Author:
Rizzi Manuela,Tonello Stelvio,Brinno Cristiana,Zecca Erika,Matino Erica,Cittone Micol,Rizzi Eleonora,Casciaro Giuseppe Francesco,D’Onghia Davide,Colangelo Donato,Minisini Rosalba,Bellan Mattia,Castello Luigi Mario,Chiocchetti Annalisa,Pirisi Mario,Rigamonti Cristina,Lilleri Daniele,Zavaglio Federica,Bergami Federica,Sola Daniele,Sainaghi Pier Paolo
Abstract
BackgroundA relevant proportion of immunocompromised patients did not reach a detectable seroconversion after a full primary vaccination cycle against SARS-CoV-2. The effect of different immunosuppressants and the potential risks for SARS-CoV-2 infection in these subjects is largely unknown.MethodsPatients from the Rivalsa prospective, observational cohort study with planned anti SARS-CoV-2 third dose mRNA vaccination between October and December 2021 were asked to participate to this follow-up study. Patients were asked about eventual confirmed positivity to SARS-CoV-2 infection within 6 months from the third dose and to undergo a blood draw to evaluate seroconversion status after the additional vaccine shot.Results19 out of 114 patients taking part in the survey developed a confirmed SARS-CoV-2 infection; we identified mycophenolate treatment as an independent predictor of an increased risk of infection even after the third vaccine dose (OR: 5.20, 95% CI: 1.70-20.00, p=0.0053). This result is in agreement with the in vitro evidence that MMF impairs both B and T lymphocytes driven immune responses (reduction both in memory B cells producing anti-spike antibodies and in proliferating CD4+ and CD8+ T cells).ConclusionsImmunocompromised patients need an additional vaccine administration to reach a detectable seroconversion, thus fostering a more personalized approach to their clinical management. Moreover, patients undergoing mycophenolate treatment show a specific increased infection risk, with respect to other immunosuppressants thus supporting a closer monitoring of their health status.
Subject
Immunology,Immunology and Allergy
Cited by
1 articles.
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