Long-Term Evolution of SARS-CoV-2 in an Immunocompromised Patient with Non-Hodgkin Lymphoma

Borges, Vítor; Isidro, Joana; Cunha, Mário; Cochicho, Daniela; Martins, Luís; Banha, Luís; Figueiredo, Margarida; Rebelo, Leonor; Trindade, Maria Céu; Duarte, Sílvia; Vieira, Luı́s; Alves, Maria João; Costa, Inês; Guiomar, Raquel; Santos, Madalena; Côrte‐Real, Rita; Dias, André; Póvoas, Diana; Cabo, J. F. González; Figueiredo, Carlos; Manata, Maria José; Maltêz, Fernando; Silva, Maria Gomes da; Gomes, João Paulo

doi:10.1128/msphere.00244-21

Cited by 81 publications

(66 citation statements)

References 22 publications

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“…Incomplete coverage with the vaccine leads to infection of immunocompromised persons who are likely to harbor the virus for prolonged periods (or chronically), allowing for mutations that are then selected for immune evasion and better fitness to the human host. 1 The new variants are sufficiently altered structurally such that neither prior SARS-CoV-2 infection or even much higher levels of vaccine-induced antibodies are protective.In this issue of JAMA, Spitzer and colleagues assess the effect of a booster dose of the mRNA vaccine BNT162b2 (Pfizer-BioNTech) on acquisition of SARS-CoV-2 infection among health care workers in a tertiary medical center in Tel Aviv, Israel. 2 Israel achieved high vaccination coverage of most health care workers, who were prioritized for immunization receiving both doses of the BNT162b2 vaccine by the end of January 2021.…”

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confidence: 99%

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Booster Vaccination to Reduce SARS-CoV-2 Transmission and Infection

Wald

2022

JAMA

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The vaccines to prevent COVID-19 are remarkable for their safety, efficacy, and pace of development. Initial enthusiasm that followed the release of the preliminary results that formed the basis for distribution of the vaccines under Emergency Use Authorization (EUA) has been dampened by the inequity in access to the vaccines across the globe, vaccine hesitancy, and emergence of variants that partly evade vaccine-induced antibodies. These factors are related, and all 3 contribute to ongoing morbidity, mortality, and societal disruption related to SARS-CoV-2 in much of the world. Incomplete coverage with the vaccine leads to infection of immunocompromised persons who are likely to harbor the virus for prolonged periods (or chronically), allowing for mutations that are then selected for immune evasion and better fitness to the human host. 1 The new variants are sufficiently altered structurally such that neither prior SARS-CoV-2 infection or even much higher levels of vaccine-induced antibodies are protective.In this issue of JAMA, Spitzer and colleagues assess the effect of a booster dose of the mRNA vaccine BNT162b2 (Pfizer-BioNTech) on acquisition of SARS-CoV-2 infection among health care workers in a tertiary medical center in Tel Aviv, Israel. 2 Israel achieved high vaccination coverage of most health care workers, who were prioritized for immunization receiving both doses of the BNT162b2 vaccine by the end of January 2021. As such, when the Delta variant arose in June 2021, most health care workers had received their second dose of vaccine about 6 months earlier, and emerging data showed that the antibody titers in response to vaccination had waned.Although Spitzer et al initially aimed to provide a booster vaccine dose only for persons with antibody titers less than the median, universal boosting was recommended by health authorities. The investigators enrolled a cohort of health care workers who had completed a 2-dose vaccination series of BNT162b2 and subsequently received a booster dose of the vaccine. Infections in the cohort were monitored by SARS-CoV-2 polymerase chain reaction (PCR) tests every 2 weeks regardless of symptoms. Anti-SARS-CoV-2 spike protein receptorbinding domain (anti-S1-RBD) was measured at baseline and 1 month after the booster.The study cohort included 1928 health workers, and 1650 (85.6%) received a booster dose during the study. The median overall follow-up was 39 days, and the median follow-up of boosted persons, beginning 7 or more days after the receipt of the booster vaccination, was 26 days. Overall, 3552 PCR tests were obtained with 51% before and 49% after boosting. A total of 44 persons tested positive for SARS-CoV-2 during

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Booster Vaccination to Reduce SARS-CoV-2 Transmission and Infection

Wald

2022

JAMA

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“…The mutation is located in close proximity to residue 144, which is deleted in the Alpha variant. A 141-144 deletion has also been reported in several chronically SARS-CoV-2 infected immunocompromised individuals 20 . Furthermore, a 143-145 deletion is also observed in the Omicron variant 21 .…”

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confidence: 92%

Fusogenicity and neutralization sensitivity of the SARS-CoV-2 Delta sublineage AY.4.2

Saunders

Planas

Bolland

et al. 2022

Preprint

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SARS-CoV-2 lineages are continuously evolving. As of December 2021, the AY.4.2 Delta sub-lineage represented 20 % of sequenced strains in UK and has been detected in dozens of countries. It has since then been supplanted by the Omicron variant. AY.4.2 displays three additional mutations (T95I, Y145H and A222V) in the N-terminal domain (NTD) of the spike when compared to the original Delta variant (B.1.617.2) and remains poorly characterized. Here, we analyzed the fusogenicity of the AY.4.2 spike and the sensitivity of an authentic AY.4.2 isolate to neutralizing antibodies. The AY.4.2 spike exhibited similar fusogenicity and binding to ACE2 than Delta. The sensitivity of infectious AY.4.2 to a panel of monoclonal neutralizing antibodies was similar to Delta, except for the anti-RBD Imdevimab, which showed incomplete neutralization. Sensitivity of AY.4.2 to sera from individuals having received two or three doses of Pfizer or two doses of AstraZeneca vaccines was reduced by 1.7 to 2.1 fold, when compared to Delta. Our results suggest that mutations in the NTD remotely impair the efficacy of anti-RBD antibodies. The temporary spread of AY.4.2 was not associated with major changes in spike function but rather to a partially reduced neutralization sensitivity.

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“…More and more studies appear where the ability to mutate the SARS-CoV-2 virus is analyzed in immunocompromised patients such as lymphomas 15,16 . Moreover, in this study carried out by Siqueira et al 17 , the authors concluded that cancer patients had a greater capacity to develop SARS-CoV-2 variants, with four globally dominant SARS-CoV-2 haplotypes (C241T, C3037T, C14408T and A23403G) as the majority of consensus sequences analyzed.…”

Section: Sars-cov-2 Variants and Cancer Patientsmentioning

confidence: 99%

Coronavirus Pandemics Era and Cancer Patients

Tomás

2021

Rev. Bras. Cancerol.

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O vírus SARS-CoV-2 e suas variantes (Delta e Mu) não serão os últimos a provocarem pandemia. Para combater as novas espécies do vírus e suas variantes, será necessário aumentar os esforços de vacinação, melhorar os sistemas de vigilância, usar o diagnóstico de forma eficiente e notificar as autoridades de saúde sistematicamente. Os pacientes com câncer podem desenvolver as novas variantes do vírus SARS-CoV-2, mas a proteção total é a chave para que isso não aconteça. O futuro das novas pandemias em todo o mundo dependerá do desenvolvimento de vacinas contra pancoronavírus e a implementação dessas medidas no mundo inteiro.

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Long-Term Evolution of SARS-CoV-2 in an Immunocompromised Patient with Non-Hodgkin Lymphoma

Cited by 81 publications

References 22 publications

Booster Vaccination to Reduce SARS-CoV-2 Transmission and Infection

Booster Vaccination to Reduce SARS-CoV-2 Transmission and Infection

Fusogenicity and neutralization sensitivity of the SARS-CoV-2 Delta sublineage AY.4.2

Coronavirus Pandemics Era and Cancer Patients

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