High Anti-CoV2S Antibody Levels at Hospitalization Are Associated with Improved Survival in Patients with COVID-19 Vaccine Breakthrough Infection

Heinzl, Matthias Wolfgang; Kolenchery, Lisa; Resl, Michael; Klammer, Carmen; Black, A. Kobza; Obendorf, Florian; Schinagl, Lukas; Feldbauer, Roland; Pohlhammer, Johannes; Wagner, Thomas; Berger, Thomas; Dieplinger, Benjamin; Clodi, Martin

doi:10.3390/ijerph192315581

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…These observations are consistent with other studies that have demonstrated similar associations between specific medical conditions and SARS-CoV-2 spike-protein targeted serology results and between serology results and subsequent outcomes (3)(4)(5). A recent study of cancer vs. non-cancer (control) patients in the United Kingdom showed that detectable levels of SARS-CoV-2 spike-protein targeted antibodies were associated with protection against subsequent SARS-CoV-2 infection and serious outcomes (26).…”

Section: Discussionsupporting

confidence: 92%

“…Currently, the efficacy of detectable antibody levels against subsequent SARS-CoV-2 infection and adverse outcomes is incompletely understood. As a result, only a small number of studies have evaluated the risk of SARS-CoV-2 infection outcomes based on SARS-CoV-2 antibody testing, and none have evaluated this risk among subgroups of the population at the highest risk for severe adverse outcomes of SARS-CoV-2 infection, e.g., immunocompromised individuals (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

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SARS-CoV-2 spike-protein targeted serology test results and their association with subsequent COVID-19-related outcomes

Kaufman

Letovsky

Meyer

et al. 2023

Front. Public Health

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ImportanceIn the absence of evidence of clinical utility, the United States' Centers for Disease Control and Prevention does not currently recommend the assessment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spike-protein antibody levels. Clinicians and their patients, especially immunocompromised patients, may benefit from an adjunctive objective clinical laboratory measure of risk, using SARS-CoV-2 serology.ObjectiveThe aim of this study is to estimate the association between SARS-CoV-2 spike-protein targeted antibody levels and clinically relevant outcomes overall and among clinically relevant subgroups, such as vaccine and immunocompetency statuses.DesignA retrospective cohort study was conducted using laboratory-based data containing SARS-CoV-2 antibody testing results, as well as medical and pharmacy claim data. SARS-CoV-2 testing was performed by two large United States-based reference clinical laboratories, Labcorp® and Quest Diagnostics, and was linked to medical insurance claims, including vaccination receipt, through the HealthVerity Marketplace. Follow-up for outcomes began after each eligible individual's first SARS-CoV-2 semiquantitative spike-protein targeted antibody test, from 16 November 2020 to 30 December 2021.ExposuresExposure is defined as having SARS-CoV-2 spike-protein targeted antibody testing.Main outcomes and measuresStudy outcomes were SARS-CoV-2 infection and a serious composite outcome (hospitalization with an associated SARS-CoV-2 infection or all-cause death). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Propensity score matching was used for confounding covariate control.ResultsIn total, 143,091 (73.2%) and 52,355 (26.8%) eligible individuals had detectable and non-detectable levels of SARS-CoV-2 spike-protein targeted antibodies, respectively. In the overall population, having detectable vs. non-detectable antibodies was associated with an estimated 44% relative reduction in SARS-CoV-2 subsequent infection risk (HR, 0.56; 95% CI 0.53–0.59) and an 80% relative reduction in the risk of serious composite outcomes (HR 0.20; 95% CI 0.15–0.26). Relative risk reductions were observed across subgroups, including among immunocompromised persons.Conclusion and relevanceIndividuals with detectable SARS-CoV-2 spike-protein targeted antibody levels had fewer associated subsequent SARS-CoV-2 infections and serious adverse clinical outcomes. Policymakers and clinicians may find SARS-CoV-2 spike-protein targeted serology testing to be a useful adjunct in counseling patients with non-detectable antibody levels about adverse risks and reinforcing appropriate actions to mitigate such risks.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 spike-protein targeted serology test results and their association with subsequent COVID-19-related outcomes

Kaufman

Letovsky

Meyer

et al. 2023

Front. Public Health

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Tracking the evolution of anti-SARS-CoV-2 antibodies and long-term humoral immunity within 2 years after COVID-19 infection

Movsisyan,

Truzyan,

Kasparova

et al. 2024

Sci Rep

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that gave rise to COVID-19 infection produced a worldwide health crisis. The virus can cause a serious or even fatal disease. Comprehending the complex immunological responses triggered by SARS-CoV-2 infection is essential for identifying pivotal elements that shape the course of the disease and its enduring effects on immunity. The span and potency of antibody responses provide valuable perspicuity into the resilience of post-infection immunity. The analysis of existing literature reveals a diverse controversy, confining varying data about the persistence of particular antibodies as well as the multifaceted factors that impact their development and titer, Within this study we aimed to understand the dynamics of anti-SARS-CoV-2 antibodies against nucleocapsid (anti-SARS-CoV-2 (N)) and spike (anti-SARS-CoV-2 (N)) proteins in long-term immunity in convalescent patients, as well as the factors influencing the production and kinetics of those antibodies. We collected 6115 serum samples from 1611 convalescent patients at different post-infection intervals up to 21 months Study showed that in the fourth month, the anti-SARS-CoV-2 (N) exhibited their peak mean value, demonstrating a 79% increase compared to the initial month. Over the subsequent eight months, the peak value experienced a modest decline, maintaining a relatively elevated level by the end of study. Conversely, anti-SARS-CoV-2 (S) exhibited a consistent increase at each three-month interval over the 15-month period, culminating in a statistically significant peak mean value at the study’s conclusion. Our findings demonstrate evidence of sustained seropositivity rates for both anti-SARS-CoV-2 (N) and (S), as well as distinct dynamics in the long-term antibody responses, with anti-SARS-CoV-2 (N) levels displaying remarkable persistence and anti-SARS-CoV-2 (S) antibodies exhibiting a progressive incline.

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Comparative Effectiveness of the mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Adults With Underlying Medical Conditions: A Systematic Literature Review and Pairwise Meta-Analysis Using GRADE

Wang,

Pahwa,

Bausch-Jurken

et al. 2024

Preprint

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IntroductionThis systematic literature review and pairwise meta-analysis evaluated the comparative effectiveness of mRNA-1273 versus BNT162b in patients with at least one underlying medical condition at high risk for severe COVID-19.MethodsMEDLINE, Embase, and Cochrane databases were searched for relevant articles from January 1, 2019 to February 9, 2024. Studies reporting effectiveness data from at least two doses of mRNA-1273 and BNT162b2 vaccination in adults with medical conditions at high risk of developing severe COVID-19 according to the US Centers for Disease Control and Prevention were included. Outcomes of interest were SARS-CoV-2 infection (overall, symptomatic, and severe), hospitalization due to COVID-19, and death due to COVID-19. Risk ratios (RRs) were calculated with random effects models. Subgroup analyses by specific medical conditions, number of vaccinations, age, and SARS-CoV-2 variant were conducted. Heterogeneity between studies was estimated with chi-square testing. The certainty of evidence was assessed using the Grading of Recommendations, Assessments, Development, and Evaluations framework.ResultsSixty-five observational studies capturing the original/ancestral-containing primary series to Omicron-containing bivalent original-BA4-5 vaccinations were included in the meta-analysis. mRNA-1273 was associated with significantly lower risk of SARS-CoV-2 infection (RR, 0.85 [95% CI, 0.79–0.92];I2=92.5%), symptomatic SARS-CoV-2 infection (RR, 0.75 [95% CI, 0.65–0.86];I2=62.3%), severe SARS-CoV-2 infection (RR, 0.83 [95% CI, 0.78–0.89];I2=38.0%), hospitalization due to COVID-19 (RR, 0.88 [95% CI, 0.82–0.94];I2=38.7%), and death due to COVID-19 (RR, 0.84 [95% CI, 0.76–0.93];I2=1.3%) than BNT162b2. Findings were generally consistent across subgroups. Evidence certainty was low or very low because sufficiently powered randomized controlled trials are impractical in this heterogeneous population.ConclusionMeta-analysis of 65 observational studies showed that vaccination with mRNA-1273 was associated with a significantly lower risk of SARS-CoV-2 infection and COVID-19-related hospitalization and death than BNT162b2 in patients with medical conditions at high risk of severe COVID-19.

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High Anti-CoV2S Antibody Levels at Hospitalization Are Associated with Improved Survival in Patients with COVID-19 Vaccine Breakthrough Infection

Cited by 4 publications

References 21 publications

SARS-CoV-2 spike-protein targeted serology test results and their association with subsequent COVID-19-related outcomes

SARS-CoV-2 spike-protein targeted serology test results and their association with subsequent COVID-19-related outcomes

Tracking the evolution of anti-SARS-CoV-2 antibodies and long-term humoral immunity within 2 years after COVID-19 infection

Comparative Effectiveness of the mRNA-1273 and BNT162b2 COVID-19 Vaccines Among Adults With Underlying Medical Conditions: A Systematic Literature Review and Pairwise Meta-Analysis Using GRADE

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