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Salvaggio M, Fusina F, Albani F, Salvaggio M, Beschi R, Ferrari E, Costa A, Agnoletti L, Facchi E, Natalini G. Antibody Response after BNT162b2 Vaccination in Healthcare Workers Previously Exposed and Not Exposed to SARS-CoV-2. J Clin Med 2021; 10:jcm10184204. [PMID: 34575315 PMCID: PMC8472660 DOI: 10.3390/jcm10184204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 11/27/2022] Open
Abstract
The Pfizer/BioNtech Comirnaty vaccine (BNT162b2 mRNA COVID-19) against SARS-CoV-2 is currently in use in Italy. Antibodies to evaluate SARS-CoV-2 infection prior to administration are not routinely tested; therefore, two doses may be administered to asymptomatic previously exposed subjects. The aim of this study is to assess if any difference in antibody concentration between subjects exposed and not exposed to SARS-CoV-2 prior to BNT162b2 was present after the first dose and after the second dose of vaccine. Data were retrospectively collected from the clinical documentation of 337 healthcare workers who underwent SARS-CoV-2 testing before and after BNT162b2. Total anti RBD (receptor-binding domain) antibodies against SARS-CoV-2′s spike protein were measured before and 21 days after the first dose, and 12 days after the second dose of BNT162b2. Twenty-one days after the first dose, there was a statistically significant difference in antibody concentration between the two groups, which was also maintained twelve days after the second dose. In conclusion, antibody response after receiving BNT162b2 is greater in subjects who have been previously exposed to SARS-CoV-2 than in subjects who have not been previously exposed to the virus, both after 21 days after the first dose and after 12 days from the second dose. Antibody levels, 21 days after the first dose, reached a titer considered positive by the test manufacturer in the majority of subjects who have been previously infected with SARS-CoV-2. Evaluating previous infection prior to vaccination in order to give the least effective number of doses should be considered.
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Affiliation(s)
- Marcello Salvaggio
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, 25128 Brescia, BS, Italy; (M.S.); (F.A.); (R.B.); (E.F.); (A.C.); (G.N.)
| | - Federica Fusina
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, 25128 Brescia, BS, Italy; (M.S.); (F.A.); (R.B.); (E.F.); (A.C.); (G.N.)
- Correspondence:
| | - Filippo Albani
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, 25128 Brescia, BS, Italy; (M.S.); (F.A.); (R.B.); (E.F.); (A.C.); (G.N.)
| | - Maurizio Salvaggio
- Department of Anesthesia and Intensive Care, Santa Chiara Hospital, 38100 Trento, TN, Italy;
| | - Rasula Beschi
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, 25128 Brescia, BS, Italy; (M.S.); (F.A.); (R.B.); (E.F.); (A.C.); (G.N.)
| | - Emanuela Ferrari
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, 25128 Brescia, BS, Italy; (M.S.); (F.A.); (R.B.); (E.F.); (A.C.); (G.N.)
| | - Alberto Costa
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, 25128 Brescia, BS, Italy; (M.S.); (F.A.); (R.B.); (E.F.); (A.C.); (G.N.)
| | - Laura Agnoletti
- Department of Laboratory Medicine, Fondazione Richiedei, 25064 Gussago, BS, Italy;
| | - Emanuela Facchi
- Health Management, Fondazione Richiedei, 25064 Gussago, BS, Italy;
| | - Giuseppe Natalini
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, 25128 Brescia, BS, Italy; (M.S.); (F.A.); (R.B.); (E.F.); (A.C.); (G.N.)
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Albani F, Sepe L, Fusina F, Prezioso C, Baronio M, Caminiti F, Di Maio A, Faggian B, Franceschetti ME, Massari M, Salvaggio M, Natalini G. Thromboprophylaxis with enoxaparin is associated with a lower death rate in patients hospitalized with SARS-CoV-2 infection. A cohort study. EClinicalMedicine 2020; 27:100562. [PMID: 33043287 PMCID: PMC7534836 DOI: 10.1016/j.eclinm.2020.100562] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) infection is associated with hypercoagulability caused by direct invasion of endothelial cells and\or proinflammatory cytokine release. Thromboprophylaxis with enoxaparin is recommended by current guidelines, but evidence is still weak. The aim of this study was to assess the impact of thromboprophylaxis with enoxaparin on hospital mortality in patients admitted for Coronavirus disease 2019 (COVID-19). The effects of enoxaparin on intensive care admission and hospital length-of-stay were evaluated as secondary outcomes. METHODS Observational cohort study, with data collected from patients admitted to Poliambulanza Foundation with positive real time reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 from 20th February to 10th May 2020. Multivariate logistic regression with overlap weight propensity score was used to model hospital mortality and intensive care admission, hospital length-of-stay was analyzed with a multivariate Poisson regression. Seven hundred and ninety nine (57%) patients who received enoxaparin at least once during the hospitalization were included in the enoxaparin cohort, 604 (43%) patients who did not were included in the control cohort. FINDINGS At the adjusted analysis enoxaparin was associated with lower in-hospital mortality (Odds Ratio 0·53, 95% C.I. 0·40-0·70) compared with no enoxaparin treatment. Hospital length-of-stay was longer for patients treated with enoxaparin (Incidence Rate Ratios 1·45, 95% C.I. 1·36-1·54). Enoxaparin treatment was associated with reduced risk of intensive care admission at the adjusted analysis (Odds Ratio 0·48, 95% C.I. 0·32-0·69). INTERPRETATION This study shows that treatment with enoxaparin during hospital stay is associated with a lower death rate and, while results from randomized clinical trials are still pending, this study supports the use of thromboprophylaxis with enoxaparin in all patients admitted for COVID-19. Moreover, when enoxaparin is used on the wards, it reduces the risk of Intensive Care Unit admission.
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Affiliation(s)
- Filippo Albani
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
- Corresponding author.
| | - Lilia Sepe
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
| | - Federica Fusina
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
| | - Chiara Prezioso
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
- Department of Intensive Care Medicine and Anaesthesiology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Manuela Baronio
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
| | - Federica Caminiti
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
| | - Antonella Di Maio
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
| | - Barbara Faggian
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
| | - Maria Elena Franceschetti
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
| | - Marco Massari
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
| | - Marcello Salvaggio
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
| | - Giuseppe Natalini
- Department of Anesthesia and Intensive Care, Fondazione Poliambulanza Hospital, via Bissolati, 57, Brescia 25124, Italy
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Abstract
DM20 is a proteolipid protein that has been extensively studied for its role in central nervous system myelination. We demonstrate that DM20 expression is widespread and independent of myelination. In the Schwann cells and neurons of the peripheral nervous system, DM20 is not incorporated into the membrane as it is in the central nervous system (CNS), but remains cytoplasmic. Mutations that severely reduce the amount of DM20 mRNA in CNS myelinating cells have little effect on DM20 expression in nonmyelinating cells of the peripheral nervous system and embryonic CNS. Most importantly, the combination of wild-type DM20 from the endogenous X-linked gene and mutant DM20 expressed from an autosomal transgene results in embryonic lethality. We propose a function for DM20 to explain these diverse findings based on the ability of DM20 to form multimeric complexes, and hypothesize that the DM20 complex participates in intracellular molecular transport.
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Affiliation(s)
- N L Nadon
- Oklahoma Medical Research Foundation, Oklahoma City 73104, USA
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