tetano
Editor, Senior Moderator
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[SUP] #[/SUP][SUP] 1 2 [/SUP], Carl S Goodyear[SUP] #[/SUP][SUP] 3 [/SUP], Michelle Willicombe[SUP] #[/SUP][SUP] 4 [/SUP], Charlotte Gaskell[SUP] #[/SUP][SUP] 5 [/SUP], Stefan Siebert[SUP] 3 [/SUP], Thushan I de Silva[SUP] 6 [/SUP], Sam M Murray[SUP] 1 [/SUP], Daniel Rea[SUP] 5 [/SUP], John A Snowden[SUP] 7 [/SUP], Miles Carroll[SUP] 8 [/SUP], Sarah Pirrie[SUP] 5 [/SUP], Sarah J Bowden[SUP] 5 [/SUP], Susanna J Dunachie[SUP] 1 2 [/SUP], Alex Richter[SUP] 9 [/SUP], Zixiang Lim[SUP] 1 [/SUP], Jack Satsangi[SUP] 1 [/SUP], Gordon Cook[SUP] 10 [/SUP], Ann Pope[SUP] 5 [/SUP], Ana Hughes[SUP] 5 [/SUP], Molly Harrison[SUP] 5 [/SUP], Sean H Lim[SUP] 11 [/SUP], Paul Miller[SUP] 12 [/SUP], Paul Klenerman[SUP] 1 2 [/SUP]; PITCH consortium; Neil Basu[SUP] 3 [/SUP], Ashley Gilmour[SUP] 3 [/SUP], Sophie Irwin[SUP] 1 [/SUP], Georgina Meacham[SUP] 1 [/SUP], Thomas Marjot[SUP] 1 [/SUP], Stavros Dimitriadis[SUP] 1 [/SUP], Peter Kelleher[SUP] 13 [/SUP], Maria Prendecki[SUP] 4 [/SUP], Candice Clarke[SUP] 4 [/SUP], Paige Mortimer[SUP] 4 [/SUP], Stacey McIntyre[SUP] 4 [/SUP], Rachael Selby[SUP] 7 [/SUP], Naomi Meardon[SUP] 6 [/SUP], Dung Nguyen[SUP] 8 [/SUP], Tom Tipton[SUP] 8 [/SUP], Stephanie Longet[SUP] 8 [/SUP], Stephen Laidlaw[SUP] 8 [/SUP], Kim Orchard[SUP] 14 [/SUP], Georgina Ireland[SUP] 15 [/SUP]; CONSENSUS; David Thomas[SUP] #[/SUP][SUP] 4 [/SUP], Pamela Kearns[SUP] #[/SUP][SUP] 5 16 [/SUP], Amanda Kirkham[SUP] #[/SUP][SUP] 5 [/SUP], Iain B McInnes[SUP] #[/SUP][SUP] 17 [/SUP]; 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[SUP]-1[/SUP]). 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[SUP] #[/SUP][SUP] 1 2 [/SUP], Carl S Goodyear[SUP] #[/SUP][SUP] 3 [/SUP], Michelle Willicombe[SUP] #[/SUP][SUP] 4 [/SUP], Charlotte Gaskell[SUP] #[/SUP][SUP] 5 [/SUP], Stefan Siebert[SUP] 3 [/SUP], Thushan I de Silva[SUP] 6 [/SUP], Sam M Murray[SUP] 1 [/SUP], Daniel Rea[SUP] 5 [/SUP], John A Snowden[SUP] 7 [/SUP], Miles Carroll[SUP] 8 [/SUP], Sarah Pirrie[SUP] 5 [/SUP], Sarah J Bowden[SUP] 5 [/SUP], Susanna J Dunachie[SUP] 1 2 [/SUP], Alex Richter[SUP] 9 [/SUP], Zixiang Lim[SUP] 1 [/SUP], Jack Satsangi[SUP] 1 [/SUP], Gordon Cook[SUP] 10 [/SUP], Ann Pope[SUP] 5 [/SUP], Ana Hughes[SUP] 5 [/SUP], Molly Harrison[SUP] 5 [/SUP], Sean H Lim[SUP] 11 [/SUP], Paul Miller[SUP] 12 [/SUP], Paul Klenerman[SUP] 1 2 [/SUP]; PITCH consortium; Neil Basu[SUP] 3 [/SUP], Ashley Gilmour[SUP] 3 [/SUP], Sophie Irwin[SUP] 1 [/SUP], Georgina Meacham[SUP] 1 [/SUP], Thomas Marjot[SUP] 1 [/SUP], Stavros Dimitriadis[SUP] 1 [/SUP], Peter Kelleher[SUP] 13 [/SUP], Maria Prendecki[SUP] 4 [/SUP], Candice Clarke[SUP] 4 [/SUP], Paige Mortimer[SUP] 4 [/SUP], Stacey McIntyre[SUP] 4 [/SUP], Rachael Selby[SUP] 7 [/SUP], Naomi Meardon[SUP] 6 [/SUP], Dung Nguyen[SUP] 8 [/SUP], Tom Tipton[SUP] 8 [/SUP], Stephanie Longet[SUP] 8 [/SUP], Stephen Laidlaw[SUP] 8 [/SUP], Kim Orchard[SUP] 14 [/SUP], Georgina Ireland[SUP] 15 [/SUP]; CONSENSUS; David Thomas[SUP] #[/SUP][SUP] 4 [/SUP], Pamela Kearns[SUP] #[/SUP][SUP] 5 16 [/SUP], Amanda Kirkham[SUP] #[/SUP][SUP] 5 [/SUP], Iain B McInnes[SUP] #[/SUP][SUP] 17 [/SUP]; 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[SUP]-1[/SUP]). 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.