Efficacy of covid-19 vaccines in immunocompromised patients: systematic review and meta-analysis

BMJ, Journal Year: 2022, Volume and Issue: unknown, P. e068632 - e068632

Published: March 2, 2022

Abstract Objective To compare the efficacy of covid-19 vaccines between immunocompromised and immunocompetent people. Design Systematic review meta-analysis. Data sources PubMed, Embase, Central Register Controlled Trials, COVID-19 Open Research Dataset Challenge (CORD-19), WHO databases for studies published 1 December 2020 5 November 2021. ClinicalTrials.gov International Clinical Trials Registry Platform were searched in 2021 to identify registered but as yet unpublished or ongoing studies. Study selection Prospective observational comparing vaccination participants. Methods A frequentist random effects meta-analysis was used separately pool relative absolute risks seroconversion after first second doses a vaccine. without SARS-CoV-2 antibody titre levels performed first, second, third vaccine rate dose. Risk bias certainty evidence assessed. Results 82 included Of these studies, 77 (94%) mRNA vaccines, 16 (20%) viral vector 4 (5%) inactivated whole virus vaccines. 63 assessed be at low risk 19 moderate bias. After one dose, about half likely patients with haematological cancers (risk ratio 0.40, 95% confidence interval 0.32 0.50, I 2 =80%; 0.29, 0.20 =89%), immune mediated inflammatory disorders (0.53, 0.39 0.71, =89%; 0.11 0.58, =97%), solid (0.55, 0.46 0.65, =78%; 0.44, 0.36 0.53, =84%) compared controls, whereas organ transplant recipients times less seroconvert (0.06, 0.04 0.09, =0%; 0.06, 0.08, =0%). remained least (0.39, 0.46, =92%; 0.35, 0.26 0.46), only achieving seroconversion. Seroconversion increasingly (0.63, 0.57 0.69, =88%; 0.62, 0.54 0.70, =90%), (0.75, 0.69 0.82, 0.77, 0.66 0.85, =93%), (0.90, 0.88 0.93, =51%; 0.89, 0.86 0.91, =49%). similar people HIV controls (1.00, 0.98 1.01, 0.97, 0.83 1.00, =89%). 11 showed that dose associated among non-responders cancers, disorders, although response variable inadequately studied those receiving non-mRNA Conclusion rates significantly lower patients, especially recipients. consistently improved across all patient groups, albeit magnitude Targeted interventions including (booster) should performed. registration PROSPERO CRD42021272088.

Language: Английский

---

Correlates of protection against SARS‐CoV‐2 infection and COVID‐19 disease

Immunological Reviews, Journal Year: 2022, Volume and Issue: 310(1), P. 6 - 26

Published: June 5, 2022

Antibodies against epitopes in S1 give the most accurate CoP infection by SARS-CoV-2 coronavirus. Measurement of those antibodies neutralization or binding assays both have predictive value, with antibody titers giving highest statistical correlation. However, protective functions are multiple. multiple other than influence efficacy. The role cellular responses can be discerned respect to CD4

Language: Английский

---

Immunological memory to SARS‐CoV ‐2 infection and COVID ‐19 vaccines

Immunological Reviews, Journal Year: 2022, Volume and Issue: 310(1), P. 27 - 46

Published: June 22, 2022

Immunological memory is the basis of protective immunity provided by vaccines and previous infections. can develop from multiple branches adaptive immune system, including CD4 T cells, CD8 B long-lasting antibody responses. Extraordinary progress has been made in understanding to SARS-CoV-2 infection COVID-19 vaccines, addressing development; quantitative qualitative features different cellular anatomical compartments; durability each component antibodies. Given sophistication measurements; size human studies; use longitudinal samples cross-sectional head-to-head comparisons between or for 1 year already supersedes that any other acute infectious disease. This knowledge may help inform public policies regarding as well scientific development future against diseases.

Language: Английский

---

Effect of SARS-CoV-2 mRNA vaccination in MS patients treated with disease modifying therapies

EBioMedicine, Journal Year: 2021, Volume and Issue: 72, P. 103581 - 103581

Published: Sept. 22, 2021

In patients with Multiple Sclerosis (pwMS) disease-modifying therapies (DMTs) affects immune response to antigens. Therefore, post-vaccination serological assessments are needed evaluate the effect of vaccine on SARS-CoV-2 antibody response.We designed a prospective multicenter cohort study enrolling pwMS who were scheduled for SARS-Cov-2 vaccination mRNA vaccines (BNT162b2, Pfizer/BioNTech,Inc or mRNA-1273, Moderna Tx,Inc). A blood collection before first dose and 4 weeks after second was planned, centralized assessment (electrochemiluminescence immunoassay, ECLIA, Roche-Diagnostics). The log-transform levels analyzed by multivariable linear regression.780 (76% BNT162b2 24% mRNA-1273) had pre- 4-week assessments. 87 (11·2%) untreated, 154 (19·7%) ocrelizumab, 25 (3·2%) rituximab, 85 (10·9%) fingolimod, cladribine 404 (51·7%) other DMTs. 677 (86·8%) detectable antibodies. At analysis, ocrelizumab (201-fold decrease (95%CI=128-317), p < 0·001), fingolimod (26-fold (95%CI=16-42), 0·001) rituximab (20-fold (95%CI=10-43), significantly reduced as compared untreated patients. Vaccination mRNA-1273 resulted in systematically 3·25-fold higher level (95%CI=2·46-4·27) than (p 0·001). anti-CD20 correlated time since last infusion, longer intervals (mean=386 days) (mean=129 days).In pwMS, treatment led humoral mRNA-based vaccines. As elicits 3·25-higher BNT162b2, this may be preferentially considered under fingolimod. Combining our data those cellular vaccines, including clinical follow-up, will contribute better define most appropriate strategies context DMTs MS.FISM[2021/Special-Multi/001]; Italian Ministry Health'Progetto Z844A 5 × 1000'.

Language: Английский

---

Humoral and cellular responses to mRNA vaccines against SARS-CoV-2 in patients with a history of CD20 B-cell-depleting therapy (RituxiVac): an investigator-initiated, single-centre, open-label study

The Lancet Rheumatology, Journal Year: 2021, Volume and Issue: 3(11), P. e789 - e797

Published: Sept. 7, 2021

B-cell-depleting therapies increase the risk of morbidity and mortality due to COVID-19. Evidence-based SARS-CoV-2 vaccination strategies for patients on are scarce. We aimed investigate humoral cell-mediated immune responses mRNA-based vaccines in receiving CD20-targeted agents autoimmune disease, malignancy, or transplantation.The RituxiVac study was an investigator-initiated, single-centre, open-label done at Bern University Hospital (Bern, Switzerland). Patients with a treatment history anti-CD20-depleting (rituximab ocrelizumab) no previous infection were enrolled between April 26 June 30, 2021, analysis (by interferon-γ [IFNγ] release assay) least 4 weeks after completing against SARS-CoV-2. Healthy controls without also All participants received two doses either Pfizer-BioNTech BNT162b2 vaccine Moderna mRNA-1273 vaccine. The primary outcome proportion anti-CD20 who showed response spike protein comparison immunocompetent controls. Prespecified secondary endpoints effect therapy (including time since last cumulative dose) vaccination, biomarkers immunocompetence. This is registered ClinicalTrials.gov, NCT04877496.The final population comprised 96 29 median age 67 years (IQR 57-72) 54 (45-62), 51 (53%) 19 (66%) female. 1·07 0·48-2·55) dose depleting agent 2·80 g (1·50-5·00). Anti-spike IgG antibodies detected 47 (49%) 1·79 months 1·16-2·48) second compared (100%) 1·81 (1·17-2·48) (p<0·001). SARS-CoV-2-specific IFNγ 13 (20%) 66 21 (75%) 28 healthy Only nine (14%) double positive anti-SARS-CoV-2 responses, Time (>7·6 months; predictive value 0·78), peripheral CD19+ cell count (>27 cells per μL; 0·70), CD4+ lymphocyte (>653 0·71) (area under curve [AUC] 67% [95% CI 56-78] therapy, [55-80] count, 66% [54-79] count).This provides further evidence blunted elicited by mRNA CD20 treatment. Lymphocyte subpopulation counts associated this highly vulnerable population. On validation, these results could help guide both administration population.Bern Hospital.

Language: Английский

---

Multiple sclerosis

The Lancet, Journal Year: 2023, Volume and Issue: 403(10422), P. 183 - 202

Published: Nov. 7, 2023

Language: Английский

---

Adaptive immunity and neutralizing antibodies against SARS-CoV-2 variants of concern following vaccination in patients with cancer: the CAPTURE study

Nature Cancer, Journal Year: 2021, Volume and Issue: 2(12), P. 1305 - 1320

Published: Oct. 27, 2021

Abstract Coronavirus disease 2019 (COVID-19) antiviral response in a pan-tumor immune monitoring (CAPTURE) ( NCT03226886 ) is prospective cohort study of COVID-19 immunity patients with cancer. Here we evaluated 585 following administration two doses BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after were 85% and 59% solid hematological malignancies, respectively. A lower proportion had detectable titers neutralizing antibodies (NAbT) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants concern (VOC) versus wild-type (WT) SARS-CoV-2. Patients malignancies more likely to have undetectable NAbT median than those cancers both SARS-CoV-2 WT VOC. By comparison individuals without cancer, hematological, but not solid, reduced antibody (NAb) responses. showed poor concordance Previous infection boosted the NAb including VOC, anti-CD20 treatment was associated NAbT. Vaccine-induced T cell responses detected 80% comparable between vaccines cancer types. Our results implications for management during ongoing pandemic.

Language: Английский

---

SARS-CoV-2-specific T cells in infection and vaccination

Cellular and Molecular Immunology, Journal Year: 2021, Volume and Issue: 18(10), P. 2307 - 2312

Published: Sept. 1, 2021

During viral infections, antibodies and T cells act together to prevent pathogen spread remove virus-infected cells. Virus-specific adaptive immunity can, however, also trigger pathological processes characterized by localized or systemic inflammatory events. The protective and/or role of virus-specific in SARS-CoV-2 infection has been the focus many studies COVID-19 patients vaccinated individuals. Here, we review works that have elucidated function SARS-CoV-2-specific Understanding whether are more linked protection pathogenesis is pivotal define future therapeutic prophylactic strategies manage current pandemic.

Language: Английский

---

Humoral- and T-Cell–Specific Immune Responses to SARS-CoV-2 mRNA Vaccination in Patients With MS Using Different Disease-Modifying Therapies

Neurology, Journal Year: 2021, Volume and Issue: 98(5)

Published: Nov. 22, 2021

Background and Objectives

To evaluate the immune-specific response after full severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination of patients with multiple sclerosis (MS) treated different disease-modifying drugs by detection both serologic T-cell responses.

Methods

Healthcare workers (HCWs) MS, having completed 2-dose schedule an mRNA-based vaccine against SARS-CoV-2 in past 2–4 weeks, were enrolled from parallel prospective studies conducted Rome, Italy, at National Institute for Infectious diseases Spallanzani–IRCSS San Camillo Forlanini Hospital. Serologic was evaluated quantifying region-binding domain (RBD) neutralizing antibodies. Cell-mediated analyzed a whole-blood test interferon (IFN)–γ to spike peptides. Cells responding stimulation identified fluorescence-activated cell sorting analysis.

Results

We prospectively 186 vaccinated individuals: 78 HCWs 108 MS. Twenty-eight MS IFN-β, 35 fingolimod, 20 cladribine, 25 ocrelizumab. A lower anti-RBD antibody rate found ocrelizumab (40%, p < 0.0001) fingolimod (85.7%, = 0.0023) compared cladribine or IFN-β. Anti-RBD median titer (p 0.0001), 0.010) IFN-β–treated patients. Serum activity present all tested only minority fingolimod-treated (16.6%). T-cell–specific detected majority (62%), albeit significantly IFN-γ levels HCWs. The lowest frequency (14.3%). correlated lymphocyte count (ρ 0.554, 0.0001 ρ 0.255, 0.0078 respectively). mediated CD4⁺ CD8⁺ T cells.

Discussion

mRNA vaccines induce humoral cell-mediated specific immune responses peptides These results carry relevant implications managing vaccinations, suggesting promoting

Classification Evidence

This study provides Class III data that induces viral proteins

Language: Английский

---

Germinal center responses to SARS-CoV-2 mRNA vaccines in healthy and immunocompromised individuals

Cell, Journal Year: 2022, Volume and Issue: 185(6), P. 1008 - 1024.e15

Published: Feb. 2, 2022

Language: Английский

---