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 by...

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Detalles Bibliográficos
Autores: Pinana, JL, Lopez-Corral, L, Martino, R, Vazquez, L, Perez, A, Martin-Martin, G, Gago, B, Sanz-Linares, G, Sanchez-Salinas, A, Villalon, L, Conesa-Garcia, V, Olave, MT, Corona, M, Marcos-Corrales, S, Tormo, M, Hernandez-Rivas, JA, Montoro, J, Rodriguez-Fernandez, A, Risco-Galvez, I, Rodriguez-Belenguer, P, Hernandez-Boluda, JC, Garcia-Cadenas, I, Ruiz-Garcia, M, Munoz-Bellido, JL, Solano, C, Cedillo, A, Sureda, A, Navarro, D
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p9893
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=9893
https://ddd.uab.cat/record/284474
Access Level:acceso abierto
Palabra clave:SARS-CoV-2 vaccines
Breakthrough SARS-CoV-2 infection
Correlates of protection
Hematological malignancies
Allogeneic stem cell transplantation
Autologous stem cell transplantation
COVID-19
Vaccine
Immunocompromised patients
Moderna mRNA-1273
Pfizer-BioNTech BNT162b2
Descripción
Sumario: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.

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