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Li C, Zhou T, Zhang P, He J, Liu Y. Investigation of epidemiological and clinical characteristics of people infected with SARS-CoV-2 during the second pandemic of COVID-19 in Chengdu, China. Front Public Health 2024; 12:1394762. [PMID: 38756875 PMCID: PMC11097775 DOI: 10.3389/fpubh.2024.1394762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
Objective This study investigated the epidemiological and clinical characteristics of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infected patients during the second pandemic of COVID-19 (coronavirus disease of 2019) in Chengdu, China. Furthermore, the differences between first infection and re-infection cases were also compared and analyzed to provide evidence for better prevention and control of SARS-CoV-2 re-infection. Methods An anonymous questionnaire survey was conducted using an online platform (wjx.cn) between May 20, 2023 to September 12, 2023. Results This investigation included 62.94% females and 32.97% of them were 18-30 years old. Furthermore, 7.19-17.18% of the participants either did not receive vaccination at all or only received full vaccination, respectively. Moreover, 577 (57.64%) participants were exposed to cluster infection. The clinical manifestations of these patients were mainly mild to moderate; 78.18% of participants had a fever for 1-3 days, while 37.84% indicated a full course of disease for 4-6 days. In addition, 40.66% of the participants had re-infection and 72.97% indicated their first infection approximately five months before. The clinical symptoms of the first SARS-CoV-2 infection were moderate to severe, while re-infection indicated mild to moderate symptoms (the severity of symptoms other than diarrhea and conjunctival congestion had statistically significant differences) (p < 0.05). Moreover, 70.53 and 59.21% of first and re-infection cases had fever durations of 3-5 and 0-2 days, respectively. Whereas 47.91 and 46.40% of first and re-infection cases had a disease course of 7-9 and 4-6 days. Conclusion The SARS-CoV-2 infected individuals in Chengdu, China, during the second pandemic of COVID-19 had mild clinical symptoms and a short course of disease. Furthermore, compared with the first infection, re-infection cases had mild symptoms, low incidences of complications, short fever duration, and course of disease.
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Affiliation(s)
- Cheng Li
- Department of Infectious Diseases, The Third People’s Hospital of Chengdu, Chengdu, China
| | - Tao Zhou
- Department of Infectious Diseases, The Third People’s Hospital of Chengdu, Chengdu, China
| | - Peilin Zhang
- Department of Infectious Diseases, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Junning He
- Department of Infectious Diseases, The Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yongfang Liu
- Department of Infectious Diseases, The Third People’s Hospital of Chengdu, Chengdu, China
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Crocchiolo R, Frassati C, Gallina AM, Pedini P, Maioli S, Veronese L, Pani A, Scaglione F, D'Amico F, Crucitti L, Sacchi N, Rossini S, Picard C. Strong humoral response after Covid-19 vaccination correlates with the common HLA allele A*03:01 and protection from breakthrough infection. HLA 2024; 103:e15421. [PMID: 38433722 DOI: 10.1111/tan.15421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
Few data exist on the role of genetic factors involving the HLA system on response to Covid-19 vaccines. Moving from suggestions of a previous study investigating the association of some HLA alleles with humoral response to BNT162b2, we here compared the HLA allele frequencies among weak (n = 111) and strong (n = 123) responders, defined as those healthcare workers with the lowest and the highest anti-Spike antibody levels after vaccination. Individuals with clinical history of Covid-19 or positive anti-nucleocapside antibodies were excluded. We found the common HLA-A*03:01 allele as an independent predictor of strong humoral response (OR = 12.46, 95% CI: 4.41-35.21, p < 0.0001), together with younger age of vaccines (p = 0.004). Correlation between antibody levels and protection from breakthrough infection has been observed, with a 2-year cumulative incidence of 42% and 63% among strong and weak responders, respectively (p = 0.03). Due to the high frequency of HLA-A*03:01 and the need for seasonal vaccinations against SARS-CoV-2 mutants, our findings provide useful information about the inter-individual differences observed in humoral response after Covid-19 vaccine and might support further studies on the next seasonal vaccines.
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Affiliation(s)
- Roberto Crocchiolo
- Dipartimento dei Servizi, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | | | - Anna Maria Gallina
- Italian Bone Marrow Donor Registry, E.O. Ospedali Galliera Genova, Genova, Italy
| | | | | | - Luca Veronese
- Dipartimento dei Servizi, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Arianna Pani
- Dipartimento dei Servizi, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Francesco Scaglione
- Dipartimento dei Servizi, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Federico D'Amico
- Dipartimento dei Servizi, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Lara Crucitti
- Hematology Department, Azienda Sanitaria Provinciale di Trapani, Castelvetrano, Italy
| | - Nicoletta Sacchi
- Italian Bone Marrow Donor Registry, E.O. Ospedali Galliera Genova, Genova, Italy
| | - Silvano Rossini
- Dipartimento dei Servizi, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
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3
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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.
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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
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4
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Magri C, Marchina E, Sansone E, D'Adamo AP, Cappellani S, Bonfanti C, Terlenghi L, Biasiotto G, Zanella I, Sala E, Caruso A, Lombardo M, Gasparini P, De Palma G, Gennarelli M. Genome-wide association studies of response and side effects to the BNT162b2 vaccine in Italian healthcare workers: Increased antibody levels and side effects in carriers of the HLA-A*03:01 allele. HLA 2023; 102:707-719. [PMID: 37469131 DOI: 10.1111/tan.15157] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/25/2023] [Accepted: 07/06/2023] [Indexed: 07/21/2023]
Abstract
The remarkable variability of response to vaccines against SARS-CoV-2 is apparent. The present study aims to estimate the extent to which the host genetic background contributes to this variability in terms of immune response and side effects following the administration of the BNT162b2 vaccine. We carried out a genome wide association study (GWAS) by genotyping 873 Italian healthcare workers who underwent anti-SARS-CoV-2 vaccination with the BNT162b2 vaccine and for whom information about anti-SARS-CoV-2 spike antibodies titers and vaccine side effects were available. The GWAS revealed a significant association between the HLA locus and the anti-SARS-CoV-2 Spike antibodies level at 2 months following the first dose of vaccine (SNP: rs1737060; p = 9.80 × 10-11 ). In particular, we observed a positive association between the antibody levels and the presence of the HLA-A*03:01 allele. The same allele was found associated with a 2-2.4-fold increased risk of experiencing specific side effects such as fever, chills and myalgia and a 1.5-1.8-fold increased risk of joint pain, nausea, fatigue, headache and asthenia, independently of age and sex. This study confirms that the heterogeneity in the immune response to the BNT162b2 vaccine and in its side effects are at least partially influenced by genetic variants. This information, integrated with individual biological and lifestyle-related correlates, could be of use in the definition of algorithms aimed at the identification of subjects in which the administration of additional vaccine doses would be particularly beneficial to maintain immunity against the virus.
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Affiliation(s)
- Chiara Magri
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Eleonora Marchina
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Emanuele Sansone
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, Brescia, Italy
| | - Adamo Pio D'Adamo
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Stefania Cappellani
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Carlo Bonfanti
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Laboratory of Microbiology, ASST Spedali Civili, Brescia, Italy
| | | | - Giorgio Biasiotto
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Highly Specialized Laboratory, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Isabella Zanella
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Clinical Chemistry Laboratory, Section of Cytogenetics and Molecular Genetics, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Emma Sala
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, ASST Spedali Civili, Brescia, Italy
| | - Arnaldo Caruso
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Laboratory of Microbiology, ASST Spedali Civili, Brescia, Italy
| | - Massimo Lombardo
- Chief Executive Office, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Paolo Gasparini
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Unit of Occupational Health and Industrial Hygiene, University of Brescia, Brescia, Italy
- Unit of Occupational Health, Hygiene, Toxicology and Prevention, ASST Spedali Civili, Brescia, Italy
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Genetics Unit, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
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Lv Z, Lv S, Li Q, Xia Y, Feng Z, Zhang H, Yang H, Wu Z, Zou N, Mo Q, Gu Q, Ying S, Wang X, Qin D, Wan C. A third (booster) dose of the inactivated SARS-CoV-2 vaccine elicits immunogenicity and T follicular helper cell responses in people living with HIV. Front Immunol 2023; 14:1264160. [PMID: 38045691 PMCID: PMC10690609 DOI: 10.3389/fimmu.2023.1264160] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction This study sought to explore the immunogenicity of a booster dose of an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine in people living with human immunodeficiency virus (HIV) and identify the factors affecting the magnitude of anti-SARS-CoV-2 antibody levels. Materials and methods A total of 34 people living with HIV (PLWH) and 34 healthy donors (HD) were administered a booster dose of the same SARS-CoV-2 vaccine. Anti-SARS-CoV-2 antibody and immunoglobulin G (IgG) levels were measured using the SARS-CoV-2 S protein neutralizing antibody Enzyme-Linked Immunosorbent Assay (ELISA) and 2019-nCov IgG Chemiluminescent Immunoassay Microparticles, respectively. Spearman correlation analysis was used to measure the correlation between laboratory markers and neutralizing antibody and IgG levels. Peripheral blood mononuclear cells (PBMCs) were extracted from each subject using density gradient centrifugation and the numbers of memory T and T follicular helper (Tfh) cells were determined using flow cytometry. Results PLWH had a marked reduction in CD4 and B cell levels that was accompanied by a lower CD4/CD8 T cell ratio. However, those who received a supplementary dose of inactivated SARS-CoV-2 vaccines exhibited antibody positivity rates that were analogous to levels previously observed. The booster vaccine led to a reduction in IgG and neutralizing antibody levels and the amplitude of this decline was substantially higher in the PLWH than HD group. Correlation analyses revealed a strong correlation between neutralizing antibody levels and the count and proportion of CD4 cells. Anti-SARS-CoV-2 IgG antibody levels followed a similar trend. The expression of memory T and Tfh cells was considerably lower in the PLWH than in the HD group. Discussion PLWH had an attenuated immune response to a third (booster) administration of an inactivated SARS-CoV-2 vaccine, as shown by lower neutralizing antibody and IgG levels. This could be attributed to the reduced responsiveness of CD4 cells, particularly memory T and cTfh subsets. CD4 and cTfh cells may serve as pivotal markers of enduring and protective antibody levels. Vaccination dose recalibration may be critical for HIV-positive individuals, particularly those with a lower proportion of CD4 and Tfh cells.
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Affiliation(s)
- Zhengchao Lv
- School of Clinical Medicine, School of Pharmacy and School of Basic Medicine, Yunnan University of Chinese Medicine, Kunming, China
- Department of AIDS Clinical Treatment, Yunnan Provincial Hospital for Infectious Diseases, Kunming, China
| | - Songqin Lv
- Medical Laboratory, The Third People’s Hospital of Kunming, Kunming, China
| | - Qin Li
- School of Clinical Medicine, School of Pharmacy and School of Basic Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Yafei Xia
- Infectious Disease Department, The First People’s Hospital of Xuan Wei, Qujing, China
| | - Zaineng Feng
- Infectious Disease Department, Malipo Country People’s Hospital, Wenshan, China
| | - Haohong Zhang
- School of Clinical Medicine, School of Pharmacy and School of Basic Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Haihao Yang
- School of Clinical Medicine, School of Pharmacy and School of Basic Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Zhao Wu
- School of Clinical Medicine, School of Pharmacy and School of Basic Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Nanting Zou
- School of Clinical Medicine, School of Pharmacy and School of Basic Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Qingyan Mo
- School of Clinical Medicine, School of Pharmacy and School of Basic Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Qianlan Gu
- Pharmacy Department, Zhengxiong Country Hospital of Traditional Medicine, Zhaotong, China
| | - Sai Ying
- School of Clinical Medicine, School of Pharmacy and School of Basic Medicine, Yunnan University of Chinese Medicine, Kunming, China
| | - Xicheng Wang
- Department of AIDS Clinical Treatment, Yunnan Provincial Hospital for Infectious Diseases, Kunming, China
| | - Dongdong Qin
- Key Laboratory of Traditional Chinese Medicine for Prevention and Treatment of Neuropsychiatric Diseases, Yunnan University of Chinese Medicine, Kunming, China
| | - Chunping Wan
- School of Clinical Medicine, School of Pharmacy and School of Basic Medicine, Yunnan University of Chinese Medicine, Kunming, China
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Schmid M, Friede T, Klein N, Weinhold L. Accounting for time dependency in meta-analyses of concordance probability estimates. Res Synth Methods 2023; 14:807-823. [PMID: 37429580 DOI: 10.1002/jrsm.1655] [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: 11/17/2022] [Revised: 04/21/2023] [Accepted: 06/19/2023] [Indexed: 07/12/2023]
Abstract
Recent years have seen the development of many novel scoring tools for disease prognosis and prediction. To become accepted for use in clinical applications, these tools have to be validated on external data. In practice, validation is often hampered by logistical issues, resulting in multiple small-sized validation studies. It is therefore necessary to synthesize the results of these studies using techniques for meta-analysis. Here we consider strategies for meta analyzing the concordance probability for time-to-event data ("C-index"), which has become a popular tool to evaluate the discriminatory power of prediction models with a right-censored outcome. We show that standard meta-analysis of the C-index may lead to biased results, as the magnitude of the concordance probability depends on the length of the time interval used for evaluation (defined e.g., by the follow-up time, which might differ considerably between studies). To address this issue, we propose a set of methods for random-effects meta-regression that incorporate time directly as covariate in the model equation. In addition to analyzing nonlinear time trends via fractional polynomial, spline, and exponential decay models, we provide recommendations on suitable transformations of the C-index before meta-regression. Our results suggest that the C-index is best meta-analyzed using fractional polynomial meta-regression with logit-transformed C-index values. Classical random-effects meta-analysis (not considering time as covariate) is demonstrated to be a suitable alternative when follow-up times are small. Our findings have implications for the reporting of C-index values in future studies, which should include information on the length of the time interval underlying the calculations.
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Affiliation(s)
- Matthias Schmid
- Department of Medical Biometry, Informatics, and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Tim Friede
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Nadja Klein
- Research Center for Trustworthy Data Science and Security, UA Ruhr/Department of Statistics, Technische Universität Dortmund, Dortmund, Germany
| | - Leonie Weinhold
- Department of Medical Biometry, Informatics, and Epidemiology, University Hospital Bonn, Bonn, Germany
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7
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Leomanni L, Collatuzzo G, Sansone E, Sala E, De Palma G, Porru S, Spiteri G, Monaco MGL, Basso D, Pavanello S, Scapellato ML, Larese Filon F, Cegolon L, Mauro M, Lodi V, Lazzarotto T, Noreña I, Reinkemeyer C, Giang LTT, Fabiánová E, Strhársky J, Dell’Omo M, Murgia N, Carrasco-Ribelles LA, Violán C, Mates D, Rascu A, Vimercati L, De Maria L, Asafo SS, Ditano G, Abedini M, Boffetta P. Determinants of Anti-S Immune Response at 12 Months after SARS-CoV-2 Vaccination in a Multicentric European Cohort of Healthcare Workers-ORCHESTRA Project. Vaccines (Basel) 2023; 11:1527. [PMID: 37896931 PMCID: PMC10610704 DOI: 10.3390/vaccines11101527] [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: 08/02/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The effectiveness of the immunity provided by SARS-CoV-2 vaccines is an important public health issue. We analyzed the determinants of 12-month serology in a multicenter European cohort of vaccinated healthcare workers (HCW). METHODS We analyzed the sociodemographic characteristics and levels of anti-SARS-CoV-2 spike antibodies (IgG) in a cohort of 16,101 vaccinated HCW from eleven centers in Germany, Italy, Romania, Slovakia and Spain. Considering the skewness of the distribution, the serological levels were transformed using log or cubic standardization and normalized by dividing them by center-specific standard errors. We fitted center-specific multivariate regression models to estimate the cohort-specific relative risks (RR) of an increase of one standard deviation of log or cubic antibody level and the corresponding 95% confidence interval (CI) for different factors and combined them in random-effects meta-analyses. RESULTS We included 16,101 HCW in the analysis. A high antibody level was positively associated with age (RR = 1.04, 95% CI = 1.00-1.08 per 10-year increase), previous infection (RR = 1.78, 95% CI 1.29-2.45) and use of Spikevax [Moderna] with combinations compared to Comirnaty [BioNTech/Pfizer] (RR = 1.07, 95% CI 0.97-1.19) and was negatively associated with the time since last vaccine (RR = 0.94, 95% CI 0.91-0.98 per 30-day increase). CONCLUSIONS These results provide insight about vaccine-induced immunity to SARS-CoV-2, an analysis of its determinants and quantification of the antibody decay trend with time since vaccination.
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Affiliation(s)
- Ludovica Leomanni
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
| | - Emanuele Sansone
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Emma Sala
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37129 Verona, Italy
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37100 Verona, Italy
| | - Gianluca Spiteri
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37100 Verona, Italy
| | | | - Daniela Basso
- Department of Medicine-DIMED, University of Padova, 35128 Padova, Italy
- Laboratory Medicine Unit, University Hospital of Padova, 35128 Padova, Italy
| | - Sofia Pavanello
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, 35128 Padova, Italy
| | - Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
- Occupational Medicine Unit, University Hospital of Padova, 35128 Padova, Italy
| | - Francesca Larese Filon
- Occupational Medicine Unit, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34100 Trieste, Italy
| | - Luca Cegolon
- Occupational Medicine Unit, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34100 Trieste, Italy
| | - Marcella Mauro
- Occupational Medicine Unit, Department of Medicine, Surgery and Health Sciences, University of Trieste, 34100 Trieste, Italy
| | - Vittorio Lodi
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
- SSD Health Surveillance, IRCCS University Hospital, 40139 Bologna, Italy
| | - Tiziana Lazzarotto
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
- Microbiology Unit, IRCCS University Hospital, 40139 Bologna, Italy
| | - Ivan Noreña
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, 81377 Munich, Germany
| | - Christina Reinkemeyer
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, 81377 Munich, Germany
| | - Le Thi Thu Giang
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospital, 81377 Munich, Germany
| | - Eleonóra Fabiánová
- Occupational Health Department, Regional Authority of Public Health, 497556 Banská Bystrica, Slovakia
| | - Jozef Strhársky
- Medical Microbiology Department, Regional Authority of Public Health, 497556 Banská Bystrica, Slovakia
| | - Marco Dell’Omo
- Unit of Occupational Medicine, Department on Medicine and Surgery, University of Perugia, 06125 Perugia, Italy
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Lucía A. Carrasco-Ribelles
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08007 Barcelona, Spain
- Grup de Recerca en Impacte de les Malalties Cròniques i les seves Trajectòries (GRIMTra), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), 08303 Barcelona, Spain
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Concepción Violán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataró, Spain
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, 08007 Barcelona, Spain
- Grup de Recerca en Impacte de les Malalties Cròniques i les seves Trajectòries (GRIMTra), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAPJGol), 08303 Barcelona, Spain
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Germans Trias i Pujol Research Institute (IGTP), 08916 Badalona, Spain
- Universitat Autónoma de Barcelona, 08193 Bellaterra, Spain
| | - Dana Mates
- National Institute of Public Health, 050463 Bucharest, Romania
| | - Agripina Rascu
- Department of Internal Medicine-Occupational Medicine, Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine, University of Bari, 70121 Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, University of Bari, 70121 Bari, Italy
| | - Shuffield S. Asafo
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy; (L.L.)
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
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8
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Azzini AM, Canziani LM, Davis RJ, Mirandola M, Hoelscher M, Meyer L, Laouénan C, Giannella M, Rodríguez-Baño J, Boffetta P, Mates D, Malhotra-Kumar S, Scipione G, Stellmach C, Rinaldi E, Hasenauer J, Tacconelli E. How European Research Projects Can Support Vaccination Strategies: The Case of the ORCHESTRA Project for SARS-CoV-2. Vaccines (Basel) 2023; 11:1361. [PMID: 37631929 PMCID: PMC10459328 DOI: 10.3390/vaccines11081361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023] Open
Abstract
ORCHESTRA ("Connecting European Cohorts to Increase Common and Effective Response To SARS-CoV-2 Pandemic") is an EU-funded project which aims to help rapidly advance the knowledge related to the prevention of the SARS-CoV-2 infection and the management of COVID-19 and its long-term sequelae. Here, we describe the early results of this project, focusing on the strengths of multiple, international, historical and prospective cohort studies and highlighting those results which are of potential relevance for vaccination strategies, such as the necessity of a vaccine booster dose after a primary vaccination course in hematologic cancer patients and in solid organ transplant recipients to elicit a higher antibody titer, and the protective effect of vaccination on severe COVID-19 clinical manifestation and on the emergence of post-COVID-19 conditions. Valuable data regarding epidemiological variations, risk factors of SARS-CoV-2 infection and its sequelae, and vaccination efficacy in different subpopulations can support further defining public health vaccination policies.
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Affiliation(s)
- Anna Maria Azzini
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.M.C.); (M.M.); (E.T.)
| | - Lorenzo Maria Canziani
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.M.C.); (M.M.); (E.T.)
| | - Ruth Joanna Davis
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.M.C.); (M.M.); (E.T.)
| | - Massimo Mirandola
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.M.C.); (M.M.); (E.T.)
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), 80802 Munich, Germany;
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
| | - Laurence Meyer
- Centre de Recherche en Epidemiologie et Sante des Population, Institut National de la Sante et de la Recherche Medicale (INSERM), Universite Paris-Saclay, 94270 Le Kremlin-Bicêtre, France;
| | - Cédric Laouénan
- INSERM, IAME UMR 1137, Universite Paris Cite, 75018 Paris, France;
- Departement d’Epidemiologie Biostatistiques e Recherche Clinique, AP-HP, Hospital Bichat, 75018 Paris, France
| | - Maddalena Giannella
- Infectious Diseases Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
| | - Jesús Rodríguez-Baño
- Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen Macarena and Department of Medicine, Biomedicines Institute of Sevilla-CSIC, University of Sevilla, 41004 Sevilla, Spain;
- Centro de Investigacion Biomedica en Red en Enfermedades Infecciosas, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 10041, USA
| | - Dana Mates
- National Institute of Public Health, 050463 Bucharest, Romania;
| | - Surbhi Malhotra-Kumar
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, 2000 Antwerp, Belgium;
| | - Gabriella Scipione
- Supercomputing Applications and Innovation Department, Cineca Consorzio Interuniversitario, 40033 Bologna, Italy;
| | - Caroline Stellmach
- Berlin Institute of Health at Charite, Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.S.); (E.R.)
| | - Eugenia Rinaldi
- Berlin Institute of Health at Charite, Universitätsmedizin Berlin, 10117 Berlin, Germany; (C.S.); (E.R.)
| | - Jan Hasenauer
- Life and Medical Sciences Institute, University of Bonn, 53113 Bonn, Germany;
- Institute of Computational Biology, Helmholtz Center Munich—German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Evelina Tacconelli
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.M.C.); (M.M.); (E.T.)
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9
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Violán C, Carrasco-Ribelles LA, Collatuzzo G, Ditano G, Abedini M, Janke C, Reinkemeyer C, Giang LTT, Liviero F, Scapellato ML, Mauro M, Rui F, Porru S, Spiteri G, Monaco MGL, Carta A, Otelea M, Rascu A, Fabiánová E, Klöslová Z, Boffetta P, Torán-Monserrat P. Multimorbidity and Serological Response to SARS-CoV-2 Nine Months after 1st Vaccine Dose: European Cohort of Healthcare Workers-Orchestra Project. Vaccines (Basel) 2023; 11:1340. [PMID: 37631908 PMCID: PMC10459685 DOI: 10.3390/vaccines11081340] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/29/2023] Open
Abstract
Understanding antibody persistence concerning multimorbidity is crucial for vaccination policies. Our goal is to assess the link between multimorbidity and serological response to SARS-CoV-2 nine months post-first vaccine. We analyzed Healthcare Workers (HCWs) from three cohorts from Italy, and one each from Germany, Romania, Slovakia, and Spain. Seven groups of chronic diseases were analyzed. We included 2941 HCWs (78.5% female, 73.4% ≥ 40 years old). Multimorbidity was present in 6.9% of HCWs. The prevalence of each chronic condition ranged between 1.9% (cancer) to 10.3% (allergies). Two regression models were fitted, one considering the chronic conditions groups and the other considering whether HCWs had diseases from ≥2 groups. Multimorbidity was present in 6.9% of HCWs, and higher 9-months post-vaccine anti-S levels were significantly associated with having received three doses of the vaccine (RR = 2.45, CI = 1.92-3.13) and with having a prior COVID-19 infection (RR = 2.30, CI = 2.15-2.46). Conversely, lower levels were associated with higher age (RR = 0.94, CI = 0.91-0.96), more time since the last vaccine dose (RR = 0.95, CI = 0.94-0.96), and multimorbidity (RR = 0.89, CI = 0.80-1.00). Hypertension is significantly associated with lower anti-S levels (RR = 0.87, CI = 0.80-0.95). The serological response to vaccines is more inadequate in individuals with multimorbidity.
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Affiliation(s)
- Concepción Violán
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Mataró, Spain; (L.A.C.-R.); (P.T.-M.)
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 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 (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) (RD21/0016/0029), Insitituto de Salud Carlos III, Av. de Monforte de Lemos, 5, 28029 Madrid, Spain
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, Ctra. de Barcelona, 473, Sabadell, 08204 Barcelona, Spain
- Universitat Autónoma de Barcelona, Plaça Cívica, 08193 Bellaterra, Spain
| | - Lucía A. Carrasco-Ribelles
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Mataró, Spain; (L.A.C.-R.); (P.T.-M.)
- 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 (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Barcelona, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) (RD21/0016/0029), Insitituto de Salud Carlos III, Av. de Monforte de Lemos, 5, 28029 Madrid, Spain
| | - Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Giorgia Ditano
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, Leopoldstraße 5, 80802 Munich, Germany; (C.J.); (C.R.)
| | - Christina Reinkemeyer
- Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, Leopoldstraße 5, 80802 Munich, Germany; (C.J.); (C.R.)
| | - Le Thi Thu Giang
- Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich, Lindwurmstrasse 4, 80337 Munich, Germany;
| | - Filippo Liviero
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy;
| | | | - Marcella Mauro
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (F.R.)
| | - Francesca Rui
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, 34129 Trieste, Italy; (M.M.); (F.R.)
| | - Stefano Porru
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
- Section of Occupational Health, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Gianluca Spiteri
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
| | - Maria Grazia Lourdes Monaco
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
| | - Angela Carta
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (S.P.); (G.S.); (M.G.L.M.); (A.C.)
- Section of Occupational Health, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Marina Otelea
- University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (M.O.); (A.R.)
| | - Agripina Rascu
- University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (M.O.); (A.R.)
| | - Eleonóra Fabiánová
- Occupational Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia; (E.F.); (Z.K.)
- Public Health Department, Faculty of Health, Catholic University, 03401 Ružomberok, Slovakia
| | - Zuzana Klöslová
- Occupational Health Department, Regional Authority of Public Health, 97556 Banská Bystrica, Slovakia; (E.F.); (Z.K.)
- Public Health Department, Faculty of Health, Catholic University, 03401 Ružomberok, Slovakia
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (G.C.); (G.D.); (M.A.); (P.B.)
| | - Pere Torán-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Mataró, Spain; (L.A.C.-R.); (P.T.-M.)
- Germans Trias i Pujol Research Institute (IGTP), Camí de les Escoles, s/n, 08916 Badalona, Spain
- Direcció d’Atenció Primària Metropolitana Nord Institut Català de Salut, Ctra. de Barcelona, 473, Sabadell, 08204 Barcelona, Spain
- Department of Medicine, Faculty of Medicine, Universitat de Girona, 17001 Girona, Spain
- Multidisciplinary Research Group in Health and Society (GREMSAS) (2021 SGR 01484), Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Mare de Déu de Guadalupe, 08303 Barcelona, Spain
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10
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Reinkemeyer C, Khazaei Y, Weigert M, Hannes M, Le Gleut R, Plank M, Winter S, Noreña I, Meier T, Xu L, Rubio-Acero R, Wiegrebe S, Le Thi TG, Fuchs C, Radon K, Paunovic I, Janke C, Wieser A, Küchenhoff H, Hoelscher M, Castelletti N. The Prospective COVID-19 Post-Immunization Serological Cohort in Munich (KoCo-Impf): Risk Factors and Determinants of Immune Response in Healthcare Workers. Viruses 2023; 15:1574. [PMID: 37515259 PMCID: PMC10383736 DOI: 10.3390/v15071574] [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: 06/14/2023] [Revised: 07/11/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
Antibody studies analyze immune responses to SARS-CoV-2 vaccination and infection, which is crucial for selecting vaccination strategies. In the KoCo-Impf study, conducted between 16 June and 16 December 2021, 6088 participants aged 18 and above from Munich were recruited to monitor antibodies, particularly in healthcare workers (HCWs) at higher risk of infection. Roche Elecsys® Anti-SARS-CoV-2 assays on dried blood spots were used to detect prior infections (anti-Nucleocapsid antibodies) and to indicate combinations of vaccinations/infections (anti-Spike antibodies). The anti-Spike seroprevalence was 94.7%, whereas, for anti-Nucleocapsid, it was only 6.9%. HCW status and contact with SARS-CoV-2-positive individuals were identified as infection risk factors, while vaccination and current smoking were associated with reduced risk. Older age correlated with higher anti-Nucleocapsid antibody levels, while vaccination and current smoking decreased the response. Vaccination alone or combined with infection led to higher anti-Spike antibody levels. Increasing time since the second vaccination, advancing age, and current smoking reduced the anti-Spike response. The cumulative number of cases in Munich affected the anti-Spike response over time but had no impact on anti-Nucleocapsid antibody development/seropositivity. Due to the significantly higher infection risk faced by HCWs and the limited number of significant risk factors, it is suggested that all HCWs require protection regardless of individual traits.
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Affiliation(s)
- Christina Reinkemeyer
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
| | - Yeganeh Khazaei
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstraße 33, 80539 Munich, Germany
| | - Maximilian Weigert
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstraße 33, 80539 Munich, Germany
- Munich Center for Machine Learning (MCML), 80539 Munich, Germany
| | - Marlene Hannes
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
| | - Ronan Le Gleut
- Institute of Computational Biology, Helmholtz Munich, 85764 Neuherberg, Germany
- Core Facility Statistical Consulting, Helmholtz Munich, 85764 Neuherberg, Germany
| | - Michael Plank
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
| | - Simon Winter
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
| | - Ivan Noreña
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
| | - Theresa Meier
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstraße 33, 80539 Munich, Germany
| | - Lisa Xu
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstraße 33, 80539 Munich, Germany
| | - Raquel Rubio-Acero
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
| | - Simon Wiegrebe
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstraße 33, 80539 Munich, Germany
- Department of Genetic Epidemiology, University of Regensburg, 93053 Regensburg, Germany
| | - Thu Giang Le Thi
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Lindwurmstrasse 4, 80337 Munich, Germany
| | - Christiane Fuchs
- Institute of Computational Biology, Helmholtz Munich, 85764 Neuherberg, Germany
- Core Facility Statistical Consulting, Helmholtz Munich, 85764 Neuherberg, Germany
- Faculty of Business Administration and Economics, Bielefeld University, 33615 Bielefeld, Germany
- Center for Mathematics, Technische Universität München, 85748 Garching, Germany
| | - Katja Radon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany
- Comprehensive Pneumology Center (CPC) Munich, German Center for Lung Research (DZL), 89337 Munich, Germany
| | - Ivana Paunovic
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799 Munich, Germany
- Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, 80336 Munich, Germany
| | - Helmut Küchenhoff
- Statistical Consulting Unit StaBLab, Department of Statistics, LMU Munich, Ludwigstraße 33, 80539 Munich, Germany
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
- Center for International Health (CIH), University Hospital, LMU Munich, 80336 Munich, Germany
- German Center for Infection Research (DZIF), Partner Site Munich, 80802 Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799 Munich, Germany
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, 80802 Munich, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, 80799 Munich, Germany
- Institute of Radiation Medicine, Helmholtz Zentrum München, 85764 Neuherberg, Germany
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11
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Sansone E, Collatuzzo G, Renzetti S, Ditano G, Bonfanti C, Sala E, Terlenghi L, Matteelli A, Abedini M, Asafo SS, Boffetta P, De Palma G. The Effect of the Immunization Schedule and Antibody Levels (Anti-S) on the Risk of SARS-CoV-2 Infection in a Large Cohort of Healthcare Workers in Northern Italy. Vaccines (Basel) 2023; 11:vaccines11040746. [PMID: 37112658 PMCID: PMC10144408 DOI: 10.3390/vaccines11040746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
Given their occupational risk profile, HCWs were the first to receive anti-SARS-CoV-2 vaccination. However, breakthrough infections remained common, mainly sustained by new SARS-CoV-2 variants of concern (VOCs) that rapidly spread one after another in Italy. Evidence suggests that the measured level of anti-SARS-CoV-2 antibodies does not clearly predict the level of protection conferred by either natural infection or vaccine-induced immunization, highlighting the need for further study on the diversity in susceptibility to SARS-CoV-2 infection. The present study aimed to characterize different risk profiles for SARS-CoV-2 infection in HCWs who had recently received the booster dose, and who were classified according to their immunization profile. The very small number of workers infected during the 8 months following the primary-cycle administration represents proof of the vaccine’s effectiveness against non-omicron strains. The comparison among different immunization profiles showed that hybrid immunization (vaccine plus natural infection) elicits higher antibody levels. However, hybrid immunization does not always provide better protection against reinfection, thus suggesting that the immunization profile plays a major role as a virus–host interaction modifier. Despite the high resistance to the reinfection, the peri-booster infection had a not-neglectable infection rate (5.6%), this further reinforcing the importance of preventive measures.
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12
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Seree-aphinan C, Ratanapokasatit Y, Suchonwanit P, Rattanakaemakorn P, O-Charoen P, Pisitkun P, Suangtamai T, Setthaudom C, Chirasuthat S, Chanprapaph K. Optimal time for COVID-19 vaccination in rituximab-treated dermatologic patients. Front Immunol 2023; 14:1138765. [PMID: 37006291 PMCID: PMC10050596 DOI: 10.3389/fimmu.2023.1138765] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundBy depleting circulating B lymphocytes, rituximab time-dependently suppresses coronavirus disease 2019 (COVID-19) vaccines’ humoral immunogenicity for a prolonged period. The optimal time to vaccinate rituximab-exposed immune-mediated dermatologic disease (IMDD) patients is currently unclear.ObjectiveTo estimate the vaccination timeframe that equalized the occurrence of humoral immunogenicity outcomes between rituximab-exposed and rituximab-naïve IMDD patients.MethodsThis retrospective cohort study recruited rituximab-exposed and age-matched rituximab-naïve subjects tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific immunity post-vaccination. Baseline clinical and immunological data (i.e., immunoglobulin levels, lymphocyte immunophenotyping) and SARS-CoV-2-specific immunity levels were extracted. The outcomes compared were the percentages of subjects who produced neutralizing antibodies (seroconversion rates, SR) and SARS-CoV-2-specific IgG levels among seroconverters. The outcomes were first analyzed using multiple regressions adjusted for the effects of corticosteroid use, steroid-spearing agents, and pre-vaccination immunological status (i.e., IgM levels, the percentages of the total, naïve, and memory B lymphocytes) to identify rituximab-related immunogenicity outcomes. The rituximab-related outcome differences with a 95% confidence interval (CI) between groups were calculated, starting by including every subject and then narrowing down to those with longer rituximab-to-vaccination intervals (≥3, ≥6, ≥9, ≥12 months). The desirable cut-off performances were <25% outcome inferiority observed among rituximab-exposed subgroups compared to rituximab-naïve subjects, and the positive likelihood ratio (LR+) for the corresponding outcomes ≥2.FindingsForty-five rituximab-exposed and 90 rituximab-naive subjects were included. The regression analysis demonstrated a negative association between rituximab exposure status and SR but not with SARS-CoV-2-specific IgG levels. Nine-month rituximab-to-vaccination cut-off fulfilled our prespecified diagnostic performance (SR difference between rituximab-exposed and rituximab-naïve group [95%CI]: -2.6 [-23.3, 18.1], LR+: 2.6) and coincided with the repopulation of naïve B lymphocytes in these patients.ConclusionsNine months of rituximab-to-vaccination interval maximize the immunological benefits of COVID-19 vaccines while avoiding unnecessary delay in vaccination and rituximab treatment for IMDD patients.
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Affiliation(s)
- Chutima Seree-aphinan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Yanisa Ratanapokasatit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ploysyne Rattanakaemakorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pichaya O-Charoen
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
| | - Prapaporn Pisitkun
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
| | - Thanitta Suangtamai
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
| | - Chavachol Setthaudom
- Immunology Laboratory, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sonphet Chirasuthat
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kumutnart Chanprapaph
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- *Correspondence: Kumutnart Chanprapaph,
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Fogolari M, Leoni BD, De Cesaris M, Italiano R, Davini F, Miccoli GA, Donati D, Clerico L, Stanziale A, Savini G, Petrosillo N, Ciccozzi M, Sommella L, Riva E, Fazii P, Angeletti S. Neutralizing Antibodies against SARS-CoV-2 Beta and Omicron Variants Inhibition Comparison after BNT162b2 mRNA Booster Doses with a New PETIA sVNT Assay. Diagnostics (Basel) 2023; 13:889. [PMID: 36900033 PMCID: PMC10000738 DOI: 10.3390/diagnostics13050889] [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: 01/28/2023] [Revised: 02/23/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Monitoring antibody response following SARS-CoV-2 vaccination is strategic, and neutralizing antibodies represent the gold standard. The neutralizing response to Beta and Omicron VOCs was evaluated versus the gold standard by a new commercial automated assay. METHODS Serum samples from 100 healthcare workers from the Fondazione Policlinico Universitario Campus Biomedico and the Pescara Hospital were collected. IgG levels were determined by chemiluminescent immunoassay (Abbott Laboratories, Wiesbaden, Germany) and serum neutralization assay as the gold standard. Moreover, a new commercial immunoassay, the PETIA test Nab (SGM, Rome, Italy), was used for neutralization evaluation. Statistical analysis was performed with R software, version 3.6.0. RESULTS Anti-SARS-CoV-2 IgG titers decayed during the first ninety days after the vaccine second dose. The following booster dose significantly (p < 0.001) increased IgG levels. A correlation between IgG expression and neutralizing activity modulation was found with a significant increase after the second and the third booster dose (p < 0.05. Compared to the Beta variant of the virus, the Omicron VOC was associated with a significantly larger quantity of IgG antibodies needed to achieve the same degree of neutralization. The best Nab test cutoff for high neutralization titer (≥1:80) was set for both Beta and Omicron variants. CONCLUSION This study correlates vaccine-induced IgG expression and neutralizing activity using a new PETIA assay, suggesting its usefulness for SARS-CoV2 infection management.
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Affiliation(s)
- Marta Fogolari
- Clinical Laboratory Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Unit of Clinical Laboratory Science, Department of Medicine and Surgery, University Campus Bio-Medico, 00128 Rome, Italy
| | | | - Marina De Cesaris
- Clinical Laboratory Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | | | - Flavio Davini
- Clinical Laboratory Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Unit of Clinical Laboratory Science, Department of Medicine and Surgery, University Campus Bio-Medico, 00128 Rome, Italy
| | - Ginevra Azzurra Miccoli
- Infection Prevention and Control Service, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Daniele Donati
- Infection Prevention and Control Service, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Luigi Clerico
- Clinical Microbiology and Virology, Spirito Santo Hospital, 65122 Pescara, Italy
| | - Andrea Stanziale
- Clinical Microbiology and Virology, Spirito Santo Hospital, 65122 Pescara, Italy
| | - Giovanni Savini
- Istituto Zooprofilattico Sperimentale dell’Abruzzo e del Molise ‘G Caporale’, 64100 Teramo, Italy
| | - Nicola Petrosillo
- Infection Prevention and Control Service, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular Epidemiology, University Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Lorenzo Sommella
- Health Management, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Elisabetta Riva
- Clinical Laboratory Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Unit of Virology, University Campus Bio-Medico of Rome, 00128 Rome, Italy
| | - Paolo Fazii
- Clinical Microbiology and Virology, Spirito Santo Hospital, 65122 Pescara, Italy
| | - Silvia Angeletti
- Clinical Laboratory Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
- Unit of Clinical Laboratory Science, Department of Medicine and Surgery, University Campus Bio-Medico, 00128 Rome, Italy
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14
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Scola L, Ferraro D, Sanfilippo GL, De Grazia S, Lio D, Giammanco GM. Age and Cytokine Gene Variants Modulate the Immunogenicity and Protective Effect of SARS-CoV-2 mRNA-Based Vaccination. Vaccines (Basel) 2023; 11:vaccines11020413. [PMID: 36851291 PMCID: PMC9962548 DOI: 10.3390/vaccines11020413] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/05/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
The introduction of anti-SARS-CoV-2 vaccines in late 2020 substantially changed the pandemic picture, inducing effective protection in the population. However, individual variability was observed with different levels of cellular response and neutralizing antibodies. We report data on the impact of age, gender, and 16 single nucleotide polymorphisms (SNPs) of cytokine genes on the anti-SARS-CoV-2 IgG titers measured 31 and 105 days after administration of the second dose of BNT162b2 vaccine to 122 healthy subjects from the health care staff of the Palermo University Hospital, Italy. The higher titers at 31 days were measured in the younger subjects and in subjects bearing T-positive genotypes of IL-1R1 rs2234650 or the GG homozygous genotype of IL-6 rs1800795 SNP. T-positive genotypes are also significantly more common in subjects with higher titers at day 105. In addition, in this group of subjects, the frequency of the CT genotype of IL-4 rs2243250 is higher among those vaccinated with higher titers. Moreover, these SNPs and TNFA rs1800629 are differently distributed in a group of subjects that were found infected by SARS-CoV-2 at day 105 of evaluation. Finally, subjects that were found to be infected by SARS-CoV-2 at day 105 were significantly older than the uninfected subjects. Taken together, these data seem to suggest that age and polymorphisms of key cytokines, which regulate inflammation and humoral immune response, might influence the magnitude of the antibody response to vaccination with BNT162B2, prompting speculation about the possible benefit of a genetic background-based assessment of a personalized approach to the anti-COVID vaccination schedule.
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Affiliation(s)
- Letizia Scola
- Clinical Pathology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Corso Tukory, 211, 90134 Palermo, Italy
| | - Donatella Ferraro
- Microbiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
| | - Giuseppa Luisa Sanfilippo
- Microbiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
| | - Simona De Grazia
- Microbiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
| | - Domenico Lio
- Interdepartmental Research Center “Migrate”, University of Palermo, 90133 Palermo, Italy
- Correspondence: ; Tel.: +39-91-6555913
| | - Giovanni Maurizio Giammanco
- Microbiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
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St Clair LA, Chaulagain S, Klein SL, Benn CS, Flanagan KL. Sex-Differential and Non-specific Effects of Vaccines Over the Life Course. Curr Top Microbiol Immunol 2023; 441:225-251. [PMID: 37695431 PMCID: PMC10917449 DOI: 10.1007/978-3-031-35139-6_9] [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] [Indexed: 09/12/2023]
Abstract
Biological sex and age have profound effects on immune responses throughout the lifespan and impact vaccine acceptance, responses, and outcomes. Mounting evidence from epidemiological, clinical, and animal model studies show that males and females respond differentially to vaccination throughout the lifespan. Within age groups, females tend to produce greater vaccine-induced immune responses than males, with sex differences apparent across all age groups, but are most pronounced among reproductive aged individuals. Females report more adverse effects following vaccination than males. Females, especially among children under 5 years of age, also experience more non-specific effects of vaccination. Despite these known sex- and age-specific differences in vaccine-induced immune responses and outcomes, sex and age are often ignored in vaccine research. Herein, we review the known sex differences in the immunogenicity, effectiveness, reactogenicity, and non-specific effects of vaccination over the lifespan. Ways in which these data can be leveraged to improve vaccine research are described.
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Affiliation(s)
- Laura A St Clair
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabal Chaulagain
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sabra L Klein
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christine Stabell Benn
- Institute of Clinical Research and Danish Institute for Advanced Study, University of Southern Denmark, Odense, Denmark
| | - Katie L Flanagan
- Tasmanian Vaccine Trial Centre, Clifford Craig Foundation, Launceston General Hospital, Launceston, TAS, Australia.
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16
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Collatuzzo G, Lodi V, Feola D, De Palma G, Sansone E, Sala E, Janke C, Castelletti N, Porru S, Spiteri G, Monaco MGL, Larese Filon F, Negro C, Cegolon L, Beresova J, Fabianova E, Carrasco-Ribelles LA, Toràn-Monserrat P, Rodriguez-Suarez MM, Fernandez-Tardon G, Asafo SS, Ditano G, Abedini M, Boffetta P. Determinants of Anti-S Immune Response at 9 Months after COVID-19 Vaccination in a Multicentric European Cohort of Healthcare Workers-ORCHESTRA Project. Viruses 2022; 14:v14122657. [PMID: 36560660 PMCID: PMC9781450 DOI: 10.3390/v14122657] [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: 10/25/2022] [Revised: 11/15/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2022] Open
Abstract
Background: The persistence of antibody levels after COVID-19 vaccination has public health relevance. We analyzed the determinants of quantitative serology at 9 months after vaccination in a multicenter cohort. Methods: We analyzed data on anti-SARS-CoV-2 spike antibody levels at 9 months from the first dose of vaccinated HCW from eight centers in Italy, Germany, Spain, Romania and Slovakia. Serological levels were log-transformed to account for the skewness of the distribution and normalized by dividing them by center-specific standard errors. We fitted center-specific multivariate regression models to estimate the cohort-specific relative risks (RR) of an increase of one standard deviation of log antibody level and the corresponding 95% confidence interval (CI), and combined them in random-effects meta-analyses. Finally, we conducted a trend analysis of 1 to 7 months' serology within one cohort. Results: We included 20,216 HCW with up to two vaccine doses and showed that high antibody levels were associated with female sex (p = 0.01), age (RR = 0.87, 95% CI = 0.86-0.88 per 10-year increase), 10-day increase in time since last vaccine (RR = 0.97, 95% CI 0.97-0.98), previous infection (3.03, 95% CI = 2.92-3.13), two vaccine doses (RR = 1.22, 95% CI = 1.09-1.36), use of Spikevax (OR = 1.51, 95% CI = 1.39-1.64), Vaxzevria (OR = 0.57, 95% CI = 0.44-0.73) or heterologous vaccination (OR = 1.33, 95% CI = 1.12-1.57), compared to Comirnaty. The trend in the Bologna cohort, based on 3979 measurements, showed a decrease in mean standardized antibody level from 8.17 to 7.06 (1-7 months, p for trend 0.005). Conclusions: Our findings corroborate current knowledge on the determinants of COVID-19 vaccine-induced immunity and declining trend with time.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Vittorio Lodi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Daniela Feola
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Emanuele Sansone
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Emma Sala
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
| | - Christian Janke
- Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, 80331 Munich, Germany
| | - Noemi Castelletti
- Division of Infectious Diseases and Tropical Medicine, LMU Klinikum, 80331 Munich, Germany
| | - Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Gianluca Spiteri
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy
| | | | | | - Corrado Negro
- Unit of Occupational Medicine, University of Trieste, 34121 Trieste, Italy
| | - Luca Cegolon
- Unit of Occupational Medicine, University of Trieste, 34121 Trieste, Italy
| | - Jana Beresova
- Epidemiology Department, Regional Authority of Public Health, 97401 Banská Bystrica, Slovakia
| | - Eleonora Fabianova
- Occupational Health Department, Regional Authority of Public Health, 97401 Banská Bystrica, Slovakia
| | - Lucia A. Carrasco-Ribelles
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, 08302 Mataró, Spain
| | - Pere Toràn-Monserrat
- Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d’Investigació en Atenció Primària Jordi Gol, 08302 Mataró, Spain
- Germans Trias i Pujol Research Institute, 08911 Badalona, Spain
- Department of Medicine, Faculty of Medicine, Universitat de Girona, 17001 Girona, Spain
- Multidisciplinary Research Group in Health and Society, 08001 Barcelona, Spain
| | - Marta Maria Rodriguez-Suarez
- Health Research Institute of Asturias, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), 33001 Oviedo, Spain
- Public Health Department, University of Oviedo, 33001 Oviedo, Spain
| | - Guillermo Fernandez-Tardon
- Health Research Institute of Asturias, Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), 33001 Oviedo, Spain
- Public Health Department, University of Oviedo, 33001 Oviedo, Spain
| | - Shuffield S. Asafo
- 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
| | - Mahsa Abedini
- 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
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 10041, USA
- Correspondence:
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