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: 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:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p16563
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/16563
Access Level: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
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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