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...

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Detalles Bibliográficos
Autores: Piñana, José Luis|||0000-0001-8533-2562, López-Corral, Lucía, Martino Bofarull, Rodrigo|||0000-0001-5143-4042, Vazquez, Lourdes|||0000-0001-8191-0046, Pérez, Ariadna, Martin-Martin, Gabriel Andres, Gago, Beatriz, Sanz-Linares, Gabriela|||0000-0001-7960-7988, Sánchez Salinas, Andrés|||0000-0001-9495-3555, Villalon, Lucia B., Conesa-García, Venancio, Olave, María Teresa, Corona de Lapuerta, Magdalena|||0000-0002-6553-0171, Marcos-Corrales, Sara, Tormo, Mar|||0000-0001-9622-1649, Hernández Rivas, José Ángel|||0000-0003-4550-757X, Montoro, Juan B., Rodríguez-Fernández, Alicia, Risco-Gálvez, Irene|||0000-0002-3931-9938, Rodríguez-Belenguer, Pablo|||0000-0001-5270-7452, Hernandez-Boluda, Juan Carlos|||0000-0002-4289-3113, García Cadenas, Irene|||0000-0002-2994-9055, Ruíz-García, Montserrat M., Muñoz-Bellido, Juan Luis, Solano, Carlos|||0000-0003-3702-0817, Cedillo Cedillo, Angel|||0000-0002-0126-7044, Sureda, Anna|||0000-0002-1238-6970, Navarro, David
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:284474
Acceso en línea:https://ddd.uab.cat/record/284474
https://dx.doi.org/urn:doi:10.1186/s13045-022-01275-7
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
Pfzer-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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