SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease
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Published:2023-07
Issue:7
Volume:29
Page:1760-1774
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ISSN:1078-8956
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Container-title:Nature Medicine
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language:en
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Short-container-title:Nat Med
Author:
Barnes EleanorORCID, Goodyear Carl S.ORCID, Willicombe MichelleORCID, Gaskell Charlotte, Siebert StefanORCID, I de Silva ThushanORCID, Murray Sam M., Rea Daniel, Snowden John A.ORCID, Carroll Miles, Pirrie Sarah, Bowden Sarah J., Dunachie Susanna J., Richter Alex, Lim Zixiang, Satsangi Jack, Cook Gordon, Pope Ann, Hughes Ana, Harrison Molly, Lim Sean H., Miller Paul, Klenerman Paul, Richter Alex G., Mentzer Alex, Deeks Alexandra, Jamsen Anni, Brown Anthony, Conlon Chris, Dold Chris, Duncan Christopher J. A., Skelly Donal, Kronsteiner Barbara, Abraham Priyanka, Phillips Eloise, Jeffery Katie, Turtle Lance, Frending Lisa, Stafford Lizzie, Ali Mohammad, Rongkard Patpong, Payne Rebecca, Adele Sandra, Travis Simon, Gardiner Siobhan, Dobson Sue L., Malone Tom, Bibi Sagida, Carroll Miles, Faustini Sian, Foulkes Sarah, Frater John, Hall Victoria, Hopkins Susan, Islam Jasmin, Lambe Teresa, Longet Stephanie, Moore Shona C., Otter Ashley, Rowland-Jones Sarah L., Thaventhir James E. D., Wootton Daniel G., Basu Neil, Gilmour Ashley, Irwin Sophie, Meacham Georgina, Marjot Thomas, Dimitriadis Stavros, Kelleher PeterORCID, Prendecki MariaORCID, Clarke Candice, Mortimer Paige, McIntyre Stacey, Selby Rachael, Meardon Naomi, Nguyen Dung, Tipton Tom, Longet Stephanie, Laidlaw Stephen, Orchard Kim, Ireland Georgina, Brown Kevin, Amirthalingam Gayatri, Thomas DavidORCID, Kearns Pamela, Kirkham Amanda, McInnes Iain B.ORCID, Beesley Richard, Churchill Vicky, Loughton Holly, Insch Elspeth, MacDonald Eilean, Middleton Gary, Billingham Lucinda, Lowe Faye, Magwaro Sophia, Al-Taei Saly, Arnott Maxine, Bennett Louise, Brock James, Keillor Victora, Melville Andrew, Melville Lisa, Miller Samantha, Najm Aurelie, Paterson Caron, Rodgers Lewis, Rutherford Matthew, Rundell Suzann, Smith Emily, Stewart Lynn, Sunzini Flavia, Tong Andrew, Woolcock Kieran, Basheer Faisal, Crawley Charles, Malladi Ram, King Andrew, Lockey Sophie, Uttenthal Ben, Koh Mickey B. C., Hansford Sam, Sandhar Gurjinder, Kesavan Murali, Moore Celia, Manousou Pinelopi, Hahn Gareth, Mullish Benjamin, Atta Maria, Gleeson Sarah, Lightstone Liz, Martin Paul, McAdoo Stephen, Thomson Tina, Avenoso Daniele, Sanderson Robin, Taylor Claire, Bhandal Khushpreet, Hull Diana, Trivedi Palak, Filer Andrew, Hurst Erin, Publicover Amy, Scouse Katy, Chalk Jem, Hanke Daniel, Hanke Josef, Healy Saoirse, Provine Nicholas, Thomas Sarah, Walker Victoria, Win Zay, Trown Doreen, Faria Patricia, Chackathayil Julie, Hutchison Clare, Richardson Deborah, , ,
Abstract
AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immune responses and infection outcomes were evaluated in 2,686 patients with varying immune-suppressive disease states after administration of two Coronavirus Disease 2019 (COVID-19) vaccines. Overall, 255 of 2,204 (12%) patients failed to develop anti-spike antibodies, with an additional 600 of 2,204 (27%) patients generating low levels (<380 AU ml−1). Vaccine failure rates were highest in ANCA-associated vasculitis on rituximab (21/29, 72%), hemodialysis on immunosuppressive therapy (6/30, 20%) and solid organ transplant recipients (20/81, 25% and 141/458, 31%). SARS-CoV-2-specific T cell responses were detected in 513 of 580 (88%) patients, with lower T cell magnitude or proportion in hemodialysis, allogeneic hematopoietic stem cell transplantation and liver transplant recipients (versus healthy controls). Humoral responses against Omicron (BA.1) were reduced, although cross-reactive T cell responses were sustained in all participants for whom these data were available. BNT162b2 was associated with higher antibody but lower cellular responses compared to ChAdOx1 nCoV-19 vaccination. We report 474 SARS-CoV-2 infection episodes, including 48 individuals with hospitalization or death from COVID-19. Decreased magnitude of both the serological and the T cell response was associated with severe COVID-19. Overall, we identified clinical phenotypes that may benefit from targeted COVID-19 therapeutic strategies.
Publisher
Springer Science and Business Media LLC
Subject
General Biochemistry, Genetics and Molecular Biology,General Medicine
Reference66 articles.
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