|
1
|
Spiteri G, D'Agostini M, Abedini M, Ditano G, Collatuzzo G, Boffetta P, Vimercati L, Sansone E, De Palma G, Modenese A, Gobba F, Liviero F, Moretto A, dell'Omo M, Fiordi T, Larese Filon F, Mauro M, Violán C, Mates D, Oravec Bérešová J, Monaco MGL, Carta A, Verlato G, Porru S. Protective role of SARS-CoV-2 anti-S IgG against breakthrough infections among European healthcare workers during pre and post-Omicron surge-ORCHESTRA project. Infection 2024:10.1007/s15010-024-02189-x. [PMID: 38326526 DOI: 10.1007/s15010-024-02189-x] [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: 12/09/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Anti SARS-CoV-2 vaccination initially showed high effectiveness in preventing COVID-19. However, after the surge of variants of concern, the effectiveness dropped. Several studies investigated if this was related to the decrease of the humoral response over time; however, this issue is still unclear. The aim of this study was to understand whether SARS-CoV-2 anti-S IgG levels can be used to predict breakthrough infection risk and define the timing for further booster doses administration. METHOD Within the framework of the ORCHESTRA Project, over 20,000 health workers from 11 European centers were enrolled since December 2020. We performed two Cox proportional hazards survival analyses regarding pre-Omicron (from January to July 2021) and Omicron (December 2021-May 2022) periods. The serological response was classified as high (above the 75th percentile), medium (25th-75th), or low (< 25th). RESULTS Seventy-four (0.33%) and 2122 (20%) health workers were infected during the first and second periods, respectively. Both Cox analyses showed that having high anti-S titer was linked to a significantly lower risk of infection as compared to having medium serological response [HR of high vs medium anti-S titer = 0.27 (95% CI 0.11-0.66) during the first phase, HR = 0.76 (95% CI 0.62-0.93) during the second phase]. CONCLUSION Vaccine effectiveness wanes significantly after new variants surge, making anti-S titer unsuitable to predict optimal timing for further booster dose administration. Studies on other immunological indicators, such as cellular immunity, are therefore needed to better understand the mechanisms and duration of protection against breakthrough infection risk.
Collapse
Affiliation(s)
- Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy
| | - Marika D'Agostini
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy.
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70121, Bari, Italy
| | - Emanuele Sansone
- Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121, Brescia, Italy
| | - Giuseppe De Palma
- Unit of Occupational Health and Industrial Hygiene, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121, Brescia, Italy
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, University Hospital ASST Spedali Civili, 25123, Brescia, Italy
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125, Modena, Italy
| | - Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128, Padua, Italy
- Occupational Medicine Unit, University Hospital of Padova, 35128, Padua, Italy
| | - Angelo Moretto
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128, Padua, Italy
- Occupational Medicine Unit, University Hospital of Padova, 35128, Padua, Italy
| | - Marco dell'Omo
- Department of Medicine and Surgery, University of Perugia, 06129, Perugia, Italy
| | - Tiziana Fiordi
- Occupational Medicine Unit, Perugia Hospital, 06129, Perugia, Italy
| | - Francesca Larese Filon
- Department of Medical Sciences, Unit of Occupational Medicine, University of Trieste, 34129, Trieste, Italy
| | - Marcella Mauro
- Department of Medical Sciences, Unit of Occupational Medicine, University of Trieste, 34129, Trieste, Italy
| | - Concepción Violán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303, Mataró, Barcelona, Spain
- Germans Trias i Pujol Research Institute (IGTP), 08916, Badalona, Spain
- Grup de REcerca en Impacte de les Malalties Cròniques i les Seves Trajectòries (GRIMTra), (2021 SGR 01537), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), 08303, Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) (RD21/0016/0029), Insitituto de Salud Carlos III, 28029, Madrid, Spain
- Direcció d'Atenció Primària Metropolitana Nord Institut Català de Salut, 08204, Barcelona, Spain
- Universitat Autónoma de Barcelona, 08193, Bellaterra, Spain
| | - Dana Mates
- National Institute of Public Health, 050463, Bucharest, Romania
| | - Jana Oravec Bérešová
- Epidemiology Department, Regional Authority of Public Health, 97556, Banská Bystrica, Slovakia
| | | | - Angela Carta
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
| | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
| | - Stefano Porru
- Occupational Medicine Unit, University Hospital of Verona, 37134, Verona, Italy
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134, Verona, Italy
| |
Collapse
|