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Int J Infect Dis . Trajectory of SARS-CoV-2 anti-S IgG levels following transfusion and a third dose of BNT162b2 vaccine in a patient with massive p

tetano

Editor, Senior Moderator
Int J Infect Dis


. 2022 Feb 24;S1201-9712(22)00122-9.
doi: 10.1016/j.ijid.2022.02.042. Online ahead of print.
Trajectory of SARS-CoV-2 anti-S IgG levels following transfusion and a third dose of BNT162b2 vaccine in a patient with massive postoperative bleeding: A case report


Marino Hirata[SUP] 1 [/SUP], Takahiko Fukuchi[SUP] 2 [/SUP], Hitoshi Sugawara[SUP] 2 [/SUP]



Affiliations

Abstract

Objective: Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to be effective in preventing infection and severe disease. Massive bleeding and transfusion after vaccination can lead to a decrease in the antibody level. The effect of an additional dose of vaccine after blood transfusion has not been described previously. We report the SARS-CoV-2 anti-S IgG trajectory in a man who received a third dose of vaccine after a massive postoperative bleed and blood and plasma transfusion.
Case presentation: A 57-year-old male physician had a SARS-CoV-2 anti-S IgG level of 44 AU/mL, measured using the Lumipulse Presto chemiluminescence assay, 3 months after receiving two doses of BNT162b2 vaccine. He underwent a hemicolectomy for colon cancer, experienced massive postoperative bleeding, and required a transfusion. His SARS-CoV-2 anti-S IgG level dropped to 9.2 AU/mL. A third dose of BNT162b2 vaccination was administered to reduce the risk of breakthrough infection. Fifteen days after receiving the third vaccine dose, the patient's SARS-CoV-2 anti-S IgG level increased to 421 AU/mL, likely to reflect protection.
Conclusion: This report suggests that administering an extra dose of vaccine is useful for restoring protective antibody levels in vaccinated patients who experience massive bleeding.

Keywords: BNT162b2 vaccine; COVID-19; Massive bleeding; Plasma transfusion; SARS-CoV-2 anti-S IgG.
 
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