Persistence and baseline determinants of seropositivity and reinfection rates in health care workers up to 12.5 months after COVID-19

Dobaño, Carlota; Ramírez‐Morros, Anna; Alonso, Selena; Vidal‐Alaball, Josep; Ruiz‐Olalla, Gemma; Vidal, Marta; Rubio, Rocío; Cascant, Emma; Parras, Daniel; Rodrigo, Natalia; Serra, Pau; Carolis, Carlo; Santamaría, Pere; Forcada, Anna; Mendioroz, Jacobo; Aguilar, Ruth; Moncunill, Gemma; Ruiz‐Comellas, Anna

doi:10.1186/s12916-021-02032-2

Cited by 44 publications

(27 citation statements)

References 24 publications

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“…Recent populationbased studies during the pandemic showed that smoking is a major factor associated with lower response to the SARS-CoV-2 vaccine [45]. Other recent studies showed that smokers had lower antibody titers, suggesting an impaired humoral response [46][47][48]. Our results contribute to the above evidence and show that smoking is a significant negative factor for impaired humoral immunity in vaccinated cancer patients.…”

Section: Discussionsupporting

confidence: 75%

Responses to SARS-CoV-2 Vaccination in Patients with Cancer (ReCOVer Study): A Prospective Cohort Study of the Hellenic Cooperative Oncology Group

Linardou

Spanakis

Koliou

et al. 2021

Cancers

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Data on the effectiveness and safety of approved SARS-CoV-2 vaccines in cancer patients are limited. This observational, prospective cohort study investigated the humoral immune response to SARS-CoV-2 vaccination in 232 cancer patients from 12 HeCOG-affiliated oncology departments compared to 100 healthcare volunteers without known active cancer. The seropositivity rate was measured 2–4 weeks after two vaccine doses, by evaluating neutralising antibodies against the SARS-CoV-2 spike protein using a commercially available immunoassay. Seropositivity was defined as ≥33.8 Binding-Antibody-Units (BAU)/mL. A total of 189 patients and 99 controls were eligible for this analysis. Among patients, 171 (90.5%) were seropositive after two vaccine doses, compared to 98% of controls (p = 0.015). Most seronegative patients were males (66.7%), >70-years-old (55.5%), with comorbidities (61.1%), and on active treatment (88.9%). The median antibody titers among patients were significantly lower than those of the controls (523 vs. 2050 BAU/mL; p < 0.001). The rate of protective titers was 54.5% in patients vs. 97% in controls (p < 0.001). Seropositivity rates and IgG titers in controls did not differ for any studied factor. In cancer patients, higher antibody titers were observed in never-smokers (p = 0.006), women (p = 0.022), <50-year-olds (p = 0.004), PS 0 (p = 0.029), and in breast or ovarian vs. other cancers. Adverse events were comparable to registration trials. In this cohort study, although the seropositivity rate after two vaccine doses in cancer patients seemed satisfactory, their antibody titers were significantly lower than in controls. Monitoring of responses and further elucidation of the clinical factors that affect immunity could guide adaptations of vaccine strategies for vulnerable subgroups.

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Section: Discussionsupporting

confidence: 75%

Responses to SARS-CoV-2 Vaccination in Patients with Cancer (ReCOVer Study): A Prospective Cohort Study of the Hellenic Cooperative Oncology Group

Linardou

Spanakis

Koliou

et al. 2021

Cancers

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“…We followed up a total of 445 health care workers (HCW, n=353 from hospital [6] and n=92 from primary care [7] ) in Barcelona, Spain, with different histories of prior COVID-19 exposure. Venous or finger prick blood was collected at different time points before and after immunization with the mRNA-1273 (Spykevax) [1] or the BNT162b2 (Comirnaty) [8] , products from Moderna Biotech and Pfizer-BioNTech, respectively.…”

Section: Methodsmentioning

confidence: 99%

Spike-based COVID-19 immunization increases antibodies to nucleocapsid antigen

Dobaño

Jiménez

Rubio

et al. 2022

Translational Research

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Antibodies to the nucleocapsid (N) antigen are suggested to be used to monitor infections after COVID-19 vaccination, as first generation subunit vaccines are based on the spike (S) protein. We used multiplex immunoassays to simultaneously measure antibody responses to different fragments of the SARS-CoV-2 S and N antigens for evaluating the immunogenicity of the mRNA-1273 (Spykevax) and the BNT162b2 (Comirnaty) vaccines in 445 health care workers. We report a >4-fold increase post-vaccination of IgG levels to the full length (N FL) and C-terminus of N (N CT) in 5.2% and 18.0% of individuals, respectively, and of IgA in 3.6% (N FL) and 9.0% (N CT) of them. The increase in IgG levels and avidity was more pronounced after Spykevax than Comirnaty vaccination (36.2% vs 13.1% for N CT, and 10.6% vs 3.7% for N FL). Data suggest the induction of cross-reactive antibodies against the N CT region after administering these S-based vaccines, and this should be taken into account when using N seropositivity to detect breakthroughs.

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“…An early study reported a rapid rise and subsequent fall of antibodies, which stabilized at later time points, indicating that immunity against SARS-CoV-2 lasted for at least four months after infection 7 . Two later studies extended this protection up to at least six months 8,2 , while recent estimates venture that it persists for at least a year 9,10 . However, knowledge of the kinetics and nature of the immune response to SARS-CoV-2 infection is still limited, and larger longitudinal studies are needed to define the half-life of antibodies against SARS-CoV-2 and their respective kinetics.…”

Section: Introductionmentioning

confidence: 98%

Antibody kinetics to SARS-CoV-2 at 13.5 months, by disease severity

Violán

Quirant

Lamonja-Vicente

et al. 2021

Preprint

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Background: Understanding humoral responses and seroprevalence in SARS-CoV-2 infection is essential for guiding vaccination strategies in both infected and uninfected individuals. Methods: We determine the kinetics of IgM against the nucleocapsid (N) and IgG against the spike (S) and N proteins of SARS-CoV-2 in a cohort of 860 health professionals (healthy and infected) in northern Barcelona. We model the kinetics of IgG and IgM at nine time points over 13.5 months from infection, using non-linear mixed models by sex and clinical disease severity. Results: Of the 781 participants who were followed up, 478 (61.2%) became infected with SARS-CoV-2. Significant differences were found for the three antibodies by disease severity and sex. At day 270 after diagnosis, median IgM(N) levels were already below the positivity threshold in patients with asymptomatic and mild-moderate disease, while IgG(N, S) levels remained positive to days 360 and 270, respectively. Kinetic modelling showed a general rise in both IgM(N) and IgG(N) levels up to day 30, followed by a decay whose rate depended on disease severity. IgG(S) levels increased at day 15 and remained relatively constant over time. Conclusions: We describe kinetic models of IgM(N) and IgG(N, S) SARS-CoV-2 antibodies at 13.5 months from infection and disease spectrum. Our analyses delineate differences in the kinetics of IgM and IgG over a year and differences in the levels of IgM and IgG as early as 15 days from symptoms onset in severe cases. These results can inform public health policies around vaccination criteria.

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Persistence and baseline determinants of seropositivity and reinfection rates in health care workers up to 12.5 months after COVID-19

Cited by 44 publications

References 24 publications

Responses to SARS-CoV-2 Vaccination in Patients with Cancer (ReCOVer Study): A Prospective Cohort Study of the Hellenic Cooperative Oncology Group

Responses to SARS-CoV-2 Vaccination in Patients with Cancer (ReCOVer Study): A Prospective Cohort Study of the Hellenic Cooperative Oncology Group

Spike-based COVID-19 immunization increases antibodies to nucleocapsid antigen

Antibody kinetics to SARS-CoV-2 at 13.5 months, by disease severity

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