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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Autores: Piñana, José Luis, Rodríguez-Belenguer, Pablo, Navarro, David, Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC)
Tipo de recurso: artículo
Estado:Versión publicada
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
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
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spelling SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disordersPiñana, José LuisRodríguez-Belenguer, PabloNavarro, DavidSpanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC)Allogeneic stem cell transplantationAutologous stem cell transplantationBreakthrough SARS-CoV-2 infectionCOVID-19Correlates of protectionHematological malignanciesImmunocompromised patientsModerna mRNA-1273Pfizer-BioNTech BNT162b2SARS-CoV-2 vaccinesVaccineBackground: 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 Central202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/54914http://dx.doi.org/10.1186/s13045-022-01275-7reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésCopyright © Piñana JL, López-Corral L, Martino R, Vazquez L, Pérez A, Martin-Martin G, Gago B, et al. 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.http://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/549142026-06-12T07:21:37Z
dc.title.none.fl_str_mv SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders
title SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders
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
title_short 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_sort SARS-CoV-2 vaccine response and rate of breakthrough infection in patients with hematological disorders
dc.creator.none.fl_str_mv Piñana, José Luis
Rodríguez-Belenguer, Pablo
Navarro, David
Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC)
author Piñana, José Luis
author_facet Piñana, José Luis
Rodríguez-Belenguer, Pablo
Navarro, David
Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC)
author_role author
author2 Rodríguez-Belenguer, Pablo
Navarro, David
Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC)
author2_role author
author
author
dc.subject.none.fl_str_mv 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 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
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.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/54914
http://dx.doi.org/10.1186/s13045-022-01275-7
url http://hdl.handle.net/10230/54914
http://dx.doi.org/10.1186/s13045-022-01275-7
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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