1
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Collins CP, Longo DL, Murphy WJ. The immunobiology of SARS-CoV-2 infection and vaccine responses: potential influences of cross-reactive memory responses and aging on efficacy and off-target effects. Front Immunol 2024; 15:1345499. [PMID: 38469293 PMCID: PMC10925677 DOI: 10.3389/fimmu.2024.1345499] [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: 11/27/2023] [Accepted: 02/12/2024] [Indexed: 03/13/2024] Open
Abstract
Immune responses to both SARS-CoV-2 infection and its associated vaccines have been highly variable within the general population. The increasing evidence of long-lasting symptoms after resolution of infection, called post-acute sequelae of COVID-19 (PASC) or "Long COVID," suggests that immune-mediated mechanisms are at play. Closely related endemic common human coronaviruses (hCoV) can induce pre-existing and potentially cross-reactive immunity, which can then affect primary SARS-CoV-2 infection, as well as vaccination responses. The influence of pre-existing immunity from these hCoVs, as well as responses generated from original CoV2 strains or vaccines on the development of new high-affinity responses to CoV2 antigenic viral variants, needs to be better understood given the need for continuous vaccine adaptation and application in the population. Due in part to thymic involution, normal aging is associated with reduced naïve T cell compartments and impaired primary antigen responsiveness, resulting in a reliance on the pre-existing cross-reactive memory cell pool which may be of lower affinity, restricted in diversity, or of shorter duration. These effects can also be mediated by the presence of down-regulatory anti-idiotype responses which also increase in aging. Given the tremendous heterogeneity of clinical data, utilization of preclinical models offers the greatest ability to assess immune responses under a controlled setting. These models should now involve prior antigen/viral exposure combined with incorporation of modifying factors such as age on immune responses and effects. This will also allow for mechanistic dissection and understanding of the different immune pathways involved in both SARS-CoV-2 pathogen and potential vaccine responses over time and how pre-existing memory responses, including potential anti-idiotype responses, can affect efficacy as well as potential off-target effects in different tissues as well as modeling PASC.
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Affiliation(s)
- Craig P. Collins
- Graduate Program in Immunology, University of California (UC) Davis, Davis, CA, United States
| | - Dan L. Longo
- Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, United States
| | - William J. Murphy
- Departments of Dermatology and Internal Medicine (Hematology/Oncology), University of California (UC) Davis School of Medicine, Sacramento, CA, United States
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2
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McClelland P, Gray BH. Cilostazol as a Treatment for COVID Toes: A Case Report. Ann Vasc Surg 2023; 91:76-80. [PMID: 36442709 PMCID: PMC9691508 DOI: 10.1016/j.avsg.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/10/2022] [Accepted: 10/14/2022] [Indexed: 11/26/2022]
Abstract
During the Coronavirus Disease 2019 (COVID-19) pandemic, skin lesions resembling those seen in pernio (chilblains) have been observed in patients with COVID-19 infection. The term "COVID toes" has been used when there is toe involvement. We describe the case of a fully vaccinated, 56-year-old woman with no prior diagnosis of COVID-19 who developed pernio-like lesions many months after being vaccinated. Her skin lesions resolved after treatment with cilostazol, suggesting that this medication may be a viable treatment for pernio in the setting of COVID-19 infection.
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Affiliation(s)
- Patton McClelland
- University of South Carolina School of Medicine Greenville, Greenville, SC
| | - Bruce H Gray
- Department of Medicine, Division of Surgery/Vascular Medicine, Prisma Health-Upstate, Greenville, SC.
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3
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Ostermann PN, Schaal H. Human brain organoids to explore SARS-CoV-2-induced effects on the central nervous system. Rev Med Virol 2023; 33:e2430. [PMID: 36790825 DOI: 10.1002/rmv.2430] [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: 12/26/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/16/2023]
Abstract
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19). In less than three years, an estimated 600 million infections with SARS-CoV-2 occurred worldwide, resulting in a pandemic with tremendous impact especially on economic and health sectors. Initially considered a respiratory disease, COVID-19, along with its long-term sequelae (long-COVID) rather is a systemic disease. Neurological symptoms like dementia or encephalopathy were reported early during the pandemic as concomitants of the acute phase and as characteristics of long-COVID. An excessive inflammatory immune response is hypothesized to play a major role in this context. However, direct infection of neural cells may also contribute to the neurological aspects of (long)-COVID-19. To mainly explore such direct effects of SARS-CoV-2 on the central nervous system, human brain organoids provide a useful platform. Infecting these three-dimensional tissue cultures allows the study of viral neurotropism as well as of virus-induced effects on single cells or even the complex cellular network within the organoid. In this review, we summarize the experimental studies that used SARS-CoV-2-infected human brain organoids to unravel the complex nature of (long)-COVID-19-related neurological manifestations.
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Affiliation(s)
- Philipp Niklas Ostermann
- Institute of Virology, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Heiner Schaal
- Institute of Virology, University Hospital Düsseldorf, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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4
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Fischer JC, Balz V, Jazmati D, Bölke E, Freise NF, Keitel V, Feldt T, Jensen BEO, Bode J, Lüdde T, Häussinger D, Adams O, Schneider EM, Enczmann J, Rox JM, Hermsen D, Schulze-Bosse K, Kindgen-Milles D, Knoefel WT, van Griensven M, Haussmann J, Tamaskovics B, Plettenberg C, Scheckenbach K, Corradini S, Pedoto A, Maas K, Schmidt L, Grebe O, Esposito I, Ehrhardt A, Peiper M, Buhren BA, Calles C, Stöhr A, Gerber PA, Lichtenberg A, Schelzig H, Flaig Y, Rezazadeh A, Budach W, Matuschek C. Prognostic markers for the clinical course in the blood of patients with SARS-CoV-2 infection. Eur J Med Res 2022; 27:255. [PMID: 36411478 PMCID: PMC9676819 DOI: 10.1186/s40001-022-00864-z] [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: 07/14/2022] [Accepted: 10/20/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The presentation of peptides and the subsequent immune response depend on the MHC characteristics and influence the specificity of the immune response. Several studies have found an association between HLA variants and differential COVID-19 outcomes and have shown that HLA genotypes are associated with differential immune responses against SARS-CoV-2, particularly in severely ill patients. Information, whether HLA haplotypes are associated with the severity or length of the disease in moderately diseased individuals is absent. METHODS Next-generation sequencing-based HLA typing was performed in 303 female and 231 male non-hospitalized North Rhine Westphalian patients infected with SARS-CoV2 during the first and second wave. For HLA-Class I, we obtained results from 528 patients, and for HLA-Class II from 531. In those patients, who became ill between March 2020 and January 2021, the 22 most common HLA-Class I (HLA-A, -B, -C) or HLA-Class II (HLA -DRB1/3/4, -DQA1, -DQB1) haplotypes were determined. The identified HLA haplotypes as well as the presence of a CCR5Δ32 mutation and number of O and A blood group alleles were associated to disease severity and duration of the disease. RESULTS The influence of the HLA haplotypes on disease severity and duration was more pronounced than the influence of age, sex, or ABO blood group. These associations were sex dependent. The presence of mutated CCR5 resulted in a longer recovery period in males. CONCLUSION The existence of certain HLA haplotypes is associated with more severe disease.
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Affiliation(s)
- Johannes C. Fischer
- grid.14778.3d0000 0000 8922 7789Institute for Transplant Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Vera Balz
- grid.14778.3d0000 0000 8922 7789Institute for Transplant Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Danny Jazmati
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Edwin Bölke
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Noemi F. Freise
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Verena Keitel
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Torsten Feldt
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Björn-Erik Ole Jensen
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Johannes Bode
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Tom Lüdde
- grid.14778.3d0000 0000 8922 7789Institute for Virology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Dieter Häussinger
- grid.14778.3d0000 0000 8922 7789Department of Gastroenterology, Hepatology and Infectious Diseases, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Ortwin Adams
- grid.14778.3d0000 0000 8922 7789Institute for Virology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - E. Marion Schneider
- grid.410712.10000 0004 0473 882XDivision of Experimental Anesthesiology, University Hospital Ulm, Ulm, Germany
| | - Jürgen Enczmann
- grid.14778.3d0000 0000 8922 7789Institute for Transplant Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Jutta M. Rox
- grid.14778.3d0000 0000 8922 7789Institute for Transplant Diagnostics and Cell Therapeutics, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Derik Hermsen
- grid.14778.3d0000 0000 8922 7789Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Karin Schulze-Bosse
- grid.14778.3d0000 0000 8922 7789Central Institute for Laboratory Diagnostics and Clinical Chemistry, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Detlef Kindgen-Milles
- grid.14778.3d0000 0000 8922 7789Department of Anesthesiology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Wolfram Trudo Knoefel
- grid.14778.3d0000 0000 8922 7789Department of Surgery and Interdisciplinary Surgical Intensive Care Unit, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Martijn van Griensven
- grid.5012.60000 0001 0481 6099Department cBITE, MERLN Institute for Technology-Inspired Regenerative Medicine, Maastricht University, Maastricht, The Netherlands
| | - Jan Haussmann
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Balint Tamaskovics
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Christian Plettenberg
- grid.14778.3d0000 0000 8922 7789Department of Ear, Nose and Throat Disease, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Kathrin Scheckenbach
- grid.14778.3d0000 0000 8922 7789Department of Ear, Nose and Throat Disease, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Stefanie Corradini
- grid.5252.00000 0004 1936 973XDepartment of Radiation Oncology, LMU University of Munich, Munich, Germany
| | - Alessia Pedoto
- grid.51462.340000 0001 2171 9952Department of Anesthesiology, Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Kitti Maas
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Livia Schmidt
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Olaf Grebe
- Department of Cardiology and Rhythmology, Petrus Hospital, Wuppertal, Germany
| | - Irene Esposito
- grid.14778.3d0000 0000 8922 7789Institute of Pathology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Anja Ehrhardt
- grid.412581.b0000 0000 9024 6397Institute of Virology, University of Witten/Herdecke, Witten, Germany
| | - Matthias Peiper
- grid.14778.3d0000 0000 8922 7789Medical Faculty, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Bettina Alexandra Buhren
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Christian Calles
- grid.14778.3d0000 0000 8922 7789Coordination Center for Clinical Studies, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Andreas Stöhr
- grid.14778.3d0000 0000 8922 7789Coordination Center for Clinical Studies, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Peter Arne Gerber
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Artur Lichtenberg
- grid.14778.3d0000 0000 8922 7789Department of Cardiac Surgery, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Hubert Schelzig
- grid.14778.3d0000 0000 8922 7789Department of Vascular Surgery, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Yechan Flaig
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Amir Rezazadeh
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Wilfried Budach
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
| | - Christiane Matuschek
- grid.14778.3d0000 0000 8922 7789Department of Radiation Oncology, Medical Faculty, University Hospital Dusseldorf, Heinrich-Heine-University Dusseldorf, Dusseldorf, Germany
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Müller L, Andrée M, Moskorz W, Drexler I, Hauka S, Ptok J, Walotka L, Grothmann R, Hillebrandt J, Ritchie A, Peter L, Walker A, Timm J, Adams O, Schaal H. Adjusted COVID-19 booster schedules balance age-dependent differences in antibody titers benefitting risk populations. FRONTIERS IN AGING 2022; 3:1027885. [PMID: 36313184 PMCID: PMC9596780 DOI: 10.3389/fragi.2022.1027885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022]
Abstract
We provide follow-up data on the humoral immune response after COVID-19 vaccinations of two distinct cohorts aged below 60 and over 80 years to screen for age-related differences in the longevity and magnitude of the induction of the antibody responses post booster-vaccinations. While anti-SARS-CoV-2 spike-specific IgG and neutralization capacity waned rapidly after the initial vaccination schedule, additional boosters highly benefitted the humoral immune responses especially in the elderly cohort, including the neutralization of Omikron variants. Thus, adjusted COVID-19 booster vaccination schedules are an appropriate tool to overcome limitations in the success of vaccinations.
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Affiliation(s)
- Lisa Müller
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany,*Correspondence: Lisa Müller,
| | - Marcel Andrée
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Wiebke Moskorz
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Ingo Drexler
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Sandra Hauka
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Johannes Ptok
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Lara Walotka
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Ramona Grothmann
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Jonas Hillebrandt
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany,Department of Nephrology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Anastasia Ritchie
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Laura Peter
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andreas Walker
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Jörg Timm
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Ortwin Adams
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Heiner Schaal
- Institute of Virology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
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6
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Yavuz SŞ, Tunçer G, Altuntaş-Aydın Ö, Aydın M, Pehlivanoğlu F, Tok Y, Mese S, Gündüz A, Güçlü CG, Özdoğan İ, Hemiş-Aydın B, Soğuksu P, Benli A, Başaran S, Midilli K, Eraksoy H. Comparison of the Clinical and Laboratory Findings and Outcomes of Hospitalized COVID-19 Patients Who Were Either Fully Vaccinated with Coronavac or Not: An Analytical, Cross Sectional Study. Vaccines (Basel) 2022; 10:vaccines10050733. [PMID: 35632489 PMCID: PMC9148084 DOI: 10.3390/vaccines10050733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 01/27/2023] Open
Abstract
COVID-19 vaccines are highly protective against severe disease; however, vaccine breakthrough infections resulting in hospitalization may still occur in a small percentage of vaccinated individuals. We investigated whether the clinical and microbiological features and outcomes were different between hospitalized COVID-19 patients who were either fully vaccinated with Coronovac or not. All hospitalized COVID-19 patients who had at least one dose of Coronavac were included in the study. The oldest unvaccinated patients with comorbidities, who were hospitalized during the same period, were chosen as controls. All epidemiologic, clinical and laboratory data of the patients were recorded and compared between the fully vaccinated and unvaccinated individuals. There were 69 and 217 patients who had been either fully vaccinated with Coronavac or not, respectively. All breakthrough infections occurred in the first 3 months of vaccination. Fully vaccinated patients were older and had more comorbidities than unvaccinated patients. There were minor differences between the groups in symptoms, physical and laboratory findings, anti-spike IgG positivity rate and level, the severity of COVID-19, complications, and clinical improvement rate. The mortality rate of fully vaccinated patients was higher than the mortality rate in unvaccinated patients in univariate analysis, which was attributed to the fact that vaccinated patients were older and had more comorbidities. The severity and clinical outcomes of hospitalized patients with breakthrough COVID-19 after Coronavac vaccination were similar to those of unvaccinated patients. Our findings suggest that the immune response elicited by Coronovac could be insufficient to prevent COVID-19-related severe disease and death within 3 months of vaccination among elderly people with comorbidities.
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Affiliation(s)
- Serap Şimşek Yavuz
- Department of Infectious Disease and Clinical Microbiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul 34093, Turkey; (B.H.-A.); (A.B.); (S.B.); (H.E.)
- Correspondence:
| | - Gülşah Tunçer
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, İstanbul 34093, Turkey; (G.T.); (F.P.); (C.G.G.)
| | - Özlem Altuntaş-Aydın
- Department of Infectious Diseases and Clinical Microbiology, Çam and Sakura City Hospital, İstanbul 34093, Turkey; (Ö.A.-A.); (A.G.)
| | - Mehtap Aydın
- Department of Infectious Diseases and Clinical Microbiology, Ümraniye Training and Research Hospital, İstanbul 34093, Turkey; (M.A.); (İ.Ö.)
| | - Filiz Pehlivanoğlu
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, İstanbul 34093, Turkey; (G.T.); (F.P.); (C.G.G.)
| | - Yeşim Tok
- Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, Division of Virology, Istanbul Cerrahpaşa University, İstanbul 34093, Turkey; (Y.T.); (K.M.)
| | - Sevim Mese
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Division of Virology and Fundamental Immunology, Istanbul University, İstanbul 34093, Turkey; (S.M.); (P.S.)
| | - Alper Gündüz
- Department of Infectious Diseases and Clinical Microbiology, Çam and Sakura City Hospital, İstanbul 34093, Turkey; (Ö.A.-A.); (A.G.)
| | - Ceyda Geyiktepe Güçlü
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, İstanbul 34093, Turkey; (G.T.); (F.P.); (C.G.G.)
| | - İklima Özdoğan
- Department of Infectious Diseases and Clinical Microbiology, Ümraniye Training and Research Hospital, İstanbul 34093, Turkey; (M.A.); (İ.Ö.)
| | - Börçe Hemiş-Aydın
- Department of Infectious Disease and Clinical Microbiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul 34093, Turkey; (B.H.-A.); (A.B.); (S.B.); (H.E.)
| | - Pınar Soğuksu
- Department of Medical Microbiology, Istanbul Faculty of Medicine, Division of Virology and Fundamental Immunology, Istanbul University, İstanbul 34093, Turkey; (S.M.); (P.S.)
| | - Aysun Benli
- Department of Infectious Disease and Clinical Microbiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul 34093, Turkey; (B.H.-A.); (A.B.); (S.B.); (H.E.)
| | - Seniha Başaran
- Department of Infectious Disease and Clinical Microbiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul 34093, Turkey; (B.H.-A.); (A.B.); (S.B.); (H.E.)
| | - Kenan Midilli
- Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, Division of Virology, Istanbul Cerrahpaşa University, İstanbul 34093, Turkey; (Y.T.); (K.M.)
| | - Haluk Eraksoy
- Department of Infectious Disease and Clinical Microbiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul 34093, Turkey; (B.H.-A.); (A.B.); (S.B.); (H.E.)
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7
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Dai YC, Lin YC, Ching LL, Tseng AC, Qin Y, Nerurkar VR, Wang WK. Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave. Front Med (Lausanne) 2022; 9:1019490. [PMID: 36523785 PMCID: PMC9745036 DOI: 10.3389/fmed.2022.1019490] [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: 08/15/2022] [Accepted: 11/11/2022] [Indexed: 11/30/2022] Open
Abstract
Uncontrolled transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the emergence of several variants of concern (VOC). As vaccine-induced neutralizing antibodies against VOC waned over time, breakthrough infections (BTIs) have been reported primarily among healthcare workers or in long-term care facilities. Most BTIs were identified by reverse transcription-polymerase chain reaction (RT-PCR) or antigen test for individuals experiencing symptoms, known as symptomatic BTIs. In this study, we detected seroconversion of anti-nucleocapsid (N) antibody to identify both symptomatic and asymptomatic BTIs in a cohort of COVID-19-naive university employees and students following two or three doses of mRNA vaccines. We reported 4 BTIs among 85 (4.7%) participants caused by the Omicron and Delta VOC during the transition from the Delta to Omicron wave of the pandemic; three were symptomatic and confirmed by RT-PCR test and one asymptomatic. A symptomatic reinfection two and half months after a BTI was found in one participant. Two of three symptomatic BTIs and the reinfection were confirmed by whole genome sequencing. All were supported by a >4-fold increase in neutralizing antibodies against the Delta or Omicron variant. Moreover, we found both symptomatic and asymptomatic BTIs can boost neutralizing antibodies against VOC with variable degrees ranging from 2.5- to 77.4-fold increase in neutralizing antibody titers. As BTIs continue, our findings highlight the application of anti-N antibody test to ongoing studies of immunity induced by spike-based vaccine, and provide new insights into the establishment of herd immunity in the community during the post-vaccination era.
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Affiliation(s)
- Yu-Ching Dai
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Yen-Chia Lin
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Lauren L Ching
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States.,Pacific Center for Emerging Infectious Diseases, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Alanna C Tseng
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States.,Pacific Center for Emerging Infectious Diseases, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Yujia Qin
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Vivek R Nerurkar
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States.,Pacific Center for Emerging Infectious Diseases, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Wei-Kung Wang
- Department of Tropical Medicine, Medical Microbiology and Pharmacology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States.,Pacific Center for Emerging Infectious Diseases, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, United States
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Fumagalli MJ, Castro-Jorge LA, Fraga-Silva TFDC, de Azevedo PO, Capato CF, Rattis BAC, Hojo-Souza NS, Floriano VG, de Castro JT, Ramos SG, da Fonseca BAL, Bonato VLD, Gazzinelli RT, Figueiredo LTM. Protective Immunity against Gamma and Zeta Variants after Inactivated SARS-CoV-2 Virus Immunization. Viruses 2021; 13:2440. [PMID: 34960708 PMCID: PMC8707686 DOI: 10.3390/v13122440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 01/08/2023] Open
Abstract
The persistent circulation of SARS-CoV-2 represents an ongoing global threat due to the emergence of new viral variants that can sometimes evade the immune system of previously exposed or vaccinated individuals. We conducted a follow-up study of adult individuals that had received an inactivated SARS-CoV-2 vaccine, evaluating antibody production and neutralizing activity over a period of 6 months. In addition, we performed mice immunization with inactivated SARS-CoV-2, and evaluated the immune response and pathological outcomes against Gamma and Zeta variant infection. Vaccinated individuals produced high levels of antibodies with robust neutralizing activity, which was significantly reduced against Gamma and Zeta variants. Production of IgG anti-S antibodies and neutralizing activity robustly reduced after 6 months of vaccination. Immunized mice demonstrated cellular response against Gamma and Zeta variants, and after viral infection, reduced viral loads, IL-6 expression, and histopathological outcome in the lungs. TNF levels were unchanged in immunized or not immunized mice after infection with the Gamma variant. Furthermore, serum neutralization activity rapidly increases after infection with the Gamma and Zeta variants. Our data suggest that immunization with inactivated WT SARS-CoV-2 induces a promptly responsive cross-reactive immunity response against the Gamma and Zeta variants, reducing COVID-19 pathological outcomes.
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Affiliation(s)
- Marcilio Jorge Fumagalli
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
- Basic and Applied Immunology Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (V.L.D.B.); (R.T.G.)
| | - Luiza Antunes Castro-Jorge
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
| | | | - Patrick Orestes de Azevedo
- Immunopathology Laboratory, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Minas Gerais, Brazil; (P.O.d.A.); (N.S.H.-S.); (J.T.d.C.)
| | - Carlos Fabiano Capato
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
| | - Bruna Amanda Cruz Rattis
- Department of Pathology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (B.A.C.R.); (S.G.R.)
| | - Natália Satchiko Hojo-Souza
- Immunopathology Laboratory, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Minas Gerais, Brazil; (P.O.d.A.); (N.S.H.-S.); (J.T.d.C.)
| | - Vitor Gonçalves Floriano
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
| | - Julia Teixeira de Castro
- Immunopathology Laboratory, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Minas Gerais, Brazil; (P.O.d.A.); (N.S.H.-S.); (J.T.d.C.)
| | - Simone Gusmão Ramos
- Department of Pathology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (B.A.C.R.); (S.G.R.)
| | - Benedito Antônio Lopes da Fonseca
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
| | - Vânia Luiza Deperon Bonato
- Basic and Applied Immunology Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (V.L.D.B.); (R.T.G.)
- Department of Biochemistry and Immunology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil;
| | - Ricardo Tostes Gazzinelli
- Basic and Applied Immunology Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (V.L.D.B.); (R.T.G.)
- Immunopathology Laboratory, René Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte 30190-002, Minas Gerais, Brazil; (P.O.d.A.); (N.S.H.-S.); (J.T.d.C.)
- Platform of Translational Medicine, Fundação Oswaldo Cruz, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil
| | - Luiz Tadeu Moraes Figueiredo
- Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (L.A.C.-J.); (C.F.C.); (V.G.F.); (B.A.L.d.F.); (L.T.M.F.)
- Basic and Applied Immunology Program, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, São Paulo, Brazil; (V.L.D.B.); (R.T.G.)
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