Anti-SARS-CoV-2 Antibodies versus Vaccination Status in CAD Patients with COVID-19: A Prospective, Propensity Score-Matched Cohort Study

Author:

Mink Sylvia12ORCID,Drexel Heinz234ORCID,Leiherer Andreas13ORCID,Cadamuro Janne5ORCID,Hitzl Wolfgang6ORCID,Frick Matthias7,Reimann Patrick27,Saely Christoph H.23,Fraunberger Peter12

Affiliation:

1. Central Medical Laboratories, 6800 Feldkirch, Austria

2. Private University in the Principality of Liechtenstein, 9495 Triesen, Liechtenstein

3. VIVIT Institute, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria

4. Drexel University College of Medicine, Philadelphia, PA 19129, USA

5. Department of Laboratory Medicine, Paracelsus Medical University, 5020 Salzburg, Austria

6. Department of Research and Innovation, Team Biostatistics and Publication of Clinical Trials, Paracelsus Medical University, 5020 Salzburg, Austria

7. Department of Internal Medicine, Academic Teaching Hospital Feldkirch, 6800 Feldkirch, Austria

Abstract

Objectives: Despite the currently prevailing, milder Omicron variant, coronary artery disease (CAD) patients constitute a major risk group in COVID-19, exhibiting 2.6 times the mortality risk of non-CAD patients and representing over 22% of non-survivors. No data are currently available on the efficacy of antibody levels in CAD patients, nor on the relevance of vaccination status versus antibody levels for predicting severe courses and COVID-19 mortality. Nor are there definitive indicators to assess if individual CAD patients are sufficiently protected from adverse outcomes or to determine the necessity of booster vaccinations. Methods: A prospective, propensity-score-matched, multicenter cohort study comprising 249 CAD patients and 903 controls was conducted. Anti-SARS-CoV-2-spike antibodies were measured on hospital admission. Prespecified endpoints were in-hospital mortality, intensive care, and oxygen administration. Results: After adjustment for potential confounders, CAD patients exhibited 4.6 and 6.1-times higher mortality risks if antibody levels were <1200 BAU/mL and <182 BAU/mL, respectively, compared to CAD patients above these thresholds (aOR 4.598, 95%CI 2.426–8.714, p < 0.001; 6.147, 95%CI 2.529–14.941, p < 0.001). Risk of intensive care was 3.7 and 4.0 (p = 0.003; p < 0.001), and risk of oxygen administration 2.6 and 2.4 times higher below these thresholds (p = 0.004; p = 0.010). Vaccination status was a weaker predictor of all three outcomes than both antibody thresholds. Conclusion: Antibody levels are a stronger predictor of outcome in CAD patients with COVID-19 than vaccination status, with 1200 BAU/mL being the more conservative threshold. Measuring anti-SARS-CoV-2 antibodies in CAD patients may ensure enhanced protection by providing timely booster vaccinations and identifying high-risk CAD patients at hospital admission.

Publisher

MDPI AG

Reference51 articles.

1. World Health Organization (WHO) (2024, April 18). WHO Coronavirus (COVID-19) Dashboard. Available online: https://covid19.who.int/.

2. World Health Organization (WHO) (2023, December 11). Statement on the Fifteenth Meeting of the IHR (2005) Emergency Committee on the COVID-19 Pandemic. Available online: https://www.who.int/news/item/05–05-2023-statement-on-the-fifteenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic.

3. European Centre for Disease Prevention and Control (2024, April 19). Data on Testing for COVID-19 by Week and Country. Available online: https://www.ecdc.europa.eu/en/publications-data/covid-19-testing.

4. (2022). Wastewater is a robust proxy for monitoring circulating SARS-CoV-2 variants. Nat. Biotechnol., 40, 1768–1769.

5. World Health Organization (WHO) (2024, April 18). Wastewater Environmental Surveillance. Available online: https://data.who.int/dashboards/covid19/wastewater.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3