Variances in BCG protection against COVID-19 mortality: A global assessment

Sarfraz, Zouina; Sarfraz, Azza; Pandav, Krunal; Makkar, Sarabjot Singh; Siddiqui, S.; Patel, Gaurav; Platero-Portillo, Tania; Singh, Bishnu Mohan; Maideen, Mohamed Iburahim Haja; Sarvepalli, Deepika; Sarfraz, Muzna; Cardona-Guzman, Jose; Sanchez-Gonzalez, Marcos A.; Chérrez-Ojeda, Iván

doi:10.1016/j.jctube.2021.100249

Cited by 7 publications

(4 citation statements)

References 28 publications

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“…Individuals vaccinated with BCG in the past five years reported lower incidence of illness and fatigue compared to BCG non-vaccinated subjects 37 and anti-SARS-CoV-2 IgG seroprevalence and selfreported COVID-19 symptoms were significantly less in healthcare workers with BCG vaccination history 38 . In contrast, other studies do not report similar benefits 39,40 perhaps due to the timing of BCG vaccination prior to SARS-CoV-2 exposure or the BCG strain used [41][42][43] .…”

Section: Introductionmentioning

confidence: 84%

BCG revaccination qualitatively and quantitatively enhances SARS-CoV-2 spike-specific neutralizing antibody and T cell responses induced by the COVISHIELDTM vaccine in SARS-CoV-2 seronegative young Indian adults

Rakshit

Adiga

Ahmed

et al. 2022

Preprint

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This study tested if prior BCG revaccination can further boost immune responses subsequently induced by an otherwise efficacious Oxford/AstraZeneca ChAdOx1nCoV-19 vaccine, referred to as COVISHIELDTM in India. We compared COVISHIELDTM induced longitudinal immune responses in 21 BCG re-vaccinees (BCG-RV) and 13 BCG-non-revaccinees (BCG-NRV), all of whom were BCG vaccinated at birth and latent tuberculosis negative, after COVISHIELDTM prime and boost with baseline samples that were collected pre-pandemic and pre-BCG revaccination. Compared to BCG-NRV, BCG-RV displayed significantly higher magnitude of spike-specific Ab and T cell responses, including a greater proportion of high responders; better quality polyfunctional CD4 and CD8 T cells that persisted and a more robust Ab and T cell response to the Delta mutant of SARS-CoV-2 highlighting greater breadth. Mechanistically, BCG adjuvant effects on COVISHIELDTM induced adaptive responses was associated with more robust innate responses to pathogen-associated-molecular-patterns through TNF-α and IL-1β secretion. This study highlights the potential of using a cheap and globally available vaccine as an adjuvant to enhance heterologous adaptive immune responses induced by COVIDSHIELDTM and other emerging vaccines.

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Section: Introductionmentioning

confidence: 84%

BCG revaccination qualitatively and quantitatively enhances SARS-CoV-2 spike-specific neutralizing antibody and T cell responses induced by the COVISHIELDTM vaccine in SARS-CoV-2 seronegative young Indian adults

Rakshit

Adiga

Ahmed

et al. 2022

Preprint

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“…The study demonstrated the immunomodulatory properties of BCG vaccination, which may play a protective role against inflammatory diseases in the elderly population [ 100 ]. Sarfraz et al [ 101 ] ( Table 1 ) analyzed mortality and death dynamics due to COVID-19 during the initial phase of the pandemic in the context of the presence or absence/limitation of a BCG vaccination program. A specially designed methodology was used to calculate mortality rates, taking into account two reference points: the date on which at least 100 confirmed cases were reported in a country (with 31 March as the cut-off date) and the 30-day period from the 100th case-day.…”

Section: Does Bcg Have the Potential To Reduce The Pandemic’s Impact?mentioning

confidence: 99%

“…It turned out that the first 10 countries with the highest death rate recommend BCG only for certain narrow groups of patients in their national vaccination programs. In contrast, the last 10 countries in the ranking (with the lowest dynamics of deaths in the initial phase) offered BCG vaccination for all citizens at birth [ 101 ]. In addition, in a paper by Charoenlap et al [ 102 ], it was reported (based on epidemiological data) that countries with a current universal BCG policy have a lower median mortality compared to countries that have had a universal BCG policy in the past [ 102 ].…”

Section: Does Bcg Have the Potential To Reduce The Pandemic’s Impact?mentioning

confidence: 99%

BCG and SARS-CoV-2—What Have We Learned?

Kulesza

Koziński³

et al. 2022

Vaccines

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Despite controversy over the protective effect of the BCG (Bacille Calmette-Guérin) vaccine in preventing pulmonary tuberculosis (TB) in adults, it has been used worldwide since 1921. Although the first reports in the 1930s had noted a remarkable decrease in child mortality after BCG immunization, this could not be explained solely by a decrease in mortality from TB. These observations gave rise to the suggestion of nonspecific beneficial effects of BCG vaccination, beyond the desired protection against M. tuberculosis. The existence of an innate immunity-training mechanism based on epigenetic changes was demonstrated several years ago. The emergence of the pandemic caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) in 2019 revived the debate about whether the BCG vaccine can affect the immune response against the virus or other unrelated pathogens. Due to the mortality of the coronavirus disease (COVID-19), it is important to verify each factor that may have a potential protective value against the severe course of COVID-19, complications, and death. This paper reviews the results of numerous retrospective studies and prospective trials which shed light on the potential of a century-old vaccine to mitigate the pandemic impact of the new virus. It should be noted, however, that although there are numerous studies intending to verify the hypothesis that the BCG vaccine may have a beneficial effect on COVID-19, there is no definitive evidence on the efficacy of the BCG vaccine against SARS-CoV-2.

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“…It would be beneficial for the investigation to be expanded in clinical settings as the outcome would not only provide essential findings on protection against COVID-19 but most importantly on the dual protection during TB-COVID-19 coinfection which is crucial in high TB burden countries. So far, the evidence from several preclinical studies is pointing towards the BCG vaccine’s ability to promote protection against the SARS-CoV-2 virus ( 102 – 105 ). Nevertheless, more evidence especially from a larger setting is needed to provide a stronger platform for this idea to be applicable.…”

Section: Covid-19 and Tuberculosismentioning

confidence: 99%

The COVID-19/Tuberculosis Syndemic and Potential Antibody Therapy for TB Based on the Lessons Learnt From the Pandemic

et al. 2022

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2020 will be marked in history for the dreadful implications of the COVID-19 pandemic that shook the world globally. The pandemic has reshaped the normality of life and affected mankind in the aspects of mental and physical health, financial, economy, growth, and development. The focus shift to COVID-19 has indirectly impacted an existing air-borne disease, Tuberculosis. In addition to the decrease in TB diagnosis, the emergence of the TB/COVID-19 syndemic and its serious implications (possible reactivation of latent TB post-COVID-19, aggravation of an existing active TB condition, or escalation of the severity of a COVID-19 during TB-COVID-19 coinfection), serve as primary reasons to equally prioritize TB. On a different note, the valuable lessons learnt for the COVID-19 pandemic provide useful knowledge for enhancing TB diagnostics and therapeutics. In this review, the crucial need to focus on TB amid the COVID-19 pandemic has been discussed. Besides, a general comparison between COVID-19 and TB in the aspects of pathogenesis, diagnostics, symptoms, and treatment options with importance given to antibody therapy were presented. Lastly, the lessons learnt from the COVID-19 pandemic and how it is applicable to enhance the antibody-based immunotherapy for TB have been presented.

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Variances in BCG protection against COVID-19 mortality: A global assessment

Cited by 7 publications

References 28 publications

BCG revaccination qualitatively and quantitatively enhances SARS-CoV-2 spike-specific neutralizing antibody and T cell responses induced by the COVISHIELDTM vaccine in SARS-CoV-2 seronegative young Indian adults

BCG revaccination qualitatively and quantitatively enhances SARS-CoV-2 spike-specific neutralizing antibody and T cell responses induced by the COVISHIELDTM vaccine in SARS-CoV-2 seronegative young Indian adults

BCG and SARS-CoV-2—What Have We Learned?

The COVID-19/Tuberculosis Syndemic and Potential Antibody Therapy for TB Based on the Lessons Learnt From the Pandemic

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