One-year breakthrough SARS-CoV-2 infection and correlates of protection in fully vaccinated hematological patients
Por:
Pinana, JL, Vazquez, L, Calabuig, M, Lopez-Corral, L, Martin-Martin, G, Villalon, L, Sanz-Linares, G, Conesa-Garcia, V, Sanchez-Salinas, A, Gago, B, Facal, A, Risco-Galvez, I, Olave, MT, Espigado, I, Lopez-Jimenez, J, Hernandez-Rivas, JA, Avendano-Pita, A, Arroyo, I, Ferrer, E, Garcia-Cadenas, I, Gonzalez-Santillana, C, Roldan-Perez, A, Ferrer, B, Guerreiro, M, Suarez-Lledo, M, Camara, A, Campos-Beltran, D, Navarro, D, Cedillo, A, Sureda, A, Solano, C, Martino, R
Publicada:
5 ene 2023
Ahead of Print:
5 ene 2023
Resumen:
The long-term clinical efficacy of SARS-CoV-2 vaccines according to antibody response in immunosuppressed patients such as hematological patients has been little explored. A prospective multicenter registry-based cohort study conducted from December 2020 to July 2022 by the Spanish Transplant and Cell Therapy group, was used to analyze the relationship of antibody response over time after full vaccination (at 3-6 weeks, 3, 6 and 12 months) (2 doses) and of booster doses with breakthrough SARS-CoV-2 infection in 1551 patients with hematological disorders. At a median follow-up of 388 days after complete immunization, 266 out of 1551 (17%) developed breakthrough SARS-CoV-2 infection at median of 86 days (range 7-391) after full vaccination. The cumulative incidence was 18% [95% confidence interval (C.I.), 16-20%]. Multivariate analysis identified higher incidence in chronic lymphocytic leukemia patients (29%) and with the use of corticosteroids (24.5%), whereas female sex (15.5%) and more than 1 year after last therapy (14%) were associated with a lower incidence (p < 0.05 for all comparisons). Median antibody titers at different time points were significantly lower in breakthrough cases than in non-cases. A serological titer cut-off of 250 BAU/mL was predictive of breakthrough infection and its severity. SARS-CoV-2 infection-related mortality was encouragingly low (1.9%) in our series. Our study describes the incidence of and risk factors for COVID-19 breakthrough infections during the initial vaccination and booster doses in the 2021 to mid-2022 period. The level of antibody titers at any time after 2-dose vaccination is strongly linked with protection against both breakthrough infection and severe disease, even with the Omicron SARS-CoV-2 variant.
Filiaciones:
Pinana, JL:
Hosp Clin Univ Valencia, Hematol Dept, Valencia, Spain
Inst Invest Sanitaria Hosp Clin Univ Valencia, Fdn INCLIVA, Valencia, Spain
Vazquez, L:
Univ Hosp Salamanca HUS IBSAL, CIBERONC, Hematol Dept, Salamanca 37007, Spain
Canc Res Inst Salamanca IBMCC USAL CSIC, Salamanca 37007, Spain
Calabuig, M:
Hosp Clin Univ Valencia, Hematol Dept, Valencia, Spain
Inst Invest Sanitaria Hosp Clin Univ Valencia, Fdn INCLIVA, Valencia, Spain
Lopez-Corral, L:
Univ Hosp Salamanca HUS IBSAL, CIBERONC, Hematol Dept, Salamanca 37007, Spain
Canc Res Inst Salamanca IBMCC USAL CSIC, Salamanca 37007, Spain
Martin-Martin, G:
Univ Hosp Salamanca HUS IBSAL, CIBERONC, Hematol Dept, Salamanca 37007, Spain
Canc Res Inst Salamanca IBMCC USAL CSIC, Salamanca 37007, Spain
Villalon, L:
Hosp Univ Fdn Alcorcon, Hematol Div, Madrid, Spain
Sanz-Linares, G:
Univ Barcelona, Inst Catala Oncol Hosp Duran & Reynals, Hematol Div, IDIBELL, Barcelona, Spain
Conesa-Garcia, V:
Hosp Gen Univ Elche, Hematol Div, Elche, Spain
Sanchez-Salinas, A:
Hosp Clin Univ Virgen Arrixaca, Hematol Div, Murcia, Spain
Gago, B:
Hosp Reg Univ Carlos Haya, Hematol Div, Malaga, Spain
Facal, A:
Hosp Univ & Politecn La Fe, Hematol Div, Valencia, Spain
Risco-Galvez, I:
Hosp Arnau Vilanova, Hematol Div, Valencia, Spain
Olave, MT:
IIS Aragon, Hosp Clin Univ Lozano Blesa, Hematol Div, Zaragoza, Spain
Espigado, I:
Hosp Univ Virgen Macarena, Hematol Div, Seville, Spain
Lopez-Jimenez, J:
Hosp Ramon & Cajal, Hematol Div, Madrid, Spain
Hernandez-Rivas, JA:
Hosp Univ Infanta Leonor, Hematol Div, Madrid, Spain
Avendano-Pita, A:
Univ Hosp Salamanca HUS IBSAL, CIBERONC, Hematol Dept, Salamanca 37007, Spain
Canc Res Inst Salamanca IBMCC USAL CSIC, Salamanca 37007, Spain
Arroyo, I:
Hosp Clin Univ Valencia, Hematol Dept, Valencia, Spain
Inst Invest Sanitaria Hosp Clin Univ Valencia, Fdn INCLIVA, Valencia, Spain
Ferrer, E:
Hosp Clin Univ Valencia, Hematol Dept, Valencia, Spain
Inst Invest Sanitaria Hosp Clin Univ Valencia, Fdn INCLIVA, Valencia, Spain
Garcia-Cadenas, I:
Hosp Santa Creu & Sant Pau, Hematol Div, Barcelona, Spain
Gonzalez-Santillana, C:
Hosp Fuenlabrada, Hematol Div, Madrid, Spain
Roldan-Perez, A:
Hosp Infanta Sofia, Hematol Div, Madrid, Spain
Ferrer, B:
Hosp Clin Univ Valencia, Hematol Dept, Valencia, Spain
Inst Invest Sanitaria Hosp Clin Univ Valencia, Fdn INCLIVA, Valencia, Spain
Guerreiro, M:
Hosp Univ & Politecn La Fe, Hematol Div, Valencia, Spain
Suarez-Lledo, M:
Hosp Clin Barcelona, Hematol Div, Barcelona, Spain
Camara, A:
Hosp Clin Univ Valencia, Hematol Dept, Valencia, Spain
Inst Invest Sanitaria Hosp Clin Univ Valencia, Fdn INCLIVA, Valencia, Spain
Campos-Beltran, D:
Hosp Clin Univ Valencia, Hematol Dept, Valencia, Spain
Inst Invest Sanitaria Hosp Clin Univ Valencia, Fdn INCLIVA, Valencia, Spain
Univ Lubeck, Ctr Brain Behav & Metab CBBM, Inst Expt & Clin Pharmacol & Toxicol, Lubeck, Germany
Navarro, D:
Hosp Clin Univ Valencia, Microbiol Dept, Valencia, Spain
Univ Valencia, Sch Med, Dept Med, Valencia, Spain
Cedillo, A:
Hematopoiet Stem Cell Transplantat & Cell Therapy, Madrid, Spain
Sureda, A:
Univ Barcelona, Inst Catala Oncol Hosp Duran & Reynals, Hematol Div, IDIBELL, Barcelona, Spain
Solano, C:
Hosp Clin Univ Valencia, Hematol Dept, Valencia, Spain
Inst Invest Sanitaria Hosp Clin Univ Valencia, Fdn INCLIVA, Valencia, Spain
Univ Valencia, Sch Med, Dept Med, Valencia, Spain
Martino, R:
Hosp Santa Creu & Sant Pau, Hematol Div, Barcelona, Spain
Green Published, gold, All Open Access, Gold, Green
|