tetano
Editor, Senior Moderator
BMC Geriatr
. 2022 Mar 10;22(1):191.
doi: 10.1186/s12877-022-02884-0.
Sero-survey on long-term care facility residents reveals increased risk of sub-optimal antibody response to BNT162b2: implications for breakthrough prevention
Barbara Caimi[SUP] #[/SUP][SUP] 1 [/SUP], Marco Franzetti[SUP] #[/SUP][SUP] 2 [/SUP], Rossella Velleca[SUP] #[/SUP][SUP] 1 [/SUP], Alessia Lai[SUP] #[/SUP][SUP] 3 [/SUP], Antonella Gatti[SUP] 1 [/SUP], Pier Luigi Rossi[SUP] 1 [/SUP], Marco D'Orso[SUP] 4 [/SUP], Fabrizio Pregliasco[SUP] 5 [/SUP], Claudia Balotta[SUP] 6 [/SUP], Giuseppe Calicchio[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The impact of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) on residents of long-term care facilities (LTCFs) has been dramatic on global scale as older age and comorbidities pose an increased risk of severe disease and death.
Methods: Aim of this study was to evaluate SARS-CoV-2 Spike-specific IgG (S-IgG) antibody titers in 478 residents and 649 health care workers of a large Italian long-term care facility two months after complete vaccination with BNT162b2. Associations among resident-related factors and predictors of humoral response were investigated.
Results: By stratifying levels of humoral responses, we found that 62.1%, 21.6%, 12.1% and 4.2% of residents had high (>1,000 BAU/ml), medium (101-1,000), low (1-100) and null (<1 BAU/mL) S-IgG titers, respectively. Residents with documented previous COVID-19 and those with SARS-CoV-2 nucleocapsid-specific IgG (N-IgG) positive serology showed higher level of serological response, while significant associations were observed for cancer with suboptimal response (p = 0.005) and the administration of corticosteroid for suboptimal response (p = 0.028) and a null one (p = 0.039). According to multivariate logistic regression, predictors of an increased risk of null response were advanced age (Odd ratio, OR: 2.630; Confidence interval, CI: 1.13-6.14; p = 0.025), corticosteroid therapy (OR: 4.964; CI: 1.06-23.52; p = 0.042) and diabetes mellitus (OR:3.415; CI:1.08-10.8; p = 0.037). In contrast, previous diagnosis of COVID-19 was strongly associated with a reduced risk of null response to vaccination (OR:0.126; CI:0.02-0.23; p < 0.001).
Conclusions: SARS-CoV-2 specific antibodies in elderly individuals should be consider when deciding the need of a third dose of vaccine for prevention of reinfections in LTCFs despite the maintenance of barrier measures.
Keywords: Comorbidities; Long term care facilities; Older age; S-IgG antibodies; SARS-CoV-2.
. 2022 Mar 10;22(1):191.
doi: 10.1186/s12877-022-02884-0.
Sero-survey on long-term care facility residents reveals increased risk of sub-optimal antibody response to BNT162b2: implications for breakthrough prevention
Barbara Caimi[SUP] #[/SUP][SUP] 1 [/SUP], Marco Franzetti[SUP] #[/SUP][SUP] 2 [/SUP], Rossella Velleca[SUP] #[/SUP][SUP] 1 [/SUP], Alessia Lai[SUP] #[/SUP][SUP] 3 [/SUP], Antonella Gatti[SUP] 1 [/SUP], Pier Luigi Rossi[SUP] 1 [/SUP], Marco D'Orso[SUP] 4 [/SUP], Fabrizio Pregliasco[SUP] 5 [/SUP], Claudia Balotta[SUP] 6 [/SUP], Giuseppe Calicchio[SUP] 1 [/SUP]
Affiliations
- PMID: 35272615
- PMCID: PMC8908300
- DOI: 10.1186/s12877-022-02884-0
Abstract
Background: The impact of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) on residents of long-term care facilities (LTCFs) has been dramatic on global scale as older age and comorbidities pose an increased risk of severe disease and death.
Methods: Aim of this study was to evaluate SARS-CoV-2 Spike-specific IgG (S-IgG) antibody titers in 478 residents and 649 health care workers of a large Italian long-term care facility two months after complete vaccination with BNT162b2. Associations among resident-related factors and predictors of humoral response were investigated.
Results: By stratifying levels of humoral responses, we found that 62.1%, 21.6%, 12.1% and 4.2% of residents had high (>1,000 BAU/ml), medium (101-1,000), low (1-100) and null (<1 BAU/mL) S-IgG titers, respectively. Residents with documented previous COVID-19 and those with SARS-CoV-2 nucleocapsid-specific IgG (N-IgG) positive serology showed higher level of serological response, while significant associations were observed for cancer with suboptimal response (p = 0.005) and the administration of corticosteroid for suboptimal response (p = 0.028) and a null one (p = 0.039). According to multivariate logistic regression, predictors of an increased risk of null response were advanced age (Odd ratio, OR: 2.630; Confidence interval, CI: 1.13-6.14; p = 0.025), corticosteroid therapy (OR: 4.964; CI: 1.06-23.52; p = 0.042) and diabetes mellitus (OR:3.415; CI:1.08-10.8; p = 0.037). In contrast, previous diagnosis of COVID-19 was strongly associated with a reduced risk of null response to vaccination (OR:0.126; CI:0.02-0.23; p < 0.001).
Conclusions: SARS-CoV-2 specific antibodies in elderly individuals should be consider when deciding the need of a third dose of vaccine for prevention of reinfections in LTCFs despite the maintenance of barrier measures.
Keywords: Comorbidities; Long term care facilities; Older age; S-IgG antibodies; SARS-CoV-2.