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Nat Med
. 2023 Jul 6.
doi: 10.1038/s41591-023-02414-4. Online ahead of print. SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease
Eleanor Barnes # 1 2 , Carl S Goodyear # 3 , Michelle Willicombe # 4 , Charlotte Gaskell # 5 , Stefan Siebert 3 , Thushan I de Silva 6 , Sam M Murray 1 , Daniel Rea 5 , John A Snowden 7 , Miles Carroll 8 , Sarah Pirrie 5 , Sarah J Bowden 5 , Susanna J Dunachie 1 2 , Alex Richter 9 , Zixiang Lim 1 , Jack Satsangi 1 , Gordon Cook 10 , Ann Pope 5 , Ana Hughes 5 , Molly Harrison 5 , Sean H Lim 11 , Paul Miller 12 , Paul Klenerman 1 2 ; PITCH consortium; Neil Basu 3 , Ashley Gilmour 3 , Sophie Irwin 1 , Georgina Meacham 1 , Thomas Marjot 1 , Stavros Dimitriadis 1 , Peter Kelleher 13 , Maria Prendecki 4 , Candice Clarke 4 , Paige Mortimer 4 , Stacey McIntyre 4 , Rachael Selby 7 , Naomi Meardon 6 , Dung Nguyen 8 , Tom Tipton 8 , Stephanie Longet 8 , Stephen Laidlaw 8 , Kim Orchard 14 , Georgina Ireland 15 ; CONSENSUS; David Thomas # 4 , Pamela Kearns # 5 16 , Amanda Kirkham # 5 , Iain B McInnes # 17 ; OCTAVE Collaborative Group
Collaborators, Affiliations
Severe 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.
. 2023 Jul 6.
doi: 10.1038/s41591-023-02414-4. Online ahead of print. SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease
Eleanor Barnes # 1 2 , Carl S Goodyear # 3 , Michelle Willicombe # 4 , Charlotte Gaskell # 5 , Stefan Siebert 3 , Thushan I de Silva 6 , Sam M Murray 1 , Daniel Rea 5 , John A Snowden 7 , Miles Carroll 8 , Sarah Pirrie 5 , Sarah J Bowden 5 , Susanna J Dunachie 1 2 , Alex Richter 9 , Zixiang Lim 1 , Jack Satsangi 1 , Gordon Cook 10 , Ann Pope 5 , Ana Hughes 5 , Molly Harrison 5 , Sean H Lim 11 , Paul Miller 12 , Paul Klenerman 1 2 ; PITCH consortium; Neil Basu 3 , Ashley Gilmour 3 , Sophie Irwin 1 , Georgina Meacham 1 , Thomas Marjot 1 , Stavros Dimitriadis 1 , Peter Kelleher 13 , Maria Prendecki 4 , Candice Clarke 4 , Paige Mortimer 4 , Stacey McIntyre 4 , Rachael Selby 7 , Naomi Meardon 6 , Dung Nguyen 8 , Tom Tipton 8 , Stephanie Longet 8 , Stephen Laidlaw 8 , Kim Orchard 14 , Georgina Ireland 15 ; CONSENSUS; David Thomas # 4 , Pamela Kearns # 5 16 , Amanda Kirkham # 5 , Iain B McInnes # 17 ; OCTAVE Collaborative Group
Collaborators, Affiliations
- PMID: 37414897
- DOI: 10.1038/s41591-023-02414-4
Severe 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.