One-year breakthrough SARS-CoV-2 infection and correlates of protection in fully vaccinated hematological patients
Piñana, José Luis (Hospital Clínic Universitari (València))
Vazquez, Lourdes (Hospital Universitario de Salamanca)
Calabuig, Marisa (Hospital Clínic Universitari (València))
López-Corral, Lucia (Hospital Universitario de Salamanca)
Martin-Martin, Gabriel (Hospital Universitario de Salamanca)
Villalon, Lucia (Hospital Universitario Fundación Alcorcón)
Sanz-Linares, Gabriela (Institut d'Investigació Biomèdica de Bellvitge)
Conesa, Venancio (Hospital General universitario de Elche (Elx, País Valencià))
Sánchez Salinas, Andrés (Hospital Clínico Universitario Virgen de la Arrixaca (El Palmar, Múrcia))
Gago, Beatriz (Hospital Regional Universitario Carlos Haya (Màlaga, Andalusia))
Facal, Ana (Hospital Universitari i Politècnic La Fe (València))
Risco-Gálvez, Irene (Hospital Arnau de Vilanova (València))
Olave, Maria T. (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Espigado, Ildefonso (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Lopez-Jimenez, Javier (Hospital Universitario Ramón y Cajal (Madrid))
Hernández Rivas, José Ángel (Hospital Universitario Infanta Leonor)
Avendaño-Pita, Alejandro (Instituto de Investigación Biomédica de Salamanca)
Arroyo, Ignacio (Hospital Clínic Universitari (València))
Ferrer, Elena (Hospital Clínic Universitari (València))
Garcia Cadenas, Irene (Institut d'Investigació Biomèdica Sant Pau)
González-Santillana, Clara (Hospital de Fuenlabrada (Madrid))
Roldán-Pérez, Alicia (Hospital Infanta Sofia (Madrid))
Ferrer, Blanca (Hospital Clínic Universitari (València))
Guerreiro, Manuel (Hospital Universitari i Politècnic La Fe (València))
Suárez-Lledó Grande, María (Hospital Clínic i Provincial de Barcelona)
Camara, Angela (Hospital Clínic Universitari (València))
Campos-Beltrán, Diana (Center for Brain Behavior and Metabolism (CBBM) (Lübeck, Alemanya))
Navarro, David (Universitat de València)
Cedillo, Ángel (Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC) office (Madrid))
Sureda, Anna (Institut d'Investigació Biomèdica de Bellvitge)
Solano, Carlos (Universitat de València)
Martino Bofarull, Rodrigo (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	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.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Blood Cancer Journal, Vol. 13 Núm. 1 (december 2023) , p. 8, ISSN 2044-5385

DOI: 10.1038/s41408-022-00778-3
PMID: 36599843

14 p, 2.1 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles