Barnes, Eleanor, Goodyear, Carl S, Willicombe, Michelle, Gaskell, Charlotte, Siebert, Stefan, de Silva, Thushan I, Murray, Sam M, Rea, Daniel, Snowden, John A, Carroll, Miles et al (show 37 more authors)
(2023)
SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease.
NATURE MEDICINE, 29 (7).
1760-+.
Abstract
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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PITCH consortium, CONSENSUS, OCTAVE Collaborative Group, Humans, Antibodies, Viral, Vaccination, COVID-19, SARS-CoV-2, COVID-19 Vaccines, BNT162 Vaccine, ChAdOx1 nCoV-19 |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 06 Feb 2024 11:10 |
| Last Modified: | 06 Feb 2024 11:10 |
| DOI: | 10.1038/s41591-023-02414-4 |
| Open Access URL: | https://doi.org/10.1038/s41591-023-02414-4 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3178434 |
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