SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders
Background: the clinical efficacy of SARS-CoV-2 vaccines according to antibody response in immunosuppressed patients such as hematological patients has not yet been established. Patients and methods: a prospective multicenter registry-based cohort study conducted from December 2020 to December 2021...
| Autores: | ; ; ; |
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| Tipo de documento: | Artículo |
| Estado: | Published version |
| Fecha de publicación: | 2022 |
| País: | España |
| Institución: | Universitat Pompeu Fabra |
| Repositorio: | Repositorio Digital de la UPF |
| OAI Identifier: | oai:repositori.upf.edu:10230/54914 |
| Acceso en línea: | http://hdl.handle.net/10230/54914 http://dx.doi.org/10.1186/s13045-022-01275-7 |
| Nivel de acceso: | Acceso abierto |
| Palabra clave: | Allogeneic stem cell transplantation Autologous stem cell transplantation Breakthrough SARS-CoV-2 infection COVID-19 Correlates of protection Hematological malignancies Immunocompromised patients Moderna mRNA-1273 Pfizer-BioNTech BNT162b2 SARS-CoV-2 vaccines Vaccine |
| _version_ | 1878742951826292736 |
|---|---|
| author | Piñana, José Luis |
| author2 | Rodríguez-Belenguer, Pablo Navarro, David Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC) |
| author2_role | author author author |
| author_browse | Navarro, David Piñana, José Luis Rodríguez-Belenguer, Pablo Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC) |
| author_facet | Piñana, José Luis Rodríguez-Belenguer, Pablo Navarro, David Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC) |
| author_role | author |
| collection | Repositorio Digital de la UPF |
| description | Background: the clinical efficacy of SARS-CoV-2 vaccines according to antibody response in immunosuppressed patients such as hematological patients has not yet been established. Patients and methods: a prospective multicenter registry-based cohort study conducted from December 2020 to December 2021 by the Spanish transplant and cell therapy group was used to analyze the relationship of antibody response at 3-6 weeks after full vaccination (2 doses) with breakthrough SARS-CoV-2 infection in 1394 patients with hematological disorders. Results: at a median follow-up of 165 days after complete immunization, 37 out of 1394 (2.6%) developed breakthrough SARS-CoV-2 infection at median of 77 days (range 7-195) after full vaccination. The incidence rate was 6.39 per 100 persons-year. Most patients were asymptomatic (19/37, 51.4%), whereas only 19% developed pneumonia. The mortality rate was 8%. Lack of detectable antibodies at 3-6 weeks after full vaccination was the only variable associated with breakthrough infection in multivariate logistic regression analysis (Odds Ratio 2.35, 95% confidence interval 1.2-4.6, p = 0.012). Median antibody titers were lower in cases than in non-cases [1.83 binding antibody units (BAU)/mL (range 0-4854.93) vs 730.81 BAU/mL (range 0-56,800), respectively (p = 0.007)]. We identified 250 BAU/mL as a cutoff above which incidence and severity of the infection were significantly lower. Conclusions: our study highlights the benefit of developing an antibody response in these highly immunosuppressed patients. Level of antibody titers at 3 to 6 weeks after 2-dose vaccination links with protection against both breakthrough infection and severe disease for non-Omicron SARS-CoV-2 variants. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_ff41367b6ee6c567dfd0fd1d4b96b879 |
| institution | Universitat Pompeu Fabra |
| instname_str | Universitat Pompeu Fabra |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:repositori.upf.edu:10230/54914 |
| publishDate | 2022 |
| publishDateSort | 2022 |
| publisher | BioMed Central |
| publisherStr | BioMed Central |
| reponame_str | Repositorio Digital de la UPF |
| spelling | SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders Piñana, José Luis Rodríguez-Belenguer, Pablo Navarro, David Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC) Allogeneic stem cell transplantation Autologous stem cell transplantation Breakthrough SARS-CoV-2 infection COVID-19 Correlates of protection Hematological malignancies Immunocompromised patients Moderna mRNA-1273 Pfizer-BioNTech BNT162b2 SARS-CoV-2 vaccines Vaccine Background: the clinical efficacy of SARS-CoV-2 vaccines according to antibody response in immunosuppressed patients such as hematological patients has not yet been established. Patients and methods: a prospective multicenter registry-based cohort study conducted from December 2020 to December 2021 by the Spanish transplant and cell therapy group was used to analyze the relationship of antibody response at 3-6 weeks after full vaccination (2 doses) with breakthrough SARS-CoV-2 infection in 1394 patients with hematological disorders. Results: at a median follow-up of 165 days after complete immunization, 37 out of 1394 (2.6%) developed breakthrough SARS-CoV-2 infection at median of 77 days (range 7-195) after full vaccination. The incidence rate was 6.39 per 100 persons-year. Most patients were asymptomatic (19/37, 51.4%), whereas only 19% developed pneumonia. The mortality rate was 8%. Lack of detectable antibodies at 3-6 weeks after full vaccination was the only variable associated with breakthrough infection in multivariate logistic regression analysis (Odds Ratio 2.35, 95% confidence interval 1.2-4.6, p = 0.012). Median antibody titers were lower in cases than in non-cases [1.83 binding antibody units (BAU)/mL (range 0-4854.93) vs 730.81 BAU/mL (range 0-56,800), respectively (p = 0.007)]. We identified 250 BAU/mL as a cutoff above which incidence and severity of the infection were significantly lower. Conclusions: our study highlights the benefit of developing an antibody response in these highly immunosuppressed patients. Level of antibody titers at 3 to 6 weeks after 2-dose vaccination links with protection against both breakthrough infection and severe disease for non-Omicron SARS-CoV-2 variants. BioMed Central http://hdl.handle.net/10230/54914 http://dx.doi.org/10.1186/s13045-022-01275-7 |
| spellingShingle | SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders Piñana, José Luis Allogeneic stem cell transplantation Autologous stem cell transplantation Breakthrough SARS-CoV-2 infection COVID-19 Correlates of protection Hematological malignancies Immunocompromised patients Moderna mRNA-1273 Pfizer-BioNTech BNT162b2 SARS-CoV-2 vaccines Vaccine |
| status_str | publishedVersion |
| title | SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders |
| title_full | SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders |
| title_fullStr | SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders |
| title_full_unstemmed | SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders |
| title_short | SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders |
| title_sort | SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders |
| topic | Allogeneic stem cell transplantation Autologous stem cell transplantation Breakthrough SARS-CoV-2 infection COVID-19 Correlates of protection Hematological malignancies Immunocompromised patients Moderna mRNA-1273 Pfizer-BioNTech BNT162b2 SARS-CoV-2 vaccines Vaccine |
| topic_facet | Allogeneic stem cell transplantation Autologous stem cell transplantation Breakthrough SARS-CoV-2 infection COVID-19 Correlates of protection Hematological malignancies Immunocompromised patients Moderna mRNA-1273 Pfizer-BioNTech BNT162b2 SARS-CoV-2 vaccines Vaccine |
| url | http://hdl.handle.net/10230/54914 http://dx.doi.org/10.1186/s13045-022-01275-7 |