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (F.M.); (S.M.); (G.M.)
| | - Stefania Notari
- Laboratory of Cellular Immunology and Clinical Pharmacology, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (S.N.); (C.A.)
| | - Chiara Agrati
- Laboratory of Cellular Immunology and Clinical Pharmacology, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (S.N.); (C.A.)
- Department of Pediatric Hematology and Oncology, Bambino Gesù Pediatric Hospital, 00152 Rome, Italy
| | - Simonetta Salemi
- Department of Clinical and Molecular Medicine, “Sapienza” University, S. Andrea University Hospital, 00189 Rome, Italy; (A.P.-D.); (B.L.); (S.S.); (R.D.R.); (D.P.); (V.D.G.); (G.S.)
| | - Roberta Di Rosa
- Department of Clinical and Molecular Medicine, “Sapienza” University, S. Andrea University Hospital, 00189 Rome, Italy; (A.P.-D.); (B.L.); (S.S.); (R.D.R.); (D.P.); (V.D.G.); (G.S.)
| | - Damiano Passarini
- Department of Clinical and Molecular Medicine, “Sapienza” University, S. Andrea University Hospital, 00189 Rome, Italy; (A.P.-D.); (B.L.); (S.S.); (R.D.R.); (D.P.); (V.D.G.); (G.S.)
| | - Valeria Di Gioia
- Department of Clinical and Molecular Medicine, “Sapienza” University, S. Andrea University Hospital, 00189 Rome, Italy; (A.P.-D.); (B.L.); (S.S.); (R.D.R.); (D.P.); (V.D.G.); (G.S.)
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, “Sapienza” University, S. Andrea University Hospital, 00189 Rome, Italy; (A.P.-D.); (B.L.); (S.S.); (R.D.R.); (D.P.); (V.D.G.); (G.S.)
| | - Fabrizio Conti
- Reumatologia, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, “Sapienza” Università di Roma, 00161 Rome, Italy; (F.C.); (F.R.S.)
| | - Francesca Romana Spinelli
- Reumatologia, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, “Sapienza” Università di Roma, 00161 Rome, Italy; (F.C.); (F.R.S.)
| | - Angela Corpolongo
- Clinical Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (A.C.); (E.N.)
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, Department of ‘Medicina dei Sistemi’, University of Rome ‘Tor Vergata’, 00133 Rome, Italy;
| | - Mario Ferraioli
- Department of Rheumatology, San Camillo Hospital, 00152 Rome, Italy; (M.F.); (G.D.S.)
| | | | - Maurizio Benucci
- Rheumatology Unit, S. Giovanni di Dio Hospital, Azienda USL—Toscana Centro, 50122 Florence, Italy; (M.B.); (F.L.G.)
| | - Francesca Li Gobbi
- Rheumatology Unit, S. Giovanni di Dio Hospital, Azienda USL—Toscana Centro, 50122 Florence, Italy; (M.B.); (F.L.G.)
| | - Anna Paola Santoro
- UOC Emerging Infections and Centro di Riferimento AIDS (CRAIDS), National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (A.P.S.); (A.C.); (V.P.)
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Bambino Gesù Children’s Hospital, 00165 Rome, Italy
| | - Andrea Capri
- UOC Emerging Infections and Centro di Riferimento AIDS (CRAIDS), National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (A.P.S.); (A.C.); (V.P.)
| | - Vincenzo Puro
- UOC Emerging Infections and Centro di Riferimento AIDS (CRAIDS), National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (A.P.S.); (A.C.); (V.P.)
| | - Emanuele Nicastri
- Clinical Division of Infectious Diseases, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (A.C.); (E.N.)
| | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani—Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00149 Rome, Italy; (A.A.); (G.C.); (A.S.); (V.V.)
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9
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Kenny G, O'Reilly S, Wrigley Kelly N, Negi R, Gaillard C, Alalwan D, Saini G, Alrawahneh T, Francois N, Angeliadis M, Garcia Leon AA, Tinago W, Feeney ER, Cotter AG, de Barra E, Yousif O, Horgan M, Doran P, Stemler J, Koehler P, Cox RJ, O'Shea D, Olesen OF, Landay A, Hogan AE, Lelievre JD, Gautier V, Cornely OA, Mallon PWG. Distinct receptor binding domain IgG thresholds predict protective host immunity across SARS-CoV-2 variants and time. Nat Commun 2023; 14:7015. [PMID: 37919289 PMCID: PMC10622572 DOI: 10.1038/s41467-023-42717-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/19/2023] [Indexed: 11/04/2023] Open
Abstract
SARS-CoV-2 neutralising antibodies provide protection against COVID-19. Evidence from early vaccine trials suggested binding antibody thresholds could serve as surrogate markers of neutralising capacity, but whether these thresholds predict sufficient neutralising capacity against variants of concern (VOCs), and whether this is impacted by vaccine or infection history remains unclear. Here we analyse individuals recovered from, vaccinated or with hybrid immunity against SARS-CoV-2. An NT50 ≥ 100 IU confers protection in vaccine trials, however, as VOC induce a reduction in NT50, we use NT50 ≥ 1000 IU as a cut off for WT NT50 that would retain neutralisation against VOC. In unvaccinated convalescent participants, a receptor binding domain (RBD) IgG of 456 BAU/mL predicts an NT50 against WT of 1000 IU with an accuracy of 80% (95%CI 73-86%). This threshold maintains accuracy in determining loss of protective immunity against VOC in two vaccinated cohorts. It predicts an NT50 < 100 IU against Beta with an accuracy of 80% (95%CI 67-89%) in 2 vaccine dose recipients. In booster vaccine recipients with a history of COVID-19 (hybrid immunity), accuracy is 87% (95%CI 77-94%) in determining an NT50 of <100 IU against BA.5. This analysis provides a discrete threshold that could be used in future clinical studies.
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Affiliation(s)
- Grace Kenny
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland.
| | - Sophie O'Reilly
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Neil Wrigley Kelly
- St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
- Kathleen Lonsdale Institute for Human Health Research, Maynooth University, Maynooth, Co Kildare, Ireland
| | - Riya Negi
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Colette Gaillard
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Dana Alalwan
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Gurvin Saini
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Tamara Alrawahneh
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Nathan Francois
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Matthew Angeliadis
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Alejandro Abner Garcia Leon
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Willard Tinago
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Eoin R Feeney
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
- St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Aoife G Cotter
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland
| | - Eoghan de Barra
- Department of Infectious Diseases, Beaumont Hospital, Beaumont, Dublin 9, Ireland
- Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Obada Yousif
- Endocrinology Department, Wexford General Hospital, Carricklawn, Wexford, Ireland
| | - Mary Horgan
- Department of Infectious Diseases, Cork University Hospital, Wilton, Co Cork, Ireland
| | - Peter Doran
- School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Jannik Stemler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Internal Medicine and University of Cologne, Faculty of Medicine Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department Cologne, Cologne, Germany
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Internal Medicine and University of Cologne, Faculty of Medicine Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department Cologne, Cologne, Germany
| | - Rebecca Jane Cox
- Influenza Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Donal O'Shea
- St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Ole F Olesen
- European Vaccine Initiative, Heidelberg, Germany
| | - Alan Landay
- Department of internal Medicine, Rush University, Chicago, IL, USA
| | - Andrew E Hogan
- Kathleen Lonsdale Institute for Human Health Research, Maynooth University, Maynooth, Co Kildare, Ireland
- National Children's Research Centre, Dublin 12, Ireland
| | | | - Virginie Gautier
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Internal Medicine and University of Cologne, Faculty of Medicine Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany
- German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne Department Cologne, Cologne, Germany
| | - Patrick W G Mallon
- Centre for Experimental Pathogen Host Research (CEPHR), University College Dublin, Belfield, Dublin 4, Ireland
- St Vincent's University Hospital, Elm Park, Dublin 4, Ireland
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10
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da Penha Gomes Gouvea M, Lira Machado KLL, de Oliveira YGP, Moulaz IR, Henriques AG, Gouveia TM, Thompson BP, Lança KEM, de Souza Ramos S, Lacerda GCC, Lenzi JPG, de Castro Pimentel F, Miossi JPM, Rassele ML, Camacho LAB, Villela DAM, de Lima SMB, de Souza Azevedo A, Horbach IS, de Araújo MF, Tort LFL, de Oliveira ACA, Siqueira MM, Garcia CC, da Costa-Rocha IA, Campi-Azevedo AC, Peruhype-Magalhães V, da Silva VG, Miyamoto ST, Dos Santos Fantoni RN, Pinto-Neto LF, Magda Domingues C, de Medeiros Junior NF, Burian AP, Teixeira-Carvalho A, Mota LMH, Mill JG, Martins-Filho OA, Valim V. Timeline kinetics of protective immunity to SARS-CoV-2 upon primary vaccination and humoral response to variants after booster dose. Vaccine 2023; 41:6514-6528. [PMID: 37661534 DOI: 10.1016/j.vaccine.2023.08.022] [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: 04/24/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023]
Abstract
New variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have emerged, imposing the need for periodic booster doses. However, whether booster doses should be applied to the entire population or groups, and the booster doses interval, remains unclear. In this study, we evaluated humoral reactivity kinetics from before the first dose to 180 days after the third booster dose in different schedules in a well-controlled health worker cohort. Among the 2,506 employees, the first 500 vaccinated health workers were invited to participate. The third booster dose was administered 8 months after the first dose. Among the invited participants, 470 were included in the study; 258 received inactivated vaccine CoronaVac (VAC group) and 212 received viral vector vaccine ChAdOx1 (AZV group). The groups were homogeneous in terms of age and sex. 347 participants were followed up after the booster dose with AZV or BNT162b2 (Pfizer, BNT group): 63 with VAC/AZV, 117 with VAC/BNT, 72 with the AZV/AZV and 95 with AZV/BNT schedules. Blood samples were collected immediately before, 28 days after each dose and 180 days after the primary vaccination and booster dose. Anti-SARS-CoV-2 antibodies were measured by chemiluminescence and plaque reduction neutralization test (PRNT). Plasma immune mediators were quantified using a multiplex immunoassay. Geometric mean of antibodies increased 28 days after the second dose with 100 % seroconversion rate in both groups and decreased 180 days after the first dose. In the baseline-seropositive VAC group, the levels of plasma immune mediators increased after the second dose. Booster dose was applied at 4-6 months after the primary vaccination. Heterologous booster in VAC or AZV primary vaccinees were effective maintaining the titers of anti-SARS-CoV-2 antibodies even after 6 months of follow-up. The heterologous schedule induced higher and stable antibody reactivity, even after 180 days, protecting to ancestral (Wuhan), Delta, and Omicron variants.
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Affiliation(s)
- Maria da Penha Gomes Gouvea
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva (PPGSC), Centro de Ciências Médicas, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Ketty Lysie Libardi Lira Machado
- Programa de Pós-graduação em Saúde Coletiva (PPGSC), Centro de Ciências Médicas, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Yasmin Gurtler Pinheiro de Oliveira
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva (PPGSC), Centro de Ciências Médicas, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Isac Ribeiro Moulaz
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | - Allan Gonçalves Henriques
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | - Thayná Martins Gouveia
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | - Beatriz Paoli Thompson
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | - Karen Evelin Monlevade Lança
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | - Sabrina de Souza Ramos
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | | | - João Pedro Gonçalves Lenzi
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | - Felipe de Castro Pimentel
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | - João Pedro Moraes Miossi
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | - Matheus Leite Rassele
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | | | | | - Sheila Maria Barbosa de Lima
- Laboratório de Tecnologia Virológica (LATEV), Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Adriana de Souza Azevedo
- Laboratório de Tecnologia Virológica (LATEV), Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Ingrid Siciliano Horbach
- Laboratório de Tecnologia Virológica (LATEV), Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Mia Ferreira de Araújo
- Laboratório de Vírus Respiratórios, Exantemáticos, Enterovírus e Emergências Virais (LVRE), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Luis Fernando Lopez Tort
- Laboratório de Vírus Respiratórios, Exantemáticos, Enterovírus e Emergências Virais (LVRE), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Any Caroline Alves de Oliveira
- Laboratório de Vírus Respiratórios, Exantemáticos, Enterovírus e Emergências Virais (LVRE), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Marilda Mendonça Siqueira
- Laboratório de Vírus Respiratórios, Exantemáticos, Enterovírus e Emergências Virais (LVRE), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | - Cristiana Couto Garcia
- Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, MG, Brazil; Laboratório de Vírus Respiratórios, Exantemáticos, Enterovírus e Emergências Virais (LVRE), Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil
| | | | | | | | - Vanézia Gonçalves da Silva
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva (PPGSC), Centro de Ciências Médicas, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | - Samira Tatiyama Miyamoto
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil
| | | | | | - Carla Magda Domingues
- External Consultant, Temporary Consulting of the Pan American Health Organization, Brazil
| | - Nésio Fernandes de Medeiros Junior
- Programa de Pós-graduação em Saúde Coletiva (PPGSC), Centro de Ciências Médicas, Universidade Federal do Espírito Santo, Vitória, ES, Brazil; Secretaria de Saúde do Estado do Espírito Santo, Vitória, ES, Brazil
| | - Ana Paula Burian
- Secretaria de Saúde do Estado do Espírito Santo, Vitória, ES, Brazil
| | | | | | - José Geraldo Mill
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva (PPGSC), Centro de Ciências Médicas, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
| | | | - Valéria Valim
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo (HUCAM-UFES/EBSERH), Vitória, ES, Brazil; Programa de Pós-graduação em Saúde Coletiva (PPGSC), Centro de Ciências Médicas, Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
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11
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Miyashita N, Nakamori Y, Ogata M, Fukuda N, Yamura A, Ishiura Y, Ito T. Clinical Efficacy of the Neutralizing Antibody Therapy Sotrovimab in Patients with SARS-CoV-2 Omicron BA.1 and BA.2 Subvariant Infections. Viruses 2023; 15:1300. [PMID: 37376600 DOI: 10.3390/v15061300] [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: 05/15/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Sotrovimab, an antibody active against severe acute respiratory syndrome coronavirus 2 that neutralizes antibodies, reduced the risk of COVID-19-related hospitalization or death in studies conducted before the emergence of the Omicron variant. The objective of this study is to evaluate the clinical efficacy of sotrovimab in patients with mild to moderate COVID-19 Omicron BA.1 and BA.2 subvariant infections using a propensity score matching method. The propensity score-matched cohort study population was derived from patients who received sotrovimab. We derived a comparator group from an age- and sex-matched population who were recuperating in a medical facility after COVID-19 infection or from elderly person entrance facilities during the same period who were eligible for but did not receive sotrovimab treatment. In total, 642 patients in the BA.1 subvariant group and 202 in the BA.2 subvariant group and matched individuals were analyzed. The outcome was the requirement for oxygen therapy. In the treatment group, 26 patients with the BA.1 subvariant and 8 patients with the BA.2 subvariant received oxygen therapy. The administration of oxygen therapy was significantly lower in the treatment group than in the control group (BA.1 subvariant group, 4.0% vs. 8.7%, p = 0.0008; BA.2 subvariant group, 4.0% vs. 9.9%, p = 0.0296). All these patients were admitted to our hospitals and received additional therapy and then recovered. No deaths were observed in either group. Our results demonstrate that the sotrovimab antibody treatment may be associated with a reduction in the requirement for oxygen therapy among high-risk patients with mild to moderate COVID-19 Omicron BA.1 and BA.2 subvariants.
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Affiliation(s)
- Naoyuki Miyashita
- Division of Respiratory Medicine, Infectious Disease and Allergology, First Department of Internal Medicine, Kansai Medical University, 2-3-1 Shin-machi, Hirakata 573-1191, Japan
| | - Yasushi Nakamori
- Department of Emergency Medicine, Kansai Medical University Medical Center, Moriguchi 570-8507, Japan
| | - Makoto Ogata
- Division of Respiratory Medicine, Infectious Disease and Allergology, First Department of Internal Medicine, Kansai Medical University, 2-3-1 Shin-machi, Hirakata 573-1191, Japan
| | - Naoki Fukuda
- Division of Respiratory Medicine, Infectious Disease and Allergology, First Department of Internal Medicine, Kansai Medical University, 2-3-1 Shin-machi, Hirakata 573-1191, Japan
| | - Akihisa Yamura
- Division of Respiratory Medicine, Infectious Disease and Allergology, First Department of Internal Medicine, Kansai Medical University, 2-3-1 Shin-machi, Hirakata 573-1191, Japan
| | - Yoshihisa Ishiura
- Division of Respiratory Medicine, Oncology and Allergology, First Department of Internal Medicine, Kansai Medical University Medical Center, Moriguchi 570-8507, Japan
| | - Tomoki Ito
- Division of Respiratory Medicine, Infectious Disease and Allergology, First Department of Internal Medicine, Kansai Medical University, 2-3-1 Shin-machi, Hirakata 573-1191, Japan
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12
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Santoro A, Capri A, Petrone D, Colavita F, Meschi S, Matusali G, Mizzoni K, Notari S, Agrati C, Goletti D, Pezzotti P, Puro V. SARS-CoV-2 Breakthrough Infections According to the Immune Response Elicited after mRNA Third Dose Vaccination in COVID-19-Naïve Hospital Personnel. Biomedicines 2023; 11:biomedicines11051247. [PMID: 37238918 DOI: 10.3390/biomedicines11051247] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/19/2023] [Accepted: 04/22/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Vaccine-induced SARS-CoV-2-anti-spike antibody (anti-S/RBD) titers are often used as a marker of immune protection and to anticipate the risk of breakthrough infections, although no clear cut-off is available. We describe the incidence of SARS-CoV-2 vaccine breakthrough infections in COVID-19-free personnel of our hospital, according to B- and T-cell immune response elicited one month after mRNA third dose vaccination. METHODS The study included 487 individuals for whom data on anti-S/RBD were available. Neutralizing antibody titers (nAbsT) against the ancestral Whuan SARS-CoV-2, and the BA.1 Omicron variant, and SARS-CoV-2 T-cell specific response were measured in subsets of 197 (40.5%), 159 (32.6%), and 127 (26.1%) individuals, respectively. RESULTS On a total of 92,063 days of observation, 204 participants (42%) had SARS-CoV-2 infection. No significant differences in the probability of SARS-CoV-2 infection for different levels of anti-S/RBD, nAbsT, Omicron nAbsT, or SARS-CoV-2 T cell specific response, and no protective thresholds for infection were found. CONCLUSIONS Routine testing for vaccine-induced humoral immune response to SARS-CoV-2 is not recommended if measured as parameters of 'protective immunity' from SARS-CoV-2 after vaccination. Whether these findings apply to new Omicron-specific bivalent vaccines is going to be evaluated.
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Affiliation(s)
- Annapaola Santoro
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
- Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Andrea Capri
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Daniele Petrone
- Department of Infectious Diseases, National Institute of Health (ISS), 00161 Rome, Italy
| | - Francesca Colavita
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Silvia Meschi
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Giulia Matusali
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Klizia Mizzoni
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Stefania Notari
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Chiara Agrati
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
- Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy
| | - Delia Goletti
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
| | - Patrizio Pezzotti
- Department of Infectious Diseases, National Institute of Health (ISS), 00161 Rome, Italy
| | - Vincenzo Puro
- National Institute for Infectious Diseases, Lazzaro Spallanzani IRCCS, 00149 Rome, Italy
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Liatsou E, Ntanasis-Stathopoulos I, Lykos S, Ntanasis-Stathopoulos A, Gavriatopoulou M, Psaltopoulou T, Sergentanis TN, Terpos E. Adult Patients with Cancer Have Impaired Humoral Responses to Complete and Booster COVID-19 Vaccination, Especially Those with Hematologic Cancer on Active Treatment: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15082266. [PMID: 37190194 DOI: 10.3390/cancers15082266] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023] Open
Abstract
The exclusion of patients with cancer in clinical trials evaluating COVID-19 vaccine efficacy and safety, in combination with the high rate of severe infections, highlights the need for optimizing vaccination strategies. The aim of this study was to perform a systematic review and meta-analysis of the published available data from prospective and retrospective cohort studies that included patients with either solid or hematological malignancies according to the PRISMA Guidelines. A literature search was performed in the following databases: Medline (Pubmed), Scopus, Clinicaltrials.gov, EMBASE, CENTRAL and Google Scholar. Overall, 70 studies were included for the first and second vaccine dose and 60 studies for the third dose. The Effect Size (ES) of the seroconversion rate after the first dose was 0.41 (95%CI: 0.33-0.50) for hematological malignancies and 0.56 (95%CI: 0.47-0.64) for solid tumors. The seroconversion rates after the second dose were 0.62 (95%CI: 0.57-0.67) for hematological malignancies and 0.88 (95%CI: 0.82-0.93) for solid tumors. After the third dose, the ES for seroconversion was estimated at 0.63 (95%CI: 0.54-0.72) for hematological cancer and 0.88 (95%CI: 0.75-0.97) for solid tumors. A subgroup analysis was performed to evaluate potential factors affecting immune response. Production of anti-SARS-CoV-2 antibodies was found to be more affected in patients with hematological malignancies, which was attributed to the type of malignancy and treatment with monoclonal antibodies according to the subgroup analyses. Overall, this study highlights that patients with cancer present suboptimal humoral responses after COVID-19 vaccination. Several factors including timing of vaccination in relevance with active therapy, type of therapy, and type of cancer should be considered throughout the immunization process.
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Affiliation(s)
- Efstathia Liatsou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | - Stavros Lykos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | | | - Maria Gavriatopoulou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Theodora Psaltopoulou
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Theodoros N Sergentanis
- Department of Public Health Policy, School of Public Health, University of West Attica, 12243 Aigaleo, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, 11528 Athens, Greece
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14
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Gerhards C, Thiaucourt M, Hetjens M, Haselmann V, Neumaier M, Kittel M. Heterologous Vector-mRNA Based SARS-CoV-2 Vaccination Strategy Appears Superior to a Homologous Vector-Based Vaccination Scheme in German Healthcare Workers Regarding Humoral SARS-CoV-2 Response Indicating a High Boosting Effect by mRNA Vaccines. Vaccines (Basel) 2023; 11:701. [PMID: 36992285 PMCID: PMC10054089 DOI: 10.3390/vaccines11030701] [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: 02/22/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Longitudinal humoral SARS-CoV-2 (severe acute respiratory syndrome coronavirus type 2) immunity for up to 15 months due to vaccination, the efficacy of vaccination strategies (homologous, vector-vector versus heterologous, vector-mRNA), the influence of vaccination side effects, and the infection rate in German healthcare workers need to be investigated. METHODS In this study, 103 individuals vaccinated against SARS-CoV-2 were enrolled to examine their anti-SARS-CoV-2 anti-N- and anti-RBD/S1-Ig levels. A total of 415 blood samples in lithium heparin tubes were prospectively obtained, and a structured survey regarding medical history, type of vaccine, and vaccination reactions was conducted. RESULTS All participants demonstrated a humoral immune response, among whom no values decreased below the positivity cutoff. Five to six months after the third vaccination, three participants showed anti-RBD/S1 antibodies of less than 1000 U/mL. We observed higher levels for heterologous mRNA-/vector-based combinations compared to pure vector-based vaccination after the second vaccination, which is harmonized after a third vaccination with the mRNA-vaccine only in both cohorts. The incidence of vaccine breakthrough in a highly exposed cohort was 60.3%. CONCLUSION Sustained long-term humoral immunity was observed, indicating the superiority of a heterologous mRNA-/vector-based combination compared to pure vector-based vaccination. There was longevity of anti-RBD/S1 antibodies of at least 4 and up to 7 months without external stimulus. Regarding vaccination reactogenity, the occurrence of local symptoms as pain at the injection site was increased after the first mRNA application compared to the vector-vector cohort with a general decrease in adverse events at later vaccination time points. Overall, a correlation between the humoral vaccination response and vaccination side effects was not observed. Despite the high prevalence of vaccine breakthroughs, these only occurred in the later course of the study when more infectious variants, which are, however, associated with milder courses, were present. These results provide insights into vaccine-related serologic responses, and the study should be expanded using additional vaccine doses and novel variants in the future.
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Affiliation(s)
- Catharina Gerhards
- Institute for Clinical Chemistry, Medical Faculty Mannheim, University of Heidelberg, Theodor Kutzer Ufer 1-3, 68167 Mannheim, Germany
| | - Margot Thiaucourt
- Institute for Clinical Chemistry, Medical Faculty Mannheim, University of Heidelberg, Theodor Kutzer Ufer 1-3, 68167 Mannheim, Germany
| | - Michael Hetjens
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health Baden-Württemberg, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Verena Haselmann
- Institute for Clinical Chemistry, Medical Faculty Mannheim, University of Heidelberg, Theodor Kutzer Ufer 1-3, 68167 Mannheim, Germany
| | - Michael Neumaier
- Institute for Clinical Chemistry, Medical Faculty Mannheim, University of Heidelberg, Theodor Kutzer Ufer 1-3, 68167 Mannheim, Germany
| | - Maximilian Kittel
- Institute for Clinical Chemistry, Medical Faculty Mannheim, University of Heidelberg, Theodor Kutzer Ufer 1-3, 68167 Mannheim, Germany
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15
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Gupta A, Konnova A, Smet M, Berkell M, Savoldi A, Morra M, Van Averbeke V, De Winter FH, Peserico D, Danese E, Hotterbeekx A, Righi E, De Nardo P, Tacconelli E, Malhotra-Kumar S, Kumar-Singh S. Host immunological responses facilitate development of SARS-CoV-2 mutations in patients receiving monoclonal antibody treatments. J Clin Invest 2023; 133:166032. [PMID: 36727404 PMCID: PMC10014108 DOI: 10.1172/jci166032] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 01/05/2023] [Indexed: 02/03/2023] Open
Abstract
BackgroundThe role of host immunity in emergence of evasive SARS-CoV-2 Spike mutations under therapeutic monoclonal antibody (mAb) pressure remains to be explored.MethodsIn a prospective, observational, monocentric ORCHESTRA cohort study, conducted between March 2021 and November 2022, mild-to-moderately ill COVID-19 patients (n = 204) receiving bamlanivimab, bamlanivimab/etesevimab, casirivimab/imdevimab, or sotrovimab were longitudinally studied over 28 days for viral loads, de novo Spike mutations, mAb kinetics, seroneutralization against infecting variants of concern, and T cell immunity. Additionally, a machine learning-based circulating immune-related biomarker (CIB) profile predictive of evasive Spike mutations was constructed and confirmed in an independent data set (n = 19) that included patients receiving sotrovimab or tixagevimab/cilgavimab.ResultsPatients treated with various mAbs developed evasive Spike mutations with remarkable speed and high specificity to the targeted mAb-binding sites. Immunocompromised patients receiving mAb therapy not only continued to display significantly higher viral loads, but also showed higher likelihood of developing de novo Spike mutations. Development of escape mutants also strongly correlated with neutralizing capacity of the therapeutic mAbs and T cell immunity, suggesting immune pressure as an important driver of escape mutations. Lastly, we showed that an antiinflammatory and healing-promoting host milieu facilitates Spike mutations, where 4 CIBs identified patients at high risk of developing escape mutations against therapeutic mAbs with high accuracy.ConclusionsOur data demonstrate that host-driven immune and nonimmune responses are essential for development of mutant SARS-CoV-2. These data also support point-of-care decision making in reducing the risk of mAb treatment failure and improving mitigation strategies for possible dissemination of escape SARS-CoV-2 mutants.FundingThe ORCHESTRA project/European Union's Horizon 2020 research and innovation program.
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Affiliation(s)
- Akshita Gupta
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences and.,Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Angelina Konnova
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences and.,Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Mathias Smet
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences and.,Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Matilda Berkell
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences and.,Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Alessia Savoldi
- Division of Infectious Diseases, Department of Diagnostics and Public Health and
| | - Matteo Morra
- Division of Infectious Diseases, Department of Diagnostics and Public Health and
| | - Vincent Van Averbeke
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences and
| | - Fien Hr De Winter
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences and
| | - Denise Peserico
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Elisa Danese
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - An Hotterbeekx
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences and
| | - Elda Righi
- Division of Infectious Diseases, Department of Diagnostics and Public Health and
| | | | - Pasquale De Nardo
- Division of Infectious Diseases, Department of Diagnostics and Public Health and
| | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostics and Public Health and
| | - Surbhi Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Samir Kumar-Singh
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences and.,Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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16
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Cimas FJ, Torres J, Ontañón J, de Cabo C, Lozano J, Requena MÁ, Blas J, Rodríguez-García JL, Mas A, Solera J. Mathematical modelling of the waning of anti-RBD IgG SARS-CoV-2 antibody titers after a two-dose BNT162b2 mRNA vaccination. Front Immunol 2023; 14:1097747. [PMID: 36776854 PMCID: PMC9909695 DOI: 10.3389/fimmu.2023.1097747] [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: 11/14/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
Background After exposure to SARS-CoV-2 and/or vaccination there is an increase in serum antibody titers followed by a non-linear waning. Our aim was to find out if this waning of antibody titers would fit to a mathematical model. Methods We analyzed anti-RBD (receptor binding domain) IgG antibody titers and the breakthrough infections over a ten-month period following the second dose of the mRNA BNT162b2 (Pfizer-BioNtech.) vaccine, in a cohort of 54 health-care workers (HCWs) who were either never infected with SARS-CoV-2 (naïve, nHCW group, n=27) or previously infected with the virus (experienced, eHCW group, n=27). Two mathematical models, exponential and power law, were used to quantify antibody waning kinetics, and we compared the relative quality of the goodness of fit to the data between both models was compared using the Akaik Information Criterion. Results We found that the waning slopes were significantly more pronounced for the naïve when compared to the experienced HCWs in exponential (p-value: 1.801E-9) and power law (p-value: 9.399E-13) models. The waning of anti-RBD IgG antibody levels fitted significantly to both exponential (average-R2: 0.957 for nHCW and 0.954 for eHCW) and power law (average-R2: 0.991 for nHCW and 0.988 for eHCW) models, with a better fit to the power law model. In the nHCW group, titers would descend below an arbitrary 1000-units threshold at a median of 210.6 days (IQ range: 74.2). For the eHCW group, the same risk threshold would be reached at 440.0 days (IQ range: 135.2) post-vaccination. Conclusion Two parsimonious models can explain the anti-RBD IgG antibody titer waning after vaccination. Regardless of the model used, eHCWs have lower waning slopes and longer persistence of antibody titers than nHCWs. Consequently, personalized vaccination booster schedules should be implemented according to the individual persistence of antibody levels.
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Affiliation(s)
- Francisco J Cimas
- Mecenazgo COVID-19, Faculty of Medicine/Centro Regional de Investigaciones Biomedicas (CRIB), University of Castilla-La Mancha at Albacete, Albacete, Spain
| | - Javier Torres
- Clinical Analysis Department, Albacete General Hospital, Ciudad Real, Spain
| | - Jesús Ontañón
- Immunology Unit, Albacete General Hospital, Albacete, Spain
| | - Carlos de Cabo
- Research Department, Albacete General Hospital, Albacete, Spain
| | - Julia Lozano
- Microbiology Department, Albacete General Hospital, Albacete, Spain
| | | | - Joaquín Blas
- Microbiology Department, Albacete General Hospital, Albacete, Spain
| | | | - Antonio Mas
- Molecular Virology Laboratory, Department of Medical Sciences, Faculty of Medicine/Centro Regional de Investigaciones Biomedicas (CRIB), University of Castilla - La Mancha at Albacete, Ciudad Real, Castilla-La Mancha, Spain
| | - Javier Solera
- Internal Medicine Department, Albacete General Hospital, Albacete, Spain.,Molecular Virology Laboratory, Department of Medical Sciences, Faculty of Medicine/Centro Regional de Investigaciones Biomedicas (CRIB), University of Castilla - La Mancha at Albacete, Ciudad Real, Castilla-La Mancha, Spain
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17
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Heinzl MW, Kolenchery L, Resl M, Klammer C, Black A, Obendorf F, Schinagl L, Feldbauer R, Pohlhammer J, Wagner T, Berger T, Dieplinger B, Clodi M. High Anti-CoV2S Antibody Levels at Hospitalization Are Associated with Improved Survival in Patients with COVID-19 Vaccine Breakthrough Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15581. [PMID: 36497655 PMCID: PMC9740194 DOI: 10.3390/ijerph192315581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Although vaccination against COVID-19 is highly effective, breakthrough infections occur, often leading to severe courses and death. The extent of protection provided by individual antibody levels in breakthrough infections is still unknown and cut-off levels have yet to be determined. METHODS In 80 consecutive fully vaccinated patients hospitalized between August and December 2021 with COVID-19 breakthrough infection (Delta variant), anti-CoV2S antibody levels were analyzed for the endpoint of death. RESULTS Ten out of the 12 patients who died (83.3%) had antibody levels < 600 U/mL; 5 (41.7%) of these had antibody levels < 200 U/mL. Only 2 patients with a level of >600 U/mL died from vaccine breakthrough infection. Correction for the number of comorbidities and age revealed that anti-CoV2S antibody levels at the time of hospitalization were a significant predictor for reduced risk of death (OR = 0.402 for every 1000 U/mL, p = 0.018). CONCLUSIONS In this retrospective data analysis, we show that almost all patients who died from COVID-19 vaccine breakthrough infection had antibody levels < 600 U/mL, most of them below 200 U/mL. In logistic regression corrected for the number of comorbidities and age, anti-CoV2S antibody levels at the time of hospitalization proved to be a significantly protective predictor against death.
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Affiliation(s)
- Matthias Wolfgang Heinzl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Lisa Kolenchery
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Michael Resl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Carmen Klammer
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Anne Black
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Florian Obendorf
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Lukas Schinagl
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
| | - Roland Feldbauer
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Johannes Pohlhammer
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Thomas Wagner
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Thomas Berger
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
| | - Martin Clodi
- Department of Internal Medicine, Konventhospital Barmherzige Brueder Linz (St. John of God Hospital Linz), 4020 Linz, Austria
- ICMR—Institute for Cardiovascular and Metabolic Research, Johannes Kepler Universität Linz (JKU Linz), 4020 Linz, Austria
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18
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Favresse J, Douxfils J, Henry B, Lippi G, Plebani M. Clinical Chemistry and Laboratory Medicine celebrates 60 years – narrative review devoted to the contribution of the journal to the diagnosis of SARS-CoV-2. Clin Chem Lab Med 2022; 61:811-821. [PMID: 36420539 DOI: 10.1515/cclm-2022-1166] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 11/25/2022]
Abstract
Abstract
This review is an integral part of the special issue for the 60 years of the journal Clinical Chemistry and Laboratory Medicine (CCLM). The aim of the review is to highlight the role of the clinical laboratory since the emergence of the “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2), which causes Coronavirus disease 2019 (COVID-19), with special focus on the contribution of the journal in generating knowledge in SARS-CoV-2 diagnosis. As of October 30, 2022, a total of 186 CCLM publications were dedicated to COVID-19. Of importance, major International Federation of Clinical Chemistry (IFCC) guidelines related to the diagnosis of COVID-19 were published in CCLM. Between early-2020 and late October 2022, COVID-19 publications represented around 27% of all articles in CCLM, highlighting the willingness of the editorial board to help the field in order to better describe and diagnose this new emerging disease. First launched in 1963 under the name “Zeitschrift für Klinische Chemie”, the Journal was entirely devoted to clinical chemistry in the strict sense. The various topics published in relation to COVID-19 including its diagnosis, its impact on biochemical or hematological measures, as well as biosafety measures, is the perfect example that shows that the journal has greatly diversified over time.
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Affiliation(s)
- Julien Favresse
- IFCC SARS-CoV-2 Variants Working Group , Verona , Italy
- Department of Laboratory Medicine , Clinique St-Luc Bouge , Namur , Belgium
- Department of Pharmacy , Namur Research Institute for Lifes Sciences, University of Namur , Namur , Belgium
| | - Jonathan Douxfils
- Department of Pharmacy , Namur Research Institute for Lifes Sciences, University of Namur , Namur , Belgium
- Qualiblood s.a. , Namur , Belgium
| | - Brandon Henry
- IFCC SARS-CoV-2 Variants Working Group , Verona , Italy
- Clinical Laboratory, Division of Nephrology and Hypertension, Cincinnati Children’s Hospital Medical Center , Cincinnati , OH , USA
| | - Giuseppe Lippi
- IFCC SARS-CoV-2 Variants Working Group , Verona , Italy
- Section of Clinical Biochemistry and School of Medicine, University of Verona , Verona , Italy
| | - Mario Plebani
- IFCC SARS-CoV-2 Variants Working Group , Verona , Italy
- Department of Laboratory Medicine , University-Hospital of Padova , Padova , Italy
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19
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Totschnig D, Augustin M, Niculescu I, Laferl H, Jansen-Skoupy S, Lehmann C, Wenisch C, Zoufaly A. SARS-CoV-2 Pre-Exposure Prophylaxis with Sotrovimab and Tixagevimab/Cilgavimab in Immunocompromised Patients-A Single-Center Experience. Viruses 2022; 14:2278. [PMID: 36298832 PMCID: PMC9607212 DOI: 10.3390/v14102278] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
Immunocompromised patients experience reduced vaccine effectiveness and are at higher risk for coronavirus disease 19 (COVID-19) death. Pre-exposure prophylaxis (PrEP) aims to protect these patients. So far, only tixagevimab/cilgavimab is authorized for use as PrEP. This paper aims to provide real-world data on the use of tixagevimab/cilgavimab and sotrovimab as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PrEP in immunocompromised patients, comparing the evolution of antibody levels and reporting the incidence of breakthrough infections. A retrospective, single-center analysis was conducted including 132 immunocompromised patients with inadequate vaccine response, who received COVID-PrEP at our clinic between January and June 2022. Initially, 95 patients received sotrovimab while 37 patients received tixagevimab/cilgavimab. Antibody levels after first PrEP with sotrovimab remain high for several months after infusion (median 10,058 and 7235 BAU/mL after 1 and 3 months, respectively), with higher titers than after tixagevimab/cilgavimab injection even 3 months later (7235 vs. 1647 BAU/mL, p = 0.0007). Overall, breakthrough infections were rare (13/132, 10%) when compared to overall infection rates during this period (over 30% of the Austrian population), with mild disease course and rapid viral clearance (median 10 days). Sotrovimab may be an additional option for SARS-CoV-2 PrEP.
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Affiliation(s)
- David Totschnig
- Department of Medicine IV, Klinik Favoriten, Vienna Healthcare Group, Kundratstraße 3, 1100 Vienna, Austria
| | - Max Augustin
- Department of Medicine IV, Klinik Favoriten, Vienna Healthcare Group, Kundratstraße 3, 1100 Vienna, Austria
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Iulia Niculescu
- Department of Medicine IV, Klinik Favoriten, Vienna Healthcare Group, Kundratstraße 3, 1100 Vienna, Austria
| | - Hermann Laferl
- Department of Medicine IV, Klinik Favoriten, Vienna Healthcare Group, Kundratstraße 3, 1100 Vienna, Austria
| | - Sonja Jansen-Skoupy
- Department of Laboratory Medicine, Klinik Favoriten, Vienna Healthcare Group, Kundratstraße 3, 1100 Vienna, Austria
| | - Clara Lehmann
- Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Christoph Wenisch
- Department of Medicine IV, Klinik Favoriten, Vienna Healthcare Group, Kundratstraße 3, 1100 Vienna, Austria
| | - Alexander Zoufaly
- Department of Medicine IV, Klinik Favoriten, Vienna Healthcare Group, Kundratstraße 3, 1100 Vienna, Austria
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Lau CS, Oh MLH, Phua SK, Liang YL, Aw TC. 210-Day Kinetics of Total, IgG, and Neutralizing Spike Antibodies across a Course of 3 Doses of BNT162b2 mRNA Vaccine. Vaccines (Basel) 2022; 10:vaccines10101703. [PMID: 36298568 PMCID: PMC9607129 DOI: 10.3390/vaccines10101703] [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: 09/19/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction: We tested the total spike antibody (S-Ab), IgG/IgM S-Ab, and neutralizing antibody (N-Ab) responses of COVID-19-naïve subjects from before their first BNT162b2 vaccination up to 210 days after boosting. Methods: We studied 136 COVID-19-naïve subjects who received three doses of the Pfizer mRNA vaccine (39 males, 97 females, mean age 43.8 ± 13.5 years) from January 2021 to May 2022. Serum was assessed for total S-Ab (Roche), IgG/M (Abbott), and N-Ab (Snibe). Results: Peak antibody levels were measured 20-30 days after each dose, with booster dosing eliciting significantly higher peak antibodies than the second dose: total S-Ab 2219 vs. 19,551 BAU/mL (difference 16,667 BAU/mL, p < 0.0001); IgG 2270 vs. 2932 BAU/mL (difference 660 BAU/mL, p = 0.04); and N-Ab 3.52 vs. 26.4 µg/mL (difference 21.4 µg/mL, p < 0.0001). Only IgM showed a lower peak post-booster antibody titer (COI 2.11 vs. 0.23, difference 1.63, 95% CI 1.05 to 2.38, p < 0.0001). By 180−210 days after the second or third vaccination, total S-Ab/IgG/N-Ab had decreased by 68.7/93.8/73.6% vs. 82.8/86.3/79.5%. The half-lives of IgG and N-Ab antibodies were longer after the third vaccination (IgG: 65 vs. 34 days, N-Ab: 99 vs. 78 days). Conclusion: Total S-Ab/IgG/N-Ab showed a greater increase post-booster, with IgG/N-Ab having a longer half-life.
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Affiliation(s)
- Chin Shern Lau
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
- Correspondence: ; Tel.: +65-68504927; Fax: +65-64269507
| | - May Lin Helen Oh
- Department of Infectious Diseases, Changi General Hospital, Singapore 529889, Singapore
| | - Soon Kieng Phua
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
| | - Ya-Li Liang
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
| | - Tar Choon Aw
- Department of Laboratory Medicine, Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
- Department of Medicine, National University of Singapore, Singapore 117599, Singapore
- Academic Pathology Program, Duke-NUS Graduate Medical School, Singapore 169857, Singapore
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García-Sastre A. Mucosal delivery of RNA vaccines by Newcastle disease virus vectors. CURRENT RESEARCH IN IMMUNOLOGY 2022; 3:234-238. [PMID: 36245642 PMCID: PMC9552541 DOI: 10.1016/j.crimmu.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/04/2022] [Indexed: 10/31/2022] Open
Abstract
The rapid evolution of SARS-CoV-2 since its pandemic outbreak has underscored the need for improved SARS-CoV-2 vaccines that efficiently reduce not only hospitalizations and deaths, but also infections and transmission. This might be achieved by a new generation of intranasally administered SARS-CoV-2 vaccines to stimulate protective mucosal immunity. Among all different approaches, preclinical and clinical information using Newcastle Disease Virus (NDV)-vectors expressing S of SARS-CoV2 as a COVID-19 vaccine show the potential of this vaccine platform as an affordable, highly immunogenic, safe strategy to intranasally vaccinate humans against SARS-CoV-2 and other infectious diseases. These vaccine vectors consist on the use of a harmless avian negative strand RNA virus to deliver intranasally a self-replicating RNA expressing the vaccine antigen in the cells of the respiratory mucosa. The vector also incorporates the antigen in the virus particle used for RNA delivery, thus combining the properties of nanoparticle-based and RNA-based vaccines. Other advantages of NDV-based vectors include the worldwide availability of manufacturing facilities for their production and their stability at non-freezing temperatures. While phase 3 clinical studies to evaluate efficacy are still pending, phase 1 and 2 clinical studies have demonstrated the safety and immunogenicity of NDV-S vaccines against SARS-CoV-2.
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Affiliation(s)
- Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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22
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Valentina M, Alessandro CL, Francesca C, Silvia R, Eleonora L, Claudia C, Jessica P, Ilaria M, Serena V, Lavinia F, Alessandra V, Gaetano M, Fabrizio C, Simone L, Emanuela C, Eugenia M, Raffaella L, Pierluca P, Enrico G, AnnaRosa G, Francesco V, Fabrizio M, Emanuele N, Andrea A. Viral load decrease in SARS-CoV-2 BA.1 and BA.2 Omicron sublineages infection after treatment with monoclonal antibodies and direct antiviral agents. J Med Virol 2022; 95:e28186. [PMID: 36184918 PMCID: PMC9539310 DOI: 10.1002/jmv.28186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/05/2022] [Accepted: 09/26/2022] [Indexed: 01/11/2023]
Abstract
The efficacy on the Omicron variant of the approved early coronavirus disease-2019 (COVID-19) therapies, especially monoclonal antibodies, has been challenged by in vitro neutralization data, while data on in vivo antiviral activity are lacking. We assessed potential decrease from Day 1 to Day 7 viral load (VL) in nasopharyngeal swabs of outpatients receiving Sotrovimab, Molnupiravir, Remdesivir, or Nirmatrelvir/ritonavir for mild-to-moderate COVID-19 due to sublineages BA.1 or BA.2, and average treatment effect by weighted marginal linear regression models. A total of 521 patients (378 BA.1 [73%], 143 [27%] BA.2) received treatments (Sotrovimab 202, Molnupiravir 117, Nirmatrelvir/ritonavir 84, and Remdesivir 118): median age 66 years, 90% vaccinated, median time from symptoms onset 3 days. Day 1 mean VL was 4.12 log2 (4.16 for BA.1 and 4.01 for BA.2). The adjusted analysis showed that Nirmatrelvir/ritonavir significantly reduced VL compared to all the other drugs, except versus Molnupiravir in BA.2. Molnupiravir was superior to Remdesivir in both BA.1 and BA.2, and to Sotrovimab in BA.2. Sotrovimab had better activity than Remdesivir only against BA.1. Nirmatrelvir/ritonavir showed the greatest antiviral activity against Omicron variant, comparable to Molnupiravir only in the BA.2 subgroup. VL decrease could be a valuable surrogate of drug activity in the context of the high prevalence of vaccinated people and low probability of hospital admission.
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Affiliation(s)
- Mazzotta Valentina
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly,PhD course in Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT)University of Rome Tor VergataRomeItaly
| | - Cozzi Lepri Alessandro
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME)Institute for Global HealthUCLLondonUK
| | - Colavita Francesca
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Rosati Silvia
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Lalle Eleonora
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Cimaglia Claudia
- Clinical Epidemiology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Paulicelli Jessica
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Mastrorosa Ilaria
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Vita Serena
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Fabeni Lavinia
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Vergori Alessandra
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Maffongelli Gaetano
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Carletti Fabrizio
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Lanini Simone
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Caraffa Emanuela
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Milozzi Eugenia
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Libertone Raffaella
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Piselli Pierluca
- Clinical Epidemiology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Girardi Enrico
- Scientific Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Garbuglia AnnaRosa
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Vaia Francesco
- General Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Maggi Fabrizio
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Nicastri Emanuele
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
| | - Antinori Andrea
- Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCSRomeItaly
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23
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D’Apice L, Trovato M, Gramigna G, Colavita F, Francalancia M, Matusali G, Meschi S, Lapa D, Bettini A, Mizzoni K, Aurisicchio L, Di Caro A, Castilletti C, De Berardinis P. Comparative analysis of the neutralizing activity against SARS-CoV-2 Wuhan-Hu-1 strain and variants of concern: Performance evaluation of a pseudovirus-based neutralization assay. Front Immunol 2022; 13:981693. [PMID: 36225911 PMCID: PMC9549111 DOI: 10.3389/fimmu.2022.981693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesEmergence of new variants of SARS-CoV-2 might affect vaccine efficacy. Therefore, assessing the capacity of sera to neutralize variants of concern (VOCs) in BSL-2 conditions will help evaluating the immune status of population following vaccination or infection.MethodsPseudotyped viruses bearing SARS-CoV-2 spike protein from Wuhan-Hu-1/D614G strains (wild type, WT), B.1.617.2 (Delta), or B.1.1.529 (Omicron) VOCs were generated to assess the neutralizing antibodies (nAbs) activity by a pseudovirus-based neutralization assay (PVNA). PVNA performance was assessed in comparison to the micro-neutralization test (MNT) based on live viruses. Sera collected from COVID-19 convalescents and vaccinees receiving mRNA (BNT16b2 or mRNA-1273) or viral vector (AZD1222 or Ad26.COV2.S) vaccines were used to measure nAbs elicited by two-dose BNT16b2, mRNA-1273, AZD1222 or one-dose Ad26.CO2.S, at different times from completed vaccination, ~ 1.5 month and ~ 4-6 months. Sera from pre-pandemic and unvaccinated individuals were analyzed as controls. Neutralizing activity following booster vaccinations against VOCs was also determined.ResultsPVNA titers correlated with the gold standard MNT assay, validating the reliability of PVNA. Sera analyzed late from the second dose showed a reduced neutralization activity compared to sera collected earlier. Ad26.CO2.S vaccination led to very low or absent nAbs. Neutralization of Delta and Omicron BA.1 VOCs showed significant reduction of nAbs respect to WT strain. Importantly, booster doses enhanced Omicron BA.1 nAbs, with persistent levels at 3 months from boosting.ConclusionsPVNA is a reliable tool for assessing anti-SARS-CoV-2 nAbs helping the establishment of a correlate of protection and the management of vaccination strategies.
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Affiliation(s)
- Luciana D’Apice
- Institute of Biochemistry and Cell Biology, Consiglio Nazionale delle Ricerche (CNR), Naples, Italy
- *Correspondence: Luciana D’Apice, ; Francesca Colavita,
| | - Maria Trovato
- Institute of Biochemistry and Cell Biology, Consiglio Nazionale delle Ricerche (CNR), Naples, Italy
| | - Giulia Gramigna
- National Institute for Infectious Diseases “L. Spallanzani” Istituto Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Francesca Colavita
- National Institute for Infectious Diseases “L. Spallanzani” Istituto Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
- *Correspondence: Luciana D’Apice, ; Francesca Colavita,
| | - Massimo Francalancia
- National Institute for Infectious Diseases “L. Spallanzani” Istituto Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giulia Matusali
- National Institute for Infectious Diseases “L. Spallanzani” Istituto Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Silvia Meschi
- National Institute for Infectious Diseases “L. Spallanzani” Istituto Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Daniele Lapa
- National Institute for Infectious Diseases “L. Spallanzani” Istituto Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Aurora Bettini
- National Institute for Infectious Diseases “L. Spallanzani” Istituto Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Klizia Mizzoni
- National Institute for Infectious Diseases “L. Spallanzani” Istituto Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | | | - Antonino Di Caro
- National Institute for Infectious Diseases “L. Spallanzani” Istituto Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Concetta Castilletti
- National Institute for Infectious Diseases “L. Spallanzani” Istituto Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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24
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Valim V, Martins-Filho OA, Gouvea MDPG, Camacho LAB, Villela DAM, de Lima SMB, Azevedo AS, Neto LFP, Domingues CMAS, de Medeiros Junior NF, Moulaz IR, Dias LH, Miyamoto ST, Teixeira-Carvalho A, Mill JG. Effectiveness, safety, and immunogenicity of half dose ChAdOx1 nCoV-19 COVID-19 Vaccine: Viana project. Front Immunol 2022; 13:966416. [PMID: 36105814 PMCID: PMC9464812 DOI: 10.3389/fimmu.2022.966416] [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: 06/10/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Fractional dose is an important strategy to increase access to vaccines. This study evaluated the effectiveness, safety, and immunogenicity of half dose of ChAdOx1 nCoV-19 vaccine. A non-inferiority non-randomized controlled trial compared a half dose of ChAdOx1 nCoV-19 with the full dose, with an interval of 8 to 10 weeks, in individuals aged 18–49 years. The primary endpoints were the incidence rate of new cases/1,000 person-year at 90 days after 14 days of the second dose, confirmed by RT-PCR and new cases registered at SUS National Health Surveillance Database (e-SUS VS). The anti-SARS-CoV-2 spike (S) protein receptor binding domain (RBD) by chemiluminescence and the neutralizing antibodies by plaque reduction neutralization test (PRNT) were titrated. The soluble biomarkers were quantified with a multiplex immunoassay. Follow-up was 90 days after 14 days of the second dose. A total of 29,598 individuals were vaccinated. After exclusion, 16,570 individuals who received half a dose and 6,402 who received full doses were analyzed. The incidence of new cases confirmed by RT-PCR of half dose was non-inferior to full dose (23.7 vs. 25.7 cases per 1,000 persons-year [coefficient group -0.09 CI95%(-0.49 to 0.31)], even after adjusting for age and sex. There were no deaths or hospitalization after immunization of either group. Immunogenicity was evaluated in a subsample (N=558) compared to 154 healthcare workers who received a full dose. The seroconversion rate in seronegative individuals at baseline half dose was 99.8%, similar to that of the full dose (100%). Geometric mean concentration (95% CI; BAU/mL) were half dose = 188 (163-217) and full dose = 529 (423–663) (p < 0.001). In seropositive subjects at baseline (pre-immune individuals), the first dose induced very high and similar IgG-S in half dose 1,359 (1,245-1,483) and full dose 1,354 (1,048–1,749) BAU/mL. A half dose induced a high increase in plasma chemokines, pro-inflammatory/regulatory cytokines, and growth factors. The frequency of adverse events was similar. No serious adverse events or deaths were reported. A half dose of ChAdOx1 nCoV-19 is as effective, safe, and immunogenic as the full dose. The immune response in pre-immune (seropositive in the baseline) individuals indicates that the half dose may be a booster dose schedule.
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Affiliation(s)
- Valéria Valim
- Hospital Universitário Cassiano Antônio Moraes [HUCAM-UFES/ Empresa de Serviços Hospitalares (EBSERH)] and Programa de Pós Graduação em Saúde Coletiva (PPGSC), Universidade Federal do Espírito Santo, Vitória, Brazil,*Correspondence: Valéria Valim,
| | - Olindo Assis Martins-Filho
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil
| | - Maria da Penha Gomes Gouvea
- Hospital Universitário Cassiano Antônio Moraes [HUCAM-UFES/ Empresa de Serviços Hospitalares (EBSERH)] and Programa de Pós Graduação em Saúde Coletiva (PPGSC), Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | | | - Sheila Maria Barbosa de Lima
- Laboratório de Tecnologia Virológica (LATEV) (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | - Adriana Souza Azevedo
- Laboratório de Tecnologia Virológica (LATEV) (Bio-Manguinhos), Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil
| | | | | | | | - Isac Ribeiro Moulaz
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo [HUCAM-UFES/ Empresa de Serviços Hospitalares (EBSERH)], Vitória, Brazil
| | - Laiza Hombre Dias
- Hospital Universitário Cassiano Antônio Moraes, Universidade Federal do Espírito Santo [HUCAM-UFES/ Empresa de Serviços Hospitalares (EBSERH)], Vitória, Brazil
| | - Samira Tatiyama Miyamoto
- Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo (DEIS/UFES), Vitória, Brazil
| | - Andréa Teixeira-Carvalho
- Grupo Integrado de Pesquisas em Biomarcadores, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ-Minas), Belo Horizonte, Brazil
| | - José Geraldo Mill
- Hospital Universitário Cassiano Antônio Moraes [HUCAM-UFES/ Empresa de Serviços Hospitalares (EBSERH)] and Departamento de Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, Brazil
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25
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Brehm J, Spaeth A, Dreßler L, Masetto T, Dannenberg R, Peter C, Grimmler M. SARS-CoV-2 antibody progression and neutralizing potential in mild symptomatic COVID-19 patients – a comparative long term post-infection study. Front Immunol 2022; 13:915338. [PMID: 36059441 PMCID: PMC9428854 DOI: 10.3389/fimmu.2022.915338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/26/2022] [Indexed: 01/08/2023] Open
Abstract
Background Since December 2019, SARS-CoV-2 has been keeping the world in suspense. Rapid tests, molecular diagnosis of acute infections, and vaccination campaigns with vaccines are building blocks of strategic pandemic control worldwide. For laboratory diagnostics, the quantification of the antibody titer of convalescents and vaccinated patients is thus increasingly coming to the fore. Methods Here we present an evaluation on the comparability of five serological tests on a cohort of 13 patients with mild COVID-19 disease. Also participants who were vaccinated after recovery were included in this study. All common immune methods (ELISA, CLIA, PETIA) and SARS-CoV-2 specific antigens (N-, S1- and RBD-) were specifically tracked and directly compared for up to 455 days. The titer of recovered participants was also set to the degree of symptoms during infection and the occurrence of Long-COVID. In addition, relative comparability of different serological tests, all standardized to WHO, was set in reference to the neutralizing potential of the corresponding participants. Findings The individual immune responses over 455 days after a mild SARS-CoV-2 infection remain stable, in contrast to vaccinated participants. All sero-tests reveal comparable performance and dynamics during the study and compared well to a surrogate neutralization test. Conclusion The information presented here will help clinicians in the daily laboratory work in the selection and evaluation of different serological tests offered. The data also will support in respect of a sero-test-based neutralization cutoff.
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Affiliation(s)
- Jessica Brehm
- MVZ Medizinische Labore Dessau Kassel GmbH, Dessau-Roßlau, Germany
| | - Alexander Spaeth
- MVZ Medizinische Labore Dessau Kassel GmbH, Dessau-Roßlau, Germany
| | - Lars Dreßler
- MVZ Medizinische Labore Dessau Kassel GmbH, Dessau-Roßlau, Germany
| | - Thomas Masetto
- Institute of Molecular Medicine I, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- DiaSys Diagnostic Systems GmbH, Holzheim, Germany
| | | | - Christoph Peter
- Institute of Molecular Medicine I, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Matthias Grimmler
- DiaSys Diagnostic Systems GmbH, Holzheim, Germany
- Hochschule Fresenius gGmbH, University of Applied Sciences, Idstein, Germany
- *Correspondence: Matthias Grimmler,
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Vergori A, Cozzi-Lepri A, Matusali G, Colavita F, Cicalini S, Gallì P, Garbuglia AR, Fusto M, Puro V, Maggi F, Girardi E, Vaia F, Antinori A. SARS-CoV-2 Omicron Variant Neutralization after Third Dose Vaccination in PLWH. Viruses 2022; 14:1710. [PMID: 36016332 PMCID: PMC9415025 DOI: 10.3390/v14081710] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/17/2022] Open
Abstract
The aim was to measure neutralizing antibody levels against the SARS-CoV-2 Omicron (BA.1) variant in serum samples obtained from vaccinated PLWH and healthcare workers (HCW) and compare them with those against the Wuhan-D614G (W-D614G) strain, before and after the third dose of a mRNA vaccine. We included 106 PLWH and 28 HCWs, for a total of 134 participants. Before the third dose, the proportion of participants with undetectable nAbsT against BA.1 was 88% in the PLWH low CD4 nadir group, 80% in the high nadir group and 100% in the HCW. Before the third dose, the proportion of participants with detectable nAbsT against BA.1 was 12% in the PLWH low nadir group, 20% in the high nadir group and 0% in HCW, respectively. After 2 weeks from the third dose, 89% of the PLWH in the low nadir group, 100% in the high nadir group and 96% of HCW elicited detectable nAbsT against BA.1. After the third dose, the mean log2 nAbsT against BA.1 in the HCW and PLWH with a high nadir group was lower than that seen against W-D614G (6.1 log2 (±1.8) vs. 7.9 (±1.1) and 6.4 (±1.3) vs. 8.6 (±0.8)), respectively. We found no evidence of a different level of nAbsT neutralization by BA.1 vs. W-D614G between PLWH with a high CD4 nadir and HCW (0.40 (−1.64, 2.43); p = 0.703). Interestingly, in PLWH with a low CD4 nadir, the mean log2 difference between nAbsT against BA.1 and W-D614G was smaller in those with current CD4 counts 201−500 vs. those with CD4 counts < 200 cells/mm3 (−0.80 (−1.52, −0.08); p = 0.029), suggesting that in this target population with a low CD4 nadir, current CD4 count might play a role in diversifying the level of SARS-CoV-2 neutralization.
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Affiliation(s)
- Alessandra Vergori
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (S.C.); (M.F.); (A.A.)
| | - Alessandro Cozzi-Lepri
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, UCL, London WC1E 6BT, UK;
| | - Giulia Matusali
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.C.); (A.R.G.); (F.M.)
| | - Francesca Colavita
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.C.); (A.R.G.); (F.M.)
| | - Stefania Cicalini
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (S.C.); (M.F.); (A.A.)
| | - Paola Gallì
- Health Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy;
| | - Anna Rosa Garbuglia
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.C.); (A.R.G.); (F.M.)
| | - Marisa Fusto
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (S.C.); (M.F.); (A.A.)
| | - Vincenzo Puro
- Risk Management Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy;
| | - Fabrizio Maggi
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (G.M.); (F.C.); (A.R.G.); (F.M.)
| | - Enrico Girardi
- Scientific Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy;
| | - Francesco Vaia
- General Direction, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy;
| | - Andrea Antinori
- HIV/AIDS Unit, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy; (S.C.); (M.F.); (A.A.)
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27
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Hirama T, Akiba M, Shundo Y, Watanabe T, Watanabe Y, Oishi H, Niikawa H, Okada Y. Efficacy and safety of mRNA SARS-CoV-2 vaccines in lung transplant recipients. J Infect Chemother 2022; 28:1153-1158. [PMID: 35599079 PMCID: PMC9110371 DOI: 10.1016/j.jiac.2022.04.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND To date, reports addressing the antibody response following mRNA SARS-CoV-2 vaccination in lung transplant (LTX) recipients are limited. Thus, the aim of this clinical study was to investigate the efficacy and safety of the vaccines in LTX recipients compared to controls. METHODS An open-label, nonrandomized prospective study was conducted at Tohoku University Hospital. LTX recipients and controls who received either the BNT162b2 vaccine or the mRNA-1273 vaccine were recruited, and SARS-CoV-2 IgG was measured before and after vaccination. The adverse events were reviewed. Predictors of negative serology after vaccination were evaluated with logistic regression. RESULTS Forty-one LTX recipients and 24 controls were analyzed. Although all controls had a positive antibody response to a SARS-CoV-2 mRNA vaccine, antibody response was found in 24.4% of LTX recipients (p < .0001). The amount of SARS-CoV-2 IgG following the 2nd dose significantly climbed to 6557 AU/mL in controls, whereas the increase in IgG in LTX recipients was 8.3 AU/mL (p < .0001). Fewer LTX recipients developed systemic fever than controls (p < .0001) despite equivalent overall adverse event percentages in both groups. A higher plasma concentration of mycophenolate was a significant predictor of negative serology (p = .032). CONCLUSIONS An impaired antibody response to mRNA vaccines was significantly found in LTX recipients compared to controls and was associated with the plasma concentration of mycophenolate. While repeating mRNA vaccination may be one of the strategies to improve antibody response given the safety of the vaccines, emerging data on humoral immune responses based on immunosuppression regimens in LTX recipients should be studied (jRCT1021210009).
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Affiliation(s)
- Takashi Hirama
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan; Division of Organ Transplantation, Tohoku University Hospital, Sendai, Miyagi, Japan.
| | - Miki Akiba
- Division of Organ Transplantation, Tohoku University Hospital, Sendai, Miyagi, Japan.
| | - Yuki Shundo
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
| | - Tatsuaki Watanabe
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
| | - Yui Watanabe
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
| | - Hisashi Oishi
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
| | - Hiromichi Niikawa
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan.
| | - Yoshinori Okada
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan; Division of Organ Transplantation, Tohoku University Hospital, Sendai, Miyagi, Japan.
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Matched Versus Mixed COVID-19 Vaccinations in Korean Solid Organ Transplant Recipients: An Observational Study. Transplantation 2022; 106:e392-e403. [PMID: 35749755 DOI: 10.1097/tp.0000000000004241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Solid organ transplant recipients (SOTRs) are vulnerable to severe coronavirus disease 2019 (COVID-19) and exhibit poor antibody responses to COVID-19 vaccines. Herein, we compared the humoral immunogenicity of a mixed vaccine (ChAdOx1 nCoV-19 [ChAd]/BNT162b2 [BNT]) with that of conventional matched vaccines (mRNA, adenoviral vector [AdV-Vec]) in SOTRs. METHODS Serum samples were collected at Severance Hospital (Seoul, Korea) between September and October 2021 (14 d-5 mo after COVID-19 vaccination; V2). The severe acute respiratory syndrome coronavirus 2 antispike IgG titer (BAU/mL; ELISA) and neutralization inhibition (percentage; neutralization assay) were compared between vaccination groups overall and stratified by V2 (poststudy vaccination visit) timing. RESULTS Of the 464 participants, 143 (31%) received mRNA vaccines, 170 (37%) received AdV-Vec vaccines, and 151 (33%) received mixed vaccines (all ChAd/BNT). The geometric mean titer for the ChAd/BNT group was 3.2-fold higher than that of the AdV-Vec group (geometric mean ratio, 3.2; confidence interval, 1.9-5.4) but lower than that of the mRNA group (geometric mean ratio, 0.4; confidence interval, 0.2-0.7). Neutralization inhibition in the ChAd/BNT group was 32%, which was higher than that in the AdV-Vec group (21%; P < 0.001) but lower than that in the mRNA group (55%; P = 0.02). There was no difference in geometric mean titer by V2 timing (ChAd/BNT, 45 versus 31, days 14-60; mRNA, 28 versus 15, days 61-150). CONCLUSIONS The ChAd/BNT group showed higher humoral immunogenicity than the AdV-Vec group, with similar immunogenicity to the mRNA vaccine. Nevertheless, immunogenicity following the primary vaccination series was poor in all vaccine groups, supporting the justification for booster vaccination in SOTRs.
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Cheung KS, Lam LK, Hui RWH, Mao X, Zhang RR, Chan KH, Hung IF, Seto WK, Yuen MF. Effect of moderate-to-severe hepatic steatosis on neutralising antibody response among BNT162b2 and CoronaVac recipients. Clin Mol Hepatol 2022; 28:553-564. [PMID: 35545127 PMCID: PMC9293606 DOI: 10.3350/cmh.2022.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 05/06/2022] [Indexed: 11/05/2022] Open
Abstract
Aim Studies of hepatic steatosis (HS) effect on COVID-19 vaccine immunogenicity are lacking. We aimed to compare immunogenicity of BNT162b2 and CoronaVac among moderate/severe HS and control subjects. Patients and Methods 295 subjects who received BNT162b2 or CoronaVac vaccines from five vaccination centers were categorized into moderate/severe HS (controlled attenuation parameter ≥268 dB/m on transient elastography) (n=74) or control (n=221) groups. Primary outcomes were seroconversion rates of neutralising antibody by live virus Microneutralization (vMN) assay (titer ≥10) at day 21 (BNT162b2) or day28 (CoronaVac) and day56 (both). Secondary outcome was highest-tier titer response (top 25% of vMN titer; cutoff: 160 [BNT162b2] and 20 [CoronaVac]) at day 56. Results For BNT162b2 (n=228 [77.3%]), there was no statistical differences in seroconversion rates (71.7% vs 76.6% [day21]; 100% vs 100% [day56]) or vMN GMT (13.2 vs 13.3, [day21]; 91.9 vs 101.4, [day56]) among moderate/severe HS and control groups respectively. However, lower proportion of moderate/severe HS patients had highest-tier response (5.0% vs 15.5%; p=0.037 [day56]). For CoronaVac (n=67 [22.7%]), there was no statistical differences in seroconversion rates (7.1% vs 15.1%, [day21]; 64.3% vs 83.0%, [day56]) or vMN GMT (5.3 vs 5.8,) at day 28. However, moderate/severe HS patients had lower vMN GMT (9.1 vs 14.8, p=0.021) at day 56 with lower proportion having highest-tier response (21.4% vs 52.8%, p=0.036). Conclusion While there was no difference in seroconversion rate between moderate/severe HS and control groups after two doses of vaccine, a lower proportion of moderate/severe HS patients achieved highest-tier response for either BNT162b2 or CoronaVac.
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Affiliation(s)
- Ka Shing Cheung
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.,Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Lok Ka Lam
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Rex Wan Hin Hui
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Xianhua Mao
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Ruiqi R Zhang
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Kwok Hung Chan
- Department of Microbiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Ivan Fn Hung
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Wai Kay Seto
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.,Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong
| | - Man Fung Yuen
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.,State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong
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Ciniselli CM, Lecchi M, Figini M, Melani CC, Daidone MG, Morelli D, Zito E, Apolone G, Verderio P. COVID-19 Vaccination in Health Care Workers in Italy: A Literature Review and a Report from a Comprehensive Cancer Center. Vaccines (Basel) 2022; 10:vaccines10050734. [PMID: 35632490 PMCID: PMC9146113 DOI: 10.3390/vaccines10050734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023] Open
Abstract
The coronavirus disease 2019 pandemic still represents a global public health emergency, despite the availability of different types of vaccines that reduced the number of severe cases, the hospitalization rate and mortality. The Italian Vaccine Distribution Plan identified healthcare workers (HCWs) as the top-priority category to receive access to a vaccine and different studies on HCWs have been implemented to clarify the duration and kinetics of antibody response. The aim of this paper is to perform a literature review across a total of 44 studies of the serologic response to COVID-19 vaccines in HCWs in Italy and to report the results obtained in a prospective longitudinal study implemented at the Fondazione IRCCS Istituto Nazionale Tumori (INT) of Milan on 1565 HCWs. At INT we found that 99.81% of the HCWs developed an antibody response one month after the second dose. About six months after the first serology evaluation, 100% of the HCWs were still positive to the antibody, although we observed a significant decrease in its levels. Overall, our literature review results highlight a robust antibody response in most of the HCWs after the second vaccination dose. These figures are also confirmed in our institutional setting seven months after the completion of the cycle of second doses of vaccination.
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Affiliation(s)
- Chiara Maura Ciniselli
- Bioinformatics and Biostatistics Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (C.M.C.); (M.L.)
| | - Mara Lecchi
- Bioinformatics and Biostatistics Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (C.M.C.); (M.L.)
| | - Mariangela Figini
- Biomarker Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Cecilia C. Melani
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (C.C.M.); (M.G.D.); (G.A.)
| | - Maria Grazia Daidone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (C.C.M.); (M.G.D.); (G.A.)
| | - Daniele Morelli
- Laboratory Medicine, Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Emanuela Zito
- ICT, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy;
| | - Giovanni Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (C.C.M.); (M.G.D.); (G.A.)
| | - Paolo Verderio
- Bioinformatics and Biostatistics Unit, Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (C.M.C.); (M.L.)
- Correspondence:
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Jeulin H, Labat C, Duarte K, Toupance S, Nadin G, Craus D, Georgiopoulos I, Gantois I, Goehringer F, Benetos A. Anti-spike IgG antibody kinetics following the second and third doses of BNT162b2 vaccine in nursing home residents. J Am Geriatr Soc 2022; 70:2552-2560. [PMID: 35484977 PMCID: PMC9115082 DOI: 10.1111/jgs.17837] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/12/2022] [Accepted: 04/23/2022] [Indexed: 11/27/2022]
Abstract
Background Duration of post‐vaccination protection against COVID‐19 in nursing home (NH) residents is a critical issue. The objective of this study was to estimate the duration of the IgG(S) response to the mRNA BNT162b2 vaccine in NH residents with (COV‐Yes) or without (COV‐No) history of SARS‐CoV‐2 infection. Methods A 574 COV‐Yes and COV‐No NH residents were included in 2 cohorts: Main (n = 115, median age 87 years) or Confirmatory (n = 459, median age 89 years). IgG(S) quantification was carried out at three different time points following the BNT162b2 vaccine: three (1st) and seven (2nd) months after the 2nd dose, and 1 month after the 3rd dose (3rd quantification) in the Main cohort, and twice (2nd and 3rd) in the Confirmatory cohort. The seroneutralization capacity according to COVID‐19 history was also measured in a subgroup of patients. Results Neutralization capacity was strongly correlated with IgG(S) levels (R2:76%) without any difference between COV‐Yes and COV‐No groups for the same levels of IgG(S). After the 2nd dose, duration of the assumed robust protection (IgG(S) >264 BAU/ml) was two‐fold higher in the COV‐Yes vs. COV‐No group: 12.60 (10.69–14.44) versus 5.76 (3.91–8.64) months, with this advantage mainly due to the higher IgG(S) titers after the 2nd dose and secondary to a slower decay over time. After the 3rd dose, duration of robust protection was estimated at 11.87 (9.88–14.87) (COV‐Yes) and 8.95 (6.85–11.04) (COV‐No) months. These results were similar in both cohorts. Conclusions and Relevance In old subjects living in NH, history of SARS‐CoV‐2 infection provides a clear advantage in the magnitude and duration of high IgG(S) titers following the 2nd dose. Importantly, the 3rd dose induces a much more pronounced IgG(S) response than the 2nd dose in COV‐No subjects, the effect of which should be able to ensure a prolonged protection against severe forms of COVID‐19 in these subjects.
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Affiliation(s)
- Helene Jeulin
- Université de Lorraine, CNRS, LCPME, Nancy, France.,Laboratoire de Virologie, CHRU de Nancy Brabois, Vandœuvre-lès-Nancy, France
| | - Carlos Labat
- Université de Lorraine, Inserm, DCAC, Vandœuvre-lès-Nancy, France
| | - Kevin Duarte
- Université de Lorraine, CHRU-Nancy Brabois, INSERM, Centre d'Investigation Clinique Pluridisciplinaire (CIC-P) 14-33, Vandœuvre-lès-Nancy, France
| | - Simon Toupance
- Université de Lorraine, Inserm, DCAC, Vandœuvre-lès-Nancy, France
| | | | - Denis Craus
- Maison Médicale F-54110 Rosières-aux-Salines, France
| | - Ioannis Georgiopoulos
- Université de Lorraine, CHRU-Nancy Brabois, Department of Clinical Geriatrics, Vandœuvre-lès-Nancy, France
| | - Isabelle Gantois
- Université de Lorraine, CHRU-Nancy Brabois, Department of Clinical Geriatrics, Vandœuvre-lès-Nancy, France
| | - François Goehringer
- Université de Lorraine, CHRU-Nancy Brabois, Service de Maladies Infectieuses et Tropicale, Vandœuvre-lès-Nancy, France
| | - Athanase Benetos
- Université de Lorraine, Inserm, DCAC, Vandœuvre-lès-Nancy, France.,Université de Lorraine, CHRU-Nancy Brabois, Department of Clinical Geriatrics, Vandœuvre-lès-Nancy, France
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Lanini S, Milleri S, Andreano E, Nosari S, Paciello I, Piccini G, Gentili A, Phogat A, Hyseni I, Leonardi M, Torelli A, Montomoli E, Paolini A, Frosini A, Antinori A, Nicastri E, Girardi E, Plazzi MM, Ippolito G, Vaia F, Della Cioppa G, Rappuoli R. Safety and serum distribution of anti-SARS-CoV-2 monoclonal antibody MAD0004J08 after intramuscular injection. Nat Commun 2022; 13:2263. [PMID: 35477725 PMCID: PMC9046195 DOI: 10.1038/s41467-022-29909-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/07/2022] [Indexed: 11/26/2022] Open
Abstract
The emerging threat represented by SARS-CoV-2 variants, demands the development of therapies for better clinical management of COVID-19. MAD0004J08 is a potent Fc-engineered monoclonal antibody (mAb) able to neutralize in vitro all current SARS-CoV-2 variants of concern (VoCs) including the omicron variant even if with significantly reduced potency. Here we evaluated data obtained from the first 30 days of a phase 1 clinical study (EudraCT N.: 2020-005469-15 and ClinicalTrials.gov Identifier: NCT04932850). The primary endpoint evaluated the percentage of severe adverse events. Secondary endpoints evaluated pharmacokinetic and serum neutralization titers. A single dose administration of MAD0004J08 via intramuscular (i.m.) route is safe and well tolerated, resulting in rapid serum distribution and sera neutralizing titers higher than COVID-19 convalescent and vaccinated subjects. A single dose administration of MAD0004J08 is also sufficient to effectively neutralize major SARS-CoV-2 variants of concern (alpha, beta, gamma and delta). MAD0004J08 can be a major advancement in the prophylaxis and clinical management of COVID-19.
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Affiliation(s)
- Simone Lanini
- Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani - IRCCS, Rome, Italy
| | - Stefano Milleri
- Centro Ricerche Cliniche di Verona, University and Hospital Trust of Verona, Verona, Italy
| | - Emanuele Andreano
- Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy
| | | | - Ida Paciello
- Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy
| | | | | | | | - Inesa Hyseni
- VisMederi S.r.l, Siena, Italy
- VisMederi Research S.r.l, Siena, Italy
| | | | | | - Emanuele Montomoli
- VisMederi S.r.l, Siena, Italy
- VisMederi Research S.r.l, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - Andrea Paolini
- Fondazione Toscana Life Sciences, Siena, Italy
- Toscana Life Sciences Sviluppo, Siena, Italy
| | | | - Andrea Antinori
- Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani - IRCCS, Rome, Italy
| | - Emanuele Nicastri
- Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani - IRCCS, Rome, Italy
| | - Enrico Girardi
- Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani - IRCCS, Rome, Italy
| | | | - Giuseppe Ippolito
- Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani - IRCCS, Rome, Italy
| | - Francesco Vaia
- Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani - IRCCS, Rome, Italy
| | | | - Rino Rappuoli
- Monoclonal Antibody Discovery (MAD) Lab, Fondazione Toscana Life Sciences, Siena, Italy.
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy.
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Stellini R, Gianello R, Gomarasca W. Durability of anti-spike antibodies after vaccination with mRNA SARS-CoV-2 vaccine is longer in subjects with previous infection: could the booster dose be delayed? Infection 2022; 50:1573-1577. [PMID: 35391649 PMCID: PMC8989116 DOI: 10.1007/s15010-022-01816-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/24/2022] [Indexed: 11/23/2022]
Abstract
Purpose The long-term effectiveness of BNT162b2/Pfizer vaccine remains undetermined. This observational prospective study was designed to verify durability of antibodies against the viral receptor-binding domain (RBD) spike (S)-protein (RBD S-Protein IgG) after the second-dose administration of the vaccine among Health Care Workers (HCWs). Methods In all HCWs at the Poliambulanza Foundation Hospital Brescia (Italy) were quantified the levels of RBD S-Protein IgG (Abbott Diagnostics) at 45 and 240 days after the second-dose vaccine. Previous infection was defined as antibodies against SARS-CoV-2 nucleocapsid positivity (Abbott Diagnostics) before vaccination. The Mann–Whitney U test was used to compare mean levels of RBD S-Protein IgG among previously infected and uninfected HCWs. Results The mean level of the RBD S-protein IgG detected 45 days after the second dose of the vaccine was 30,041 AU/mL (95% CI 145–80,000) for the 250 previously infected HCWs and it was significantly higher (p < 0.001) than that observed in the 1121 previously uninfected subject with the mean level of 10,604 AU/mL (95% CI 165–62,241). Similarly, at 240 days in previously infected subjects the antibody titer was of 8145 AU/mL (95% CI 347–80,000) and significantly higher (p < 0.001) than that observed in the 1121 previously uninfected HCWs with a mean antibody level of 1271 AU/mL (95% CI 50–80,000). When comparing the change in mean antibody levels overtime, the previously infected HCWs presented a 72.9% reduction in RBD S-protein IgG while in the previously uninfected HCWs the reduction was 88.0%. In addition, in the HCWs group without previous infection we reported 53 new SARS-CoV-2 infections and they had a mean level of RBD S-protein IgG antibodies of 1039 AU/mL (95% CI 157–4237) at 240 days. No new infections were found in previously SARS-CoV-2 infected subjects.
Conclusions We report that the mean level of post vaccinal RBD S-protein IgG was significantly higher in the previously infected HCWs than in previously uninfected subjects at 45 and 240 days after the second-dose vaccine. Moreover, our data suggest that the risk of a new SARS-CoV-2 infection was higher in the previously uninfected HCWs than in those who had already contracted natural viral infection. The limitations of this study prevent us to draw definitive conclusions on the antibody titers and on the role of a previous SARS-CoV-2 infection in influencing the levels of post-vaccine RBD S-protein IgG. The booster dose of the vaccine could be delayed after the second dose in previously naturally infected subject and it could have an important strategic impact on the organization of the future COVID-19 vaccination campaign.
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Affiliation(s)
- Roberto Stellini
- Infectious Diseases Service, Health Care Department, Poliambulanza Foundation Hospital, Via Bissolati, 57-25124, Brescia, Italy.
| | - Renzo Gianello
- Department of Clinical Laboratory, Poliambulanza Foundation Hospital, Brescia, Italy
| | - Walter Gomarasca
- Health Care Department, Poliambulanza Foundation Hospital, Brescia, Italy
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Cerna K, Duricova D, Hindos M, Hindos HJ, Lukas M, Machkova N, Hruba V, Mitrova K, Kubickova K, Kastylova K, Teplan V, Lukas M. Cellular and Humoral Immune Responses to SARS-CoV-2 Vaccination in Inflammatory Bowel Disease Patients. J Crohns Colitis 2022; 16:1347-1353. [PMID: 35358307 PMCID: PMC8992348 DOI: 10.1093/ecco-jcc/jjac048] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/13/2022] [Accepted: 03/24/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Knowledge on the immunogenicity of anti-SARS-CoV-2 vaccines in inflammatory bowel disease [IBD] patients is limited. Therefore, SARS-CoV-2-specific T-cell responses and antibodies were analysed in 60 IBD vaccine recipients and 30 controls. METHODS SARS-CoV-2 IgG antibodies against the viral spike protein were measured at baseline and at 8 and 26 weeks after the second vaccine dose. SARS-CoV-2 IgG antibodies against the nucleocapsid antigens were measured at week 26. A SARS-CoV-2 interferon-gamma released assay [IGRA] was performed in all vaccinees at week 26. RESULTS At weeks 0 and 8, no differences were found in anti-spike antibodies between cohorts. At week 26, the decrease in antibody levels was more significant in the IBD cohort compared to the healthy cohort, and anti-nucleocapsid antibodies were not detected in either group. At week 26, 16 of 90 [18%] vaccinated individuals had a negative IGRA test result, seven of 90 [8%] were borderline and 67 [74%] had a positive IGRA result; 22 of the 23 individuals with negative or borderline IGRA results belonged to the IBD cohort. However, the overall functional ability of T-lymphocytes to produce interferon-gamma after the unspecific mitogen stimulation was lower in IBD patients. In vaccinated individuals with low or borderline IGRA, treatment with tumour necrosis factor-alpha inhibitors was the most frequent. In individuals with a significant drop in anti-spike antibody levels, plasmatic interferon-gamma concentrations after the specific SARS-CoV-2 stimulation were also insufficient. CONCLUSIONS Simple humoral and cellular post-vaccination monitoring is advisable in IBD patients so that repeated vaccine doses may be scheduled.
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Affiliation(s)
- Karin Cerna
- Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic,GENNET Prague, Czech Republic
| | - Dana Duricova
- Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic,Institute of Pharmacology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | | | - Martin Lukas
- Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic,Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Libechov, Czech Republic
| | - Nadezda Machkova
- Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Veronika Hruba
- Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Katarina Mitrova
- Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic,Department of Pediatrics, University Hospital Motol and Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kristyna Kubickova
- Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kristyna Kastylova
- Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vladimir Teplan
- Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Prague, Czech Republic,Institute for Postgradual Medical Education, Prague Czech Republic,Department of Internal Medicine, University Hospital and Medical Faculty, Ostrava, Czech Republic
| | - Milan Lukas
- Address for correspondence Prof. Milan Lukas, MD, PhD, AGAF, Clinical and Research Centre for Inflammatory Bowel Disease ISCARE and First Faculty of Medicine, Charles University, Ceskomoravska 1510/19, 190 00 Prague 9, Czech Republic, +420 234 770 299,
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Bajwa HM, Novak F, Nilsson AC, Nielsen C, Holm DK, Østergaard K, Witt AH, Byg KE, Johansen IS, Mittl K, Rowles W, Zamvil SS, Bove R, Sabatino JJ, Sejbaek T. Persistently reduced humoral and sustained cellular immune response from first to third SARS-CoV-2 mRNA vaccination in anti-CD20-treated multiple sclerosis patients. Mult Scler Relat Disord 2022; 60:103729. [PMID: 35334278 PMCID: PMC8898195 DOI: 10.1016/j.msard.2022.103729] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/25/2022] [Accepted: 03/04/2022] [Indexed: 01/14/2023]
Abstract
Objective To examine humoral and cellular response in multiple sclerosis patients on anti-CD20 therapy after third BNT162b2 mRNA SARS-CoV-2 vaccination. Methods A prospective longitudinal study design from first throughout third vaccination in Danish and American MS centers. All participants were treated with ocrelizumab. Antibody (Ab) levels were assessed before and after third vaccination using SARS-CoV-2 IgG II Quant assay (Abbott Laboratories). B- and T-lymphocytes enumeration was done with BD Multitest™6-color TBNK reagent. Spike-specific T-cell responses were measured through PBMC stimulation with spike peptide pools (JPT Peptide Technologies). Results We found that 14.0%, 37.7%, and 33.3% were seropositive after first, second and third vaccination. The median Ab-levels were 74.2 BAU/mL (range: 8.5–2427) after second vaccination, as well as 43.7 BAU/ml (range: 7.8–366.1) and 31.3 BAU/mL (range: 7.9–507.0) before and after third vaccination, respectively. No difference was found in levels after second and third vaccination (p = 0.1475). Seropositivity dropped to 25.0% of participants before the third vaccination, a relative reduction of 33.3% (p = 0.0020). No difference was found between frequencies of spike reactive CD4+and CD8+ T-cells after second (0.65 ± 0.08% and 0.95 ± 0.20%, respectively) and third vaccination (0.99 ± 0.22% and 1.3 ± 0.34%, respectively). Conclusion In this longitudinal cohort we found no significant increased humoral or cellular response with administration of a third SARS-CoV-2 mRNA vaccination. These findings suggest the need for clinical strategies to include allowance of B cell reconstitution before repeat vaccination and/or provision of pre-exposure prophylactic monoclonal antibodies.
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Matusali G, Sberna G, Meschi S, Gramigna G, Colavita F, Lapa D, Francalancia M, Bettini A, Capobianchi MR, Puro V, Castilletti C, Vaia F, Bordi L. Differential Dynamics of SARS-CoV-2 Binding and Functional Antibodies upon BNT162b2 Vaccine: A 6-Month Follow-Up. Viruses 2022; 14:312. [PMID: 35215903 PMCID: PMC8878369 DOI: 10.3390/v14020312] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 01/14/2023] Open
Abstract
To investigate the dynamic association among binding and functional antibodies in health-care-workers receiving two doses of BNT162b2 mRNA COVID-19-vaccine, SARS-CoV-2 anti-RBD IgG, anti-Trimeric-S IgG, and neutralizing antibodies (Nabs) were measured in serum samples collected at 2 weeks, 3 months, and 6 months from full vaccination. Despite the high correlation, results for anti-RBD and anti-Trimeric S IgG were numerically different even after recalculation to BAU/mL following WHO standards indications. Moreover, after a peak response at 2 weeks, anti-RBD IgG levels showed a 4.5 and 13 fold decrease at 3 and 6 months, respectively, while the anti-Trimeric S IgG presented a less pronounced decay of 2.8 and 4.7 fold. Further different dynamics were observed for Nabs titers, resulting comparable at 3 and 6 months from vaccination. We also demonstrated that at NAbs titers ≥40, the area under the receiver operating characteristic curve and the optimal cutoff point decreased with time from vaccination for both anti-RBD and anti-Trimeric S IgG. The mutating relation among the anti-RBD IgG, anti-Trimeric S IgG, and neutralizing antibodies are indicative of antibody maturation upon vaccination. The lack of standardized laboratory procedures is one factor interfering with the definition of a correlate of protection from COVID-19.
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Affiliation(s)
- Giulia Matusali
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Giuseppe Sberna
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Silvia Meschi
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Giulia Gramigna
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Francesca Colavita
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Daniele Lapa
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Massimo Francalancia
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Aurora Bettini
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Maria R. Capobianchi
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Vincenzo Puro
- Risk Management Unit, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy;
| | - Concetta Castilletti
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
| | - Francesco Vaia
- General Direction, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy;
| | - Licia Bordi
- Laboratory of Virology and Biosafety Laboratories, National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Via Portuense 292, 00149 Rome, Italy; (G.M.); (G.S.); (G.G.); (F.C.); (D.L.); (M.F.); (A.B.); (M.R.C.); (C.C.); (L.B.)
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Kolland M, Riedl R, Bachler B, Ribitsch W, Niedrist T, Meissl AM, Rosenkranz AR, Kirsch AH. OUP accepted manuscript. Nephrol Dial Transplant 2022; 37:1188-1190. [PMID: 35137203 PMCID: PMC9383466 DOI: 10.1093/ndt/gfac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Michael Kolland
- Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Bernhard Bachler
- Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
| | - Werner Ribitsch
- Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
| | - Tobias Niedrist
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Anna-Maria Meissl
- Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
| | - Alexander R Rosenkranz
- Department of Internal Medicine, Division of Nephrology, Medical University of Graz, Graz, Austria
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