학술논문
SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease
Document Type
Article
Author
Barnes, Eleanor; Goodyear, Carl S.; Willicombe, Michelle; Gaskell, Charlotte; Siebert, Stefan; I de Silva, Thushan; Murray, Sam M.; Rea, Daniel; Snowden, John A.; Carroll, Miles; Pirrie, Sarah; Bowden, Sarah J.; Dunachie, Susanna J.; Richter, Alex; Lim, Zixiang; Satsangi, Jack; Cook, Gordon; Pope, Ann; Hughes, Ana; Harrison, Molly; Lim, Sean H.; Miller, Paul; Klenerman, Paul; Basu, Neil; Gilmour, Ashley; Irwin, Sophie; Meacham, Georgina; Marjot, Thomas; Dimitriadis, Stavros; Kelleher, Peter; Prendecki, Maria; Clarke, Candice; Mortimer, Paige; McIntyre, Stacey; Selby, Rachael; Meardon, Naomi; Nguyen, Dung; Tipton, Tom; Longet, Stephanie; Laidlaw, Stephen; Orchard, Kim; Ireland, Georgina; Thomas, David; Kearns, Pamela; Kirkham, Amanda; McInnes, Iain B.
Source
Nature Medicine; 20230101, Issue: Preprints p1-15, 15p
Subject
Language
ISSN
10788956; 1546170X
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−1). 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.