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Tharmaraj D, Boo I, O'Hara J, Sun S, Polkinghorne KR, Dendle C, Turner SJ, van Zelm MC, Drummer HE, Khoury G, Mulley WR. Serological responses and clinical outcomes following a three-dose primary COVID-19 vaccine schedule in kidney transplant recipients and people on dialysis. Clin Transl Immunology 2024; 13:e1523. [PMID: 39055736 PMCID: PMC11272417 DOI: 10.1002/cti2.1523] [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: 04/16/2024] [Revised: 06/10/2024] [Accepted: 07/13/2024] [Indexed: 07/27/2024] Open
Abstract
Objectives Despite vaccination strategies, people with chronic kidney disease, particularly kidney transplant recipients (KTRs), remained at high risk of poor COVID-19 outcomes. We assessed serological responses to the three-dose COVID-19 vaccine schedule in KTRs and people on dialysis, as well as seroresponse predictors and the relationship between responses and breakthrough infection. Methods Plasma from 30 KTRs and 17 people receiving dialysis was tested for anti-Spike receptor binding domain (RBD) IgG and neutralising antibodies (NAb) to the ancestral and Omicron BA.2 variant after Doses 2 and 3 of vaccination. Results After three doses, KTRs achieved lower anti-Spike RBD IgG levels (P < 0.001) and NAb titres than people receiving dialysis (P = 0.002). Seropositive cross-reactive Omicron neutralisation levels were achieved in 11/27 (40.7%) KTRs and 11/14 (78.6%) dialysis recipients. ChAdOx1/viral-vector vaccine type, higher mycophenolate dose (> 1 g per day) and lower absolute B-cell counts predicted poor serological responses in KTRs. ChAdOx-1 vaccine type and higher monocyte counts were negative predictors in dialysis recipients. Among ancestral NAb seroresponders, higher NAb levels positively correlated with higher Omicron neutralisation (R = 0.9, P < 0.001). More KTRs contracted SARS-CoV-2 infection (14/30; 47%) than dialysis recipients (5/17; 29%) and had more severe disease. Those with breakthrough infections had significantly lower median interdose incremental change in anti-Spike RBD IgG and ancestral NAb titres. Conclusion Serological responses to COVID-19 vaccines in KTRs lag behind their dialysis counterparts. KTRs remained at high risk of breakthrough infection after their primary vaccination schedule underlining their need for booster doses, strict infection prevention measures and close surveillance.
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Affiliation(s)
- Dhakshayini Tharmaraj
- Department of NephrologyMonash HealthClaytonVICAustralia
- Department of Medicine, Centre for Inflammatory DiseasesMonash UniversityMelbourneVICAustralia
| | - Irene Boo
- Burnet InstituteMelbourneVICAustralia
| | - Jessie O'Hara
- Department of Microbiology, Monash Biomedicine Discovery InstituteMonash UniversityMelbourneVICAustralia
| | - Shir Sun
- Burnet InstituteMelbourneVICAustralia
- Department of Immunology, School of Translational MedicineMonash University and Alfred HealthMelbourneVICAustralia
| | - Kevan R Polkinghorne
- Department of NephrologyMonash HealthClaytonVICAustralia
- Department of Medicine, Centre for Inflammatory DiseasesMonash UniversityMelbourneVICAustralia
- Department of Epidemiology and Preventive MedicineMonash UniversityMelbourneVICAustralia
| | - Claire Dendle
- Department of Medicine, Centre for Inflammatory DiseasesMonash UniversityMelbourneVICAustralia
- Monash Infectious DiseasesMonash HealthClaytonVICAustralia
| | - Stephen J Turner
- Department of Microbiology, Monash Biomedicine Discovery InstituteMonash UniversityMelbourneVICAustralia
| | - Menno C van Zelm
- Department of Immunology, School of Translational MedicineMonash University and Alfred HealthMelbourneVICAustralia
- Department of Immunology, Erasmus MCUniversity Medical CenterRotterdamThe Netherlands
| | - Heidi E Drummer
- Burnet InstituteMelbourneVICAustralia
- Department of Microbiology, Monash Biomedicine Discovery InstituteMonash UniversityMelbourneVICAustralia
- Department of Microbiology and ImmunologyUniversity of MelbourneMelbourneVictoriaAustralia
| | - Gabriela Khoury
- Burnet InstituteMelbourneVICAustralia
- Department of Microbiology, Monash Biomedicine Discovery InstituteMonash UniversityMelbourneVICAustralia
| | - William R Mulley
- Department of NephrologyMonash HealthClaytonVICAustralia
- Department of Medicine, Centre for Inflammatory DiseasesMonash UniversityMelbourneVICAustralia
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Garay E, Whelan SPJ, DuBois RM, O’Rourke SM, Salgado-Escobar AE, Muñoz-Medina JE, Arias CF, López S. Immune response to SARS-CoV-2 variants after immunization with different vaccines in Mexico. Epidemiol Infect 2024; 152:e30. [PMID: 38312015 PMCID: PMC10894899 DOI: 10.1017/s0950268824000219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/11/2024] [Accepted: 01/24/2024] [Indexed: 02/06/2024] Open
Abstract
There is limited information on the antibody responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in subjects from developing countries with populations having a high incidence of co-morbidities. Here, we analysed the immunogenicity of homologous schemes using the ChAdOx1-S, Sputnik V, or BNT162b2 vaccines and the effect of a booster dose with ChAdOx1-S in middle-aged adults who were seropositive or seronegative to the SARS-CoV-2 spike protein before vaccination. The study was conducted post-vaccination with a follow-up of 4 months for antibody titre using enzyme-linked immunosorbent assay (ELISA) and pseudovirus (PV) neutralization assays (PNAs). All three vaccines elicited a superior IgG anti-receptor-binding domain (RBD) and neutralization response against the Alpha and Delta variants when administered to individuals with a previous infection by SARS-CoV-2. The booster dose spiked the neutralization activity among individuals with and without a prior SARS-CoV-2 infection. The ChAdOx1-S vaccine induced weaker antibody responses in infection-naive subjects. A follow-up of 4 months post-vaccination showed a drop in antibody titre, with about 20% of the infection-naive and 100% of SARS-CoV-2 pre-exposed participants with detectable neutralization capacity against Alpha pseudovirus (Alpha-PV) and Delta PV (Delta-PV). Our observations support the use of different vaccines in a country with high seroprevalence at the vaccination time.
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Affiliation(s)
- Erika Garay
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Morelos, Mexico
| | - Sean P. J. Whelan
- Department of Molecular Microbiology, Washington University in St. Louis, Saint Louis, United States
- Department of Microbiology, Harvard Medical School, Boston, United States
| | - Rebecca M. DuBois
- Department of Biomolecular Engineering, University of California, Santa Cruz, United States
| | - Sara M. O’Rourke
- Department of Biomolecular Engineering, University of California, Santa Cruz, United States
| | - Angel Eduardo Salgado-Escobar
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Morelos, Mexico
| | - José Esteban Muñoz-Medina
- Coordinación de Calidad de Insumos y Laboratorios Especializados, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - Carlos F. Arias
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Morelos, Mexico
| | - Susana López
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Morelos, Mexico
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3
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Guo F, Adekanmbi V, Hsu CD, Polychronopoulou E, Berenson AB. One dose versus two doses of COVID-19 vaccine for the prevention of breakthrough infections among people previously infected with SARS-Cov-2. J Med Virol 2024; 96:e29391. [PMID: 38235834 PMCID: PMC10837048 DOI: 10.1002/jmv.29391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/04/2023] [Accepted: 01/01/2024] [Indexed: 01/19/2024]
Abstract
Studies have suggested the effectiveness of COVID-19 vaccines in preventing SARS-CoV-2 reinfection among those previously infected. However, it is not yet clear if one dose of the vaccine is enough to prevent breakthrough infections compared to two doses. Using data from Optum deidentified COVID-19 Electronic Health Record (EHR) data set, we assessed breakthrough infection risks in individuals previously infected, comparing those with one vaccine dose to those with two doses. Propensity scores were applied to mitigate confounding factors. Follow-up spanned 6 months, beginning 2 weeks postvaccination. Among 213 845 individuals, those receiving one vaccine dose had a significantly higher breakthrough infection risk than the two-dose group (HR 1.69, 95% CI 1.54-1.85). This pattern was observed across genders, racial/ethnic groups, age categories, and vaccine types. This study reveals a substantial disparity in the risk of breakthrough infections between individuals receiving one versus two doses of the COVID-19 vaccine, suggesting that a single dose may not provide adequate protection against reinfection.
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Affiliation(s)
- Fangjian Guo
- Division of Population and Preventive Health, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
| | - Victor Adekanmbi
- Division of Population and Preventive Health, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
| | - Christine D. Hsu
- Division of Population and Preventive Health, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
| | - Efstathia Polychronopoulou
- Office of Biostatistics, School of Public and Population Health, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
| | - Abbey B. Berenson
- Division of Population and Preventive Health, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
- Center for Interdisciplinary Research in Women’s Health, School of Medicine, The University of Texas Medical Branch at Galveston, Galveston, Texas, United States
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Freitas MTDS, Sena LOC, Fukutani KF, dos Santos CA, Neto FDCB, Ribeiro JS, dos Reis ES, Balbino VDQ, de Sá Paiva Leitão S, de Aragão Batista MV, Lipscomb MW, de Moura TR. The increase in SARS-CoV-2 lineages during 2020-2022 in a state in the Brazilian Northeast is associated with a number of cases. Front Public Health 2023; 11:1222152. [PMID: 38186707 PMCID: PMC10771345 DOI: 10.3389/fpubh.2023.1222152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 11/15/2023] [Indexed: 01/09/2024] Open
Abstract
SARS-CoV-2 has caused a high number of deaths in several countries. In Brazil, there were 37 million confirmed cases of COVID-19 and 700,000 deaths caused by the disease. The population size and heterogeneity of the Brazilian population should be considered in epidemiological surveillance due to the varied tropism of the virus. As such, municipalities and states must be factored in for their unique specificities, such as socioeconomic conditions and population distribution. Here, we investigate the spatiotemporal dispersion of emerging SARS-CoV-2 lineages and their dynamics in each microregion from Sergipe state, northeastern Brazil, in the first 3 years of the pandemic. We analyzed 586 genomes sequenced between March 2020 and November 2022 extracted from the GISAID database. Phylogenetic analyses were carried out for each data set to reconstruct evolutionary history. Finally, the existence of a correlation between the number of lineages and infection cases by SARS-CoV-2 was evaluated. Aracaju, the largest city in northeastern Brazil, had the highest number of samples sequenced. This represented 54.6% (320) of the genomes, and consequently, the largest number of lineages identified. Studies also analyzed the relationship between mean lineage distributions and mean monthly infections, daily cases, daily deaths, and hospitalizations of vaccinated and unvaccinated patients. For this, a correlation matrix was created. Results revealed that the increase in the average number of SARS-CoV-2 variants was related to the average number of SARS-CoV-2 cases in both unvaccinated and vaccinated individuals. Thus, our data indicate that it is necessary to maintain epidemiological surveillance, especially in capital cities, since they have a high rate of circulation of resident and non-resident inhabitants, which contributes to the dynamics of the virus.
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Affiliation(s)
- Moises Thiago de Souza Freitas
- Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Brazil
- Parasitic Biology Graduate Program, Federal University of Sergipe, São Cristóvão, Brazil
| | - Ludmila Oliveira Carvalho Sena
- Health Foundation Parreiras Horta, Central Laboratory of Public Health (LACEN/SE), Sergipe State Health Secretariat, Aracaju, Brazil
| | - Kiyoshi Ferreira Fukutani
- Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Cliomar Alves dos Santos
- Health Foundation Parreiras Horta, Central Laboratory of Public Health (LACEN/SE), Sergipe State Health Secretariat, Aracaju, Brazil
| | | | - Julienne Sousa Ribeiro
- Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Brazil
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Zhu L, Mao N, Yi C, Simayi A, Feng J, Feng Y, He M, Ding S, Wang Y, Wang Y, Wei M, Hong J, Li C, Tian H, Zhou L, Peng J, Zhang S, Song C, Jin H, Zhu F, Xu W, Zhao J, Bao C. Impact of vaccination on kinetics of neutralizing antibodies against SARS-CoV-2 by serum live neutralization test based on a prospective cohort. Emerg Microbes Infect 2023; 12:2146535. [PMID: 36373485 PMCID: PMC9858416 DOI: 10.1080/22221751.2022.2146535] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
How much the vaccine contributes to the induction and development of neutralizing antibodies (NAbs) of breakthrough cases relative to those unvaccinated-infected cases is not fully understood. We conducted a prospective cohort study and collected serum samples from 576 individuals who were diagnosed with SARS-CoV-2 Delta strain infection, including 245 breakthrough cases and 331 unvaccinated-infected cases. NAbs were analysed by live virus microneutralization test and transformation of NAb titre. NAbs titres against SARS-CoV-2 ancestral and Delta variant in breakthrough cases were 7.8-fold and 4.0-fold higher than in unvaccinated-infected cases, respectively. NAbs titres in breakthrough cases peaked at the second week after onset/infection. However, the NAbs titres in the unvaccinated-infected cases reached their highest levels during the third week. Compared to those with higher levels of NAbs, those with lower levels of NAbs had no difference in viral clearance duration time (P>0.05), did exhibit higher viral load at the beginning of infection/maximum viral load of infection. NAb levels were statistically higher in the moderate cases than in the mild cases (P<0.0001). Notably, in breakthrough cases, NAb levels were highest longer than 4 months after vaccination (Delta strain: 53,118.2 U/mL), and lowest in breakthrough cases shorter than 1 month (Delta strain: 7551.2 U/mL). Cross-neutralization against the ancestral strain and the current circulating isolate (Omicron BA.5) was significantly lower than against the Delta variant in both breakthrough cases and unvaccinated-infected cases. Our study demonstrated that vaccination could induce immune responses more rapidly and greater which could be effective in controlling SARS-CoV-2.
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Affiliation(s)
- Liguo Zhu
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Naiying Mao
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Changhua Yi
- Nanjing Infectious Diseases Clinical Medical Center (The Second Hospital of Nanjing, Nanjing University of Chinese Medicine), Nanjing, P.R China
| | - Aidibai Simayi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Jialu Feng
- School of Public Health, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Yi Feng
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Min He
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, People’s Republic of China
| | - Songning Ding
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, People’s Republic of China
| | - Yin Wang
- Yangzhou Center for Disease Control and Prevention, Yangzhou, Pople's Republic of China
| | - Yan Wang
- Yangzhou Center for Disease Control and Prevention, Yangzhou, Pople's Republic of China
| | - Mingwei Wei
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jie Hong
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Chuchu Li
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hua Tian
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Lu Zhou
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jiefu Peng
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Shihan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Ci Song
- School of Public Health, Nanjing Medical University, Nanjing, People’s Republic of China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Fengcai Zhu
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Wenbo Xu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China, Wenbo Xu NHC Key Laboratory of Medical Virology and Viral Diseases, WHO WPRO Regional Reference Laboratory of Measles and Rubella, Measles Laboratory in National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155# Changbai Road, Changping District, Beijing, People’s Republic of China
| | - Jun Zhao
- The Third People's Hospital of Yangzhou, Yangzhou, People’s Republic of China,Jun Zhao The Third People's Hospital of Yangzhou, Yangzhou, Jiangsu Province, People’s Republic of China
| | - Changjun Bao
- NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China,Changjun Bao NHC Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, People’s Republic of China
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Schest S, Langer C, Stiegler Y, Karnuth B, Arends J, Stiegler H, Masetto T, Peter C, Grimmler M. Vaccine-induced SARS-CoV-2 antibody response: the comparability of S1-specific binding assays depends on epitope and isotype discrimination. Front Immunol 2023; 14:1257265. [PMID: 37965324 PMCID: PMC10641008 DOI: 10.3389/fimmu.2023.1257265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/28/2023] [Indexed: 11/16/2023] Open
Abstract
Background Quantification of the SARS-CoV-2-specific immune response by serological immunoassays is critical for the management of the COVID-19 pandemic. In particular, neutralizing antibody titers to the viral spike (S) protein have been proposed as a correlate of protection (CoP). The WHO established the First International Standard (WHO IS) for anti-SARS-CoV-2 immunoglobulin (Ig) (NIBSC 20/136) to harmonize binding assays with the same antigen specificity by assigning the same unitage in binding antibody units (BAU)/ml. Method In this study, we analyzed the S1-specific antibody response in a cohort of healthcare workers in Germany (n = 76) during a three-dose vaccination course over 8.5 months. Subjects received either heterologous or homologous prime-boost vaccination with ChAdOx1 nCoV-19 (AstraZeneca) and BNT162b2 (Pfizer-BioNTech) or three doses of BNT162b2. Antibodies were quantified using three anti-S1 binding assays (ELISA, ECLIA, and PETIA) harmonized to the WHO IS. Serum levels of neutralizing antibodies were determined using a surrogate virus neutralization test (sVNT). Binding assays were compared using Spearman's rank correlation and Passing-Bablok regression. Findings All assays showed good correlation and similar antibody kinetics correlating with neutralizing potential. However, the assays show large proportional differences in BAU/ml. ECLIA and PETIA, which detect total antibodies against the receptor- binding domain (RBD) within the S1 subunit, interact similarly with the convalescent plasma-derived WHO IS but differently with vaccine serum, indicating a high sensitivity to the IgG/IgM/IgA ratio. Conclusion All three binding assays allow monitoring of the antibody response in COVID-19-vaccinated individuals. However, the assay-specific differences hinder the definition of a common protective threshold in BAU/ml. Our results highlight the need for the thoughtful use of conversion factors and consideration of method-specific differences. To improve the management of future pandemics and harmonize total antibody assays, we should strive for reference material with a well-characterized Ig isotype composition.
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Affiliation(s)
- Silvia Schest
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
- Health University of Applied Sciences Tyrol, Innsbruck, Austria
| | - Claus Langer
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Yuriko Stiegler
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Bianca Karnuth
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Jan Arends
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Hugo Stiegler
- Medizinisches Versorgungszentrum für Labormedizin und Mikrobiologie Ruhr GmbH, Essen, Germany
| | - Thomas Masetto
- Institute of Molecular Medicine I, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- DiaSys Diagnostic Systems GmbH, Holzheim, Germany
| | - Christoph Peter
- Institute of Molecular Medicine I, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Matthias Grimmler
- DiaSys Diagnostic Systems GmbH, Holzheim, Germany
- Institute for Biomolecular Research, Hochschule Fresenius gGmbH, University of Applied Sciences, Idstein, Germany
- DiaServe Laboratories GmbH, Iffeldorf, Germany
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7
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Amellal H, Assaid N, Charoute H, Akarid K, Maaroufi A, Ezzikouri S, Sarih M. Kinetics of specific anti-SARS-CoV-2 IgM, IgA, and IgG responses during the first 12 months after SARS-CoV-2 infection: A prospective longitudinal study. PLoS One 2023; 18:e0288557. [PMID: 37437051 DOI: 10.1371/journal.pone.0288557] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/29/2023] [Indexed: 07/14/2023] Open
Abstract
Coronavirus 2019 (COVID-19) is a global health threat. The kinetics of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) need to be assessed, as the long-term duration of these immunoglobulins remains largely controversial. The aim of this study was to assess the longitudinal dynamics of anti-SARS-CoV-2 antibodies against the nucleocapsid (N) protein and the receptor-binding domain (RBD) of the spike protein up to one year in a cohort of 190 COVID-19 patients. Between March and September 2021, we enrolled patients from two regional hospitals in Casablanca, Morocco. Blood samples were collected and analyzed for antibody levels. We used the commercial Euroimmun ELISA for the determination of anti-N IgM, the Abbott Architect™ SARS-CoV-2 IgG test for the detection of anti-RBD IgG, and an in-house kit for the assay of anti-N IgG and anti-N IgA. IgM and IgA antibodies were assessed 2-5, 9-12, 17-20 and 32-37 days after symptom onset. IgG antibodies were also assessed 60, 90, 120 and 360 days after symptom onset. One-third of patients developed IgM (32%), while two-thirds developed IgA (61%). One month of symptom onset, most patients developed IgG, with 97% and 93% positivity for anti-RBD IgG and anti-N IgG, respectively. The anti-RBD IgG positivity rate remained high up to one year of follow-up. However, the anti-N IgG positivity rate decreased over time, with only 41% of patients testing positive after one year's follow-up. IgG levels were significantly higher in older people (over 50 years) than in other study participants. We also found that patients who had received two doses of ChAdOx1 nCoV-19 vaccine prior to infection had a lower IgM response than unvaccinated patients. This difference was statistically significant two weeks after the onset of symptoms. We present the first study in Africa to measure the kinetics of antibody response (IgA, IgM and IgG) to SARS-CoV-2 over one year. Most participants remained seropositive for anti-RBD IgG after one year but showed a significant decline in antibody titers.
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Affiliation(s)
- Houda Amellal
- Department of Parasitology and Vector-Borne Diseases, Institut Pasteur du Maroc, Casablanca, Morocco
- Aïn Chock Faculty of Sciences, Health and Environment Laboratory, Biochemistry, Biotechnology and Immunophysiopathology Research Team, Hassan II University of Casablanca, Casablanca, Morocco
| | - Najlaa Assaid
- Department of Parasitology and Vector-Borne Diseases, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Hicham Charoute
- Institut Pasteur du Maroc, Research Unit of Epidemiology, Biostatistics and Bioinformatics, Casablanca, Morocco
| | - Khadija Akarid
- Aïn Chock Faculty of Sciences, Health and Environment Laboratory, Biochemistry, Biotechnology and Immunophysiopathology Research Team, Hassan II University of Casablanca, Casablanca, Morocco
| | - Abderrahmane Maaroufi
- Department of Parasitology and Vector-Borne Diseases, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Sayeh Ezzikouri
- Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Virology Unit, Casablanca, Morocco
| | - M'hammed Sarih
- Department of Parasitology and Vector-Borne Diseases, Institut Pasteur du Maroc, Casablanca, Morocco
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8
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Joseph G, Cohen C, Rubin C, Murad H, Indenbaum V, Asraf K, Weiss-Ottolenghi Y, Segal-Lieberman G, Kreiss Y, Lustig Y, Regev-Yochay G. Humoral Immunity of Unvaccinated COVID-19 Recovered vs. Naïve BNT162b2 Vaccinated Individuals: A Prospective Longitudinal Study. Microorganisms 2023; 11:1628. [PMID: 37512801 PMCID: PMC10384358 DOI: 10.3390/microorganisms11071628] [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: 05/08/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
To study the differences in the immune response to SARS-CoV-2 infection compared to the response to vaccination, we characterized the humoral immune kinetics of these situations. In this prospective longitudinal study, we followed unvaccinated COVID-19-recovered individuals (n = 130) and naïve, two-dose BNT162b2-vaccinated individuals (n = 372) who were age- and BMI-matched for six months during the first pandemic year. Anti-RBD-IgG, neutralizing antibodies (NAbs), and avidity were assessed monthly. For recovered patients, data on symptoms and the severity of the disease were collected. Anti-RBD-IgG and NAbs titers at peak were higher after vaccination vs. after infection, but the decline was steeper (peak log IgG: 3.08 vs. 1.81, peak log NAbs: 5.93 vs. 5.04, slopes: -0.54 vs. -0.26). Peak anti-RBD-IgG and NAbs were higher in recovered individuals with BMI > 30 and in older individuals compared to individuals with BMI < 30, younger population. Of the recovered, 42 (36%) experienced long-COVID symptoms. Avidity was initially higher in vaccinated individuals compared with recovered individuals, though with time, it increased in recovered individuals but not among vaccinated individuals. Here, we show that while the initial antibody titers, neutralization, and avidity are lower in SARS-CoV-2-recovered individuals, they persist for a longer duration. These results suggest differential protection against COVID-19 in recovered-unvaccinated vs. naïve-vaccinated individuals.
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Affiliation(s)
- Gili Joseph
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Carmit Cohen
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Carmit Rubin
- Gertner Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Havi Murad
- Gertner Institute, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Victoria Indenbaum
- Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Keren Asraf
- The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Yael Weiss-Ottolenghi
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Gabriella Segal-Lieberman
- Division of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
| | - Yitshak Kreiss
- General Management, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
| | - Yaniv Lustig
- Central Virology Laboratory, Public Health Services, Ministry of Health, Tel-Hashomer, Ramat Gan 52621, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
| | - Gili Regev-Yochay
- The Sheba Pandemic Preparedness Research Institute (SPRI), and Infection Prevention & Control Unit, Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel Aviv 69978, Israel
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9
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Ramdani Y, Bettuzzi T, Bouznad A, Delaitre L, Nassarmadji K, Didier K, Paul C, Liozon E, Tieu A, Richard-Colmant G, Terrier B, Moulis G, Lafaurie M, Pillebout E, Maillot F, Audemard-Verger A. IgA Vasculitis Following COVID-19 Vaccination: A French Multicenter Case Series Including 12 Patients. J Rheumatol 2023; 50:252-257. [PMID: 36319000 DOI: 10.3899/jrheum.220545] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The worldwide coronavirus disease 2019 (COVID-19) vaccination campaign triggered several autoimmune diseases. We hereby aimed to describe IgA vasculitis (IgAV) following COVID-19 vaccination. METHODS We conducted a national, multicenter, retrospective study in France of new-onset adult IgAV diagnosis following COVID-19 vaccination. RESULTS In total, 12 patients with new-onset IgAV were included. Of these, 5 (41.7%) were women, and the median age was 52.5 (IQR 30.75-60.5) years. Of the 12 patients, 10 had received an mRNA vaccine and 2 had received a viral vector vaccine. The median time from vaccination to onset of symptoms was 11.5 (IQR 4.25-21.25) days. Vasculitis occurred after the first vaccine dose in most patients (n = 8). All patients had skin involvement, with skin necrosis in 4 patients. In total, 7 patients had joint involvement and 2 had arthritis. A total of 4 patients had nonsevere gastrointestinal involvement and 2 had nonsevere renal involvement. The median C-reactive protein level was 26 (IQR 10-66.75) mg/L, the median creatininemia level was 72 (IQR 65-81) μmol/L, and 1 patient had an estimated glomerular filtration rate of less than 60 mL/min at management. All patients received treatment, including 9 patients (75%) who received glucocorticoids. In total, 5 patients received a vaccine dose after developing IgAV, 1 of whom experienced a minor cutaneous relapse. CONCLUSION The baseline presentation of IgAV following COVID-19 vaccination was mild to moderate, and outcomes were favorable. Thus, a complete COVID-19 vaccination regimen should be completed in this population. Of note, a fortuitous link cannot be ruled out, requiring a worldwide pharmacovigilance search to confirm these findings.
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Affiliation(s)
- Yanis Ramdani
- Y. Ramdani, MD, F. Maillot, MD, PhD, A. Audemard-Verger, MD, PhD, Department of Internal Medicine and Clinical Immunology, CHRU de Tours, and Université de Tours, Tours
| | - Thomas Bettuzzi
- T. Bettuzzi, MD, Department of Dermatology, AP-HP, Hôpital Henri Mondor, Créteil
| | - Amel Bouznad
- A. Bouznad, MD, C. Paul, MD, PhD, Department of Dermatology, Centre Hospitalier Universitaire de Toulouse, Toulouse
| | - Léa Delaitre
- L. Delaitre, MD, Department of Dermatology, Centre Hospitalier Universitaire d'Angers, Angers
| | - Kladoum Nassarmadji
- K. Nassarmadji, MD, Department of Internal Medicine, AP-HP, Hôpital Lariboisière, Paris
| | - Kevin Didier
- K. Didier, MD, Department of Internal Medicine, Robert Debré University Hospital, Reims
| | - Carle Paul
- A. Bouznad, MD, C. Paul, MD, PhD, Department of Dermatology, Centre Hospitalier Universitaire de Toulouse, Toulouse
| | - Eric Liozon
- E. Liozon, MD, PhD, Department of Internal Medicine, Centre Hospitalier Universitaire Dupuytren 2, Limoges
| | - Ashley Tieu
- A. Tieu, MD, Department of Internal Medicine, Hôpital Jacques Cartier, Massy
| | - Gaëlle Richard-Colmant
- G. Richard-Colmant, MD, Department of Internal Medicine, Hospices Civils de Lyon, Groupement Hospitalier Nord, Lyon
| | - Benjamin Terrier
- B. Terrier, MD, PhD, Department of Internal Medicine, AP-HP, Hôpital Cochin, Paris
| | - Guillaume Moulis
- G. Moulis, MD, PhD, Department of Internal Medicine, Centre Hospitalier Universitaire de Toulouse, Toulouse
| | - Margaux Lafaurie
- M. Lafaurie, MD, PhD, Department of Medical and Clinical Pharmacology, Centre Hospitalier Universitaire de Toulouse, Toulouse
| | - Evangeline Pillebout
- E. Pillebout, MD, PhD, Nephrology Department, AP-HP, Hôpital St Louis, Paris, France
| | - François Maillot
- Y. Ramdani, MD, F. Maillot, MD, PhD, A. Audemard-Verger, MD, PhD, Department of Internal Medicine and Clinical Immunology, CHRU de Tours, and Université de Tours, Tours
| | - Alexandra Audemard-Verger
- Y. Ramdani, MD, F. Maillot, MD, PhD, A. Audemard-Verger, MD, PhD, Department of Internal Medicine and Clinical Immunology, CHRU de Tours, and Université de Tours, Tours;
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10
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Coelho LE, Luz PM, Pires DC, Jalil EM, Perazzo H, Torres TS, Cardoso SW, Peixoto EM, Nazer S, Massad E, Silveira MF, Barros FC, Vasconcelos AT, Costa CA, Amancio RT, Villela DA, Pereira T, Goedert GT, Santos CV, Rodrigues NC, Grinsztejn B, Veloso VG, Struchiner CJ. Prevalence and predictors of anti-SARS-CoV-2 serology in a highly vulnerable population of Rio de Janeiro: A population-based serosurvey. THE LANCET REGIONAL HEALTH - AMERICAS 2022; 15:100338. [PMID: 35936224 PMCID: PMC9337985 DOI: 10.1016/j.lana.2022.100338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background COVID-19 serosurveys allow for the monitoring of the level of SARS-CoV-2 transmission and support data-driven decisions. We estimated the seroprevalence of anti-SARS-CoV-2 antibodies in a large favela complex in Rio de Janeiro, Brazil. Methods A population-based panel study was conducted in Complexo de Manguinhos (16 favelas) with a probabilistic sampling of participants aged ≥1 year who were randomly selected from a census of individuals registered in primary health care clinics that serve the area. Participants answered a structured interview and provided blood samples for serology. Multilevel regression models (with random intercepts to account for participants’ favela of residence) were used to assess factors associated with having anti-S IgG antibodies. Secondary analyses estimated seroprevalence using an additional anti-N IgG assay. Findings 4,033 participants were included (from Sep/2020 to Feb/2021, 22 epidemic weeks), the median age was 39·8 years (IQR:21·8-57·7), 61% were female, 41% were mixed-race (Pardo) and 23% Black. Overall prevalence was 49·0% (95%CI:46·8%-51·2%) which varied across favelas (from 68·3% to 31·4%). Lower prevalence estimates were found when using the anti-N IgG assay. Odds of having anti-S IgG antibodies were highest for young adults, and those reporting larger household size, poor adherence to social distancing and use of public transportation. Interpretation We found a significantly higher prevalence of anti-S IgG antibodies than initially anticipated. Disparities in estimates obtained using different serological assays highlight the need for cautious interpretation of serosurveys estimates given the heterogeneity of exposure in communities, loss of immunological biomarkers, serological antigen target, and variant-specific test affinity. Funding Fundação Oswaldo Cruz, Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Fundação de Amparo a Pesquisa do Estado do Rio de Janeiro (FAPERJ), the European Union's Horizon 2020 research and innovation programme, Royal Society, Serrapilheira Institute, and FAPESP.
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11
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Garlantezec R, Tadié E, Heslan C, Gary-Bobo P, Oumari S, Saade A, Sitruk A, Tattevin P, Thibault V, Paris C. SARS-CoV-2 seroprevalence and antibodies persistence among health care workers after the first COVID-19 wave in nine hospitals in Western France. Infect Dis Now 2022; 52:447-452. [PMID: 36108975 PMCID: PMC9467933 DOI: 10.1016/j.idnow.2022.09.004] [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: 04/25/2022] [Revised: 07/05/2022] [Accepted: 09/06/2022] [Indexed: 11/15/2022]
Abstract
Objectives To estimate the SARS-CoV-2 IgG seroprevalence rate in healthcare workers (HCWs) from Western France after the first 2020 wave, its determinants and the kinetics of total SARS-CoV-2 antibodies. Patients and methods Overall, 9,453 HCWs responded to a self-questionnaire and underwent a lateral flow immunoassay to assess SARS-CoV-2 IgG presence. For 72 HCWs who tested positive, total anti-nucleocapsid antibodies were assessed at day 0, 30, and 90. Results SARS-CoV-2 IgG seroprevalence rate was 1.06 % [0.86 %–1.27 %]. Factors associated with IgG presence were gender, performing upper respiratory tract samples, contact with HCWs or household members diagnosed with COVID-19. Total antibodies decreased between day 0 and day 90, with anosmia or ageusia, and were higher in HCWs older than 50 years. Conclusion We reported a low prevalence rate of IgG and identified several risk factors associated with its presence and persistence of total antibodies. Additional studies are needed to confirm these observations.
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Affiliation(s)
- R Garlantezec
- CHU de Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France.
| | - E Tadié
- CHU de Rennes, F-35000 Rennes, France
| | - C Heslan
- CHU de Rennes, F-35000 Rennes, France
| | | | - S Oumari
- CHU de Rennes, F-35000 Rennes, France
| | - A Saade
- CHU de Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - A Sitruk
- CHU de Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - P Tattevin
- CHU de Rennes, Univ Rennes, INSERM U1230, IFR140, F-35033 Rennes, France
| | - V Thibault
- CHU de Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
| | - C Paris
- CHU de Rennes, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-35000 Rennes, France
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12
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Lai A, Caimi B, Franzetti M, Bergna A, Velleca R, Gatti A, Rossi PL, D’Orso M, Pregliasco F, Balotta C, Calicchio G. Durability of Humoral Responses after the Second Dose of mRNA BNT162b2 Vaccine in Residents of a Long Term Care Facility. Vaccines (Basel) 2022; 10:vaccines10030446. [PMID: 35335078 PMCID: PMC8954729 DOI: 10.3390/vaccines10030446] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/03/2022] [Accepted: 03/10/2022] [Indexed: 02/04/2023] Open
Abstract
Residents of long-term care facilities (LTCFs) have been dramatically hit by the COVID-19 pandemic on a global scale as older age and comorbidities pose an increased risk of severe disease and death. The aim of the study was to assess the quantity and durability of specific antibody responses to SARS-CoV-2 after the first cycle (two doses) of BNT162b2 vaccine. To achieve this, SARS-CoV-2 Spike-specific IgG (S-IgG) titers was evaluated in 432 residents of the largest Italian LTCF at months 2 and 6 after vaccination. By stratifying levels of humoral responses as high, medium, low and null, we did not find any difference when comparing the two time points; however, the median levels of antibodies halved overtime. As positive nucleocapsid serology was associated with a reduced risk of a suboptimal response at both time points, we conducted separate analyses accordingly. In subjects with positive serology, the median level of anti-S IgG slightly increased at the second time point, while a significant reduction was observed in patients without previous exposure to the virus. At month 6, diabetes alone was associated with an increased risk of impaired response. Our data provide additional insights into the longitudinal dynamics of the immune response to BNT162b2 vaccination in the elderly, highlighting the need for SARS-CoV-2 antibody monitoring following third-dose administration.
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Affiliation(s)
- Alessia Lai
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.)
- Correspondence: ; Tel.: +39-025-0319-775
| | - Barbara Caimi
- Azienda Servizi alla Persona, Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy; (B.C.); (R.V.); (A.G.); (P.L.R.); (G.C.)
| | - Marco Franzetti
- Infectious Diseases Unit, Legnano General Hospital, ASST Ovest Milanese, 20025 Legnano, Italy;
| | - Annalisa Bergna
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.)
| | - Rossella Velleca
- Azienda Servizi alla Persona, Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy; (B.C.); (R.V.); (A.G.); (P.L.R.); (G.C.)
| | - Antonella Gatti
- Azienda Servizi alla Persona, Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy; (B.C.); (R.V.); (A.G.); (P.L.R.); (G.C.)
| | - Pier Luigi Rossi
- Azienda Servizi alla Persona, Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy; (B.C.); (R.V.); (A.G.); (P.L.R.); (G.C.)
| | - Marco D’Orso
- Department of Medicine and Surgery, University of Milan-Bicocca, 20900 Monza, Italy;
| | - Fabrizio Pregliasco
- Department of Biomedical Sciences, IRCCS Istituto Ortopedico Galeazzi, University of Milan, 20161 Milan, Italy;
| | - Claudia Balotta
- Department of Biomedical and Clinical Sciences L. Sacco, University of Milan, 20157 Milan, Italy; (A.B.); (C.B.)
| | - Giuseppe Calicchio
- Azienda Servizi alla Persona, Istituti Milanesi Martinitt e Stelline e Pio Albergo Trivulzio, 20146 Milan, Italy; (B.C.); (R.V.); (A.G.); (P.L.R.); (G.C.)
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13
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Benning L, Klein K, Morath C, Bartenschlager M, Kim H, Buylaert M, Reineke M, Töllner M, Nusshag C, Kälble F, Reichel P, Schnitzler P, Zeier M, Süsal C, Bartenschlager R, Schaier M, Speer C. Neutralizing Antibody Activity Against the B.1.617.2 (delta) Variant Before and After a Third BNT162b2 Vaccine Dose in Hemodialysis Patients. Front Immunol 2022; 13:840136. [PMID: 35309320 PMCID: PMC8931261 DOI: 10.3389/fimmu.2022.840136] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/11/2022] [Indexed: 12/20/2022] Open
Abstract
Hemodialysis patients are at high risk for severe COVID-19, and impaired seroconversion rates have been demonstrated after COVID-19 vaccination. Humoral immunity wanes over time and variants of concern with immune escape are posing an increasing threat. Little is known about protection against the B.1.617.2 (delta) variant of concern in hemodialysis patients before and after third vaccination. We determined anti-S1 IgG, surrogate neutralizing, and IgG antibodies against different SARS-CoV-2 epitopes in 84 hemodialysis patients directly before and three weeks after a third vaccine dose with BNT162b2. Third vaccination was performed after a median (IQR) of 119 (109–165) days after second vaccination. In addition, neutralizing activity against the B.1.617.2 (delta) variant was assessed in 31 seroconverted hemodialysis patients before and after third vaccination. Triple seropositivity for anti-S1 IgG, surrogate neutralizing, and anti-RBD antibodies increased from 31/84 (37%) dialysis patients after second to 80/84 (95%) after third vaccination. Neutralizing activity against the B.1.617.2 (delta) variant was significantly higher after third vaccination with a median (IQR) ID50 of 1:320 (1:160–1:1280) compared with 1:20 (0–1:40) before a third vaccine dose (P<0.001). The anti-S1 IgG index showed the strongest correlation with the ID50 against the B.1.617.2 (delta) variant determined by live virus neutralization (r=0.91). We demonstrate low neutralizing activity against the B.1.617.2 (delta) variant in dialysis patients four months after standard two-dose vaccination but a substantial increase after a third vaccine dose. Booster vaccination(s) should be considered earlier than 6 months after the second vaccine dose in immunocompromised individuals.
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Affiliation(s)
- Louise Benning
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
- *Correspondence: Louise Benning,
| | - Katrin Klein
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Christian Morath
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Marie Bartenschlager
- Department of Infectious Diseases, Molecular Virology, University of Heidelberg, Heidelberg, Germany
| | - Heeyoung Kim
- Department of Infectious Diseases, Molecular Virology, University of Heidelberg, Heidelberg, Germany
| | - Mirabel Buylaert
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Marvin Reineke
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | | | - Christian Nusshag
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Florian Kälble
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Paula Reichel
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Paul Schnitzler
- Department of Virology, University of Heidelberg, Heidelberg, Germany
| | - Martin Zeier
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Caner Süsal
- Institute of Immunology, University of Heidelberg, Heidelberg, Germany
- Transplant Immunology Research Center of Excellence, Koç University Hospital, Istanbul, Turkey
| | - Ralf Bartenschlager
- Department of Infectious Diseases, Molecular Virology, University of Heidelberg, Heidelberg, Germany
- German Center for Infection Research, Partner Site Heidelberg, Heidelberg, Germany
- Division Virus-Associated Carcinogenesis, German Cancer Research Center, Heidelberg, Germany
| | - Matthias Schaier
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - Claudius Speer
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
- Department of Molecular Medicine Partnership Unit Heidelberg, European Molecular Biology Laboratory, Heidelberg, Germany
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