SARS-CoV-2 vaccination and risk of infectious diseases in hospitalized older patients

Balducci, Marco; Locatelli, Edoardo; Barbieri, Maria Giorgia; Ferrighi, Elena; Scardina, Serena; Barrile, Giulia; Sganga, Federica; Mattioli, Irene; Remelli, Francesca; Maggi, Stefania; Volpato, Stefano; Trevisan, Caterina

doi:10.1007/s41999-023-00902-x

Cited by 3 publications

References 31 publications

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Immune signature in vaccinated versus non-vaccinated aged people with COVID-19 pneumonia

Alessandra,

Sara,

Claudia

et al. 2024

J Transl Med

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Background A definition of the immunological features of COVID-19 pneumonia is needed to support clinical management of aged patients. In this study, we characterized the humoral and cellular immune responses in presence or absence of SARS-CoV-2 vaccination, in aged patients admitted to the IRCCS San Raffaele Hospital (Italy) for COVID-19 pneumonia between November 2021 and March 2022. Methods The study was approved by local authorities. Disease severity was evaluated according to WHO guidelines. We tested: (A) anti-SARS-CoV-2 humoral response (anti-RBD-S IgG, anti-S IgM, anti-N IgG, neutralizing activity against Delta, BA1, BA4/5 variants); (B) Lymphocyte B, CD4 and CD8 T-cell phenotype; (C) plasma cytokines. The impact of vaccine administration and different variants on the immunological responses was evaluated using standard linear regression models and Tobit models for censored outcomes adjusted for age, vaccine doses and gender. Result We studied 47 aged patients (median age 78.41), 22 (47%) female, 33 (70%) older than 70 years (elderly). At hospital admission, 36% were unvaccinated (VAC no ), whilst 63% had received 2 (VAC 2 ) or 3 doses (VAC 3 ) of vaccine. During hospitalization, WHO score > 5 was higher in unvaccinated (14% in VAC 3 vs. 43% in VAC 2 and 44% VACno). Independently from vaccination doses and gender, elderly had overall reduced anti-SARS-CoV-2 humoral response (IgG-RBD-S, p = 0.0075). By linear regression, the anti-RBD-S ( p = 0.0060), B ( p = 0.0079), CD8 ( p = 0.0043) and Th2 cell counts ( p = 0.0131) were higher in VAC 2 + 3 compared to VAC no . Delta variant was the most representative in VAC 2 ( n = 13/18, 72%), detected in 41% of VAC no , whereas undetected in VAC 3, and anti-RBD-S production was higher in VAC 2 vs. VAC no ( p = 0.0001), alongside neutralization against Delta ( p = 0141), BA1 ( p = 0.0255), BA4/5 ( p = 0.0162). Infections with Delta also drove an increase of pro-inflammatory cytokines (IFN-α, p = 0.0463; IL-6, p = 0.0010). Conclusions Administration of 3 vaccination doses reduces the severe symptomatology in aged and elderly. Vaccination showed a strong association with anti-SARS-CoV-2 humoral response and an expansion of Th2 T-cells populations, independently of age. Delta variants and number of vaccine doses affected the magnitu...

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Immune signature in vaccinated versus non-vaccinated aged people with COVID-19 pneumonia

Alessandra,

Sara,

Claudia

et al. 2024

J Transl Med

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Immune signature in vaccinated versus non-vaccinated aged people with COVID-19 pneumonia

Ruggiero,

Caldrer,

Pastori

et al. 2024

Preprint

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Background A definition of the immunological features of COVID-19 pneumonia is needed to support clinical management of aged patients. In this study, we characterized the humoral and cellular immune responses in presence or absence of SARS-CoV-2 vaccination, in aged patients admitted to the IRCCS San Raffaele Hospital (Italy) for COVID-19 pneumonia between November 2021 and March 2022. Methods The study was approved by local authorities. Disease severity was evaluated according to WHO guidelines. We tested: A) anti-SARS-CoV-2 humoral response (anti-RBD-S IgG, anti-S IgM, anti-N IgG, neutralizing activity against Delta, BA1, BA4/5 variants); B) Lymphocyte B, CD4 and CD8 T-cell phenotype; C) plasma cytokines. The impact of vaccine administration and different variants on the immunological responses was evaluated using standard linear regression models and Tobit models for censored outcomes adjusted for age, vaccine doses and gender. Result We studied 47 aged patients (median age 78.41), 22 (47%) female, 33 (70%) older than 70 years (elderly). At hospital admission, 36% were unvaccinated (VACno), whilst 63% had received 2 (VAC2) or 3 doses (VAC3) of vaccine. During hospitalization, WHO score > 5 was higher in unvaccinated (14% in VAC3 vs 43% in VAC2 and 44% VACno). Independently from vaccination doses and gender, elderly had overall reduced anti-SARS-CoV-2 humoral response (IgG-RBD-S, p = 0.0075). By linear regression, the anti-RBD-S (p = 0.0060), B (p = 0.0079), CD8 (p = 0.0043) and Th2 cell counts (p = 0.0131) were higher in VAC2 + 3 compared to VACno. Delta variant was the most representative in VAC2 (n = 13/18, 72%), detected in 41% of VACno, whereas undetected in VAC3, and anti-RBD-S production was higher in VAC2 vs VACno (p = 0.0001), alongside neutralization against Delta (p = 0141), BA1 (p = 0.0255), BA4/5 (p = 0.0162). Infections with Delta also drove an increase of pro-inflammatory cytokines (IFN-α, p = 0.0463; IL-6, p = 0.0010). Conclusions Administration of 3 vaccination doses reduces the severe symptomatology in aged and elderly. Vaccination showed a strong association with anti-SARS-CoV-2 humoral response and an expansion of Th2 T-cells populations, independently of age. Delta variants and number of vaccine doses affected the magnitude of the humoral response against the original SARS-CoV-2 and emerging variants. A systematic surveillance of the emerging variants is paramount to define future vaccination strategies.

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Assessing the impact of vaccines on COVID-19 efficacy in survival rates: a survival analysis approach for clinical decision support

González Rodríguez,

Oprescu,

Muñoz Lezcano

et al. 2024

Front. Public Health

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BackgroundThe global COVID-19 pandemic, caused by the SARS-CoV-2 virus, has presented significant challenges to healthcare systems worldwide.ObjectiveThis study, based on an analysis of a cohort from the Public Health System of Andalusia (Spain), aims to evaluate how vaccination affects case-fatality rate in patients hospitalized due to COVID-19 infection in Andalusia.MethodsThe cohort consists of 37,274 individuals after applying the inclusion criteria. We conducted survival analyses employing the Cox proportional hazards models and generated adjusted survival curves to examine the outcomes. The analyses were performed from three perspectives: vaccinated vs. unvaccinated patients, vaccinated and unvaccinated patients grouped by age, and stratified by vaccination status.ResultsResults indicate a substantial correlation between vaccination and a 20% reduction in the risk of case-fatality. Age-specific effects reveal varying degrees of protection across different age groups.ConclusionThese findings emphasize the pivotal role of vaccination status in COVID-19 risk assessment, supporting the development of a clinical decision support system for accurate predictions and optimizing healthcare management at admission.

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SARS-CoV-2 vaccination and risk of infectious diseases in hospitalized older patients

Cited by 3 publications

References 31 publications

Immune signature in vaccinated versus non-vaccinated aged people with COVID-19 pneumonia

Immune signature in vaccinated versus non-vaccinated aged people with COVID-19 pneumonia

Immune signature in vaccinated versus non-vaccinated aged people with COVID-19 pneumonia

Assessing the impact of vaccines on COVID-19 efficacy in survival rates: a survival analysis approach for clinical decision support

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