Susceptibility to COVID-19 and Immunologic Response to Vaccination in Patients With Immune-Mediated Inflammatory Diseases

Finckh, Axel; Ciurea, Adrian; Raptis, Catherine; Rubbert-Roth, Andrea

doi:10.1093/infdis/jiad148

Cited by 3 publications

(2 citation statements)

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“…(Cordtz et al, 2021;Dewanjee et al, 2021;England et al, 2021;Grainger et al, 2021;Bournia et al, 2023). The expected response to SARS-CoV-2 vaccination for many patients with RD receiving systemic immunomodulatory therapies is blunted in its magnitude and duration compared with that in the general population but nonetheless emphasizes the importance of vaccination (Cordtz et al, 2022;Ammitzbøll et al, 2023;Curtis et al, 2023;Finckh et al, 2023). Moreover, other high-risk patients with RD who experience breakthrough infection (particularly among not fully vaccinated individuals infected with pre-Omicron variants) tend to have a worse prognosis (Bakasis et al, 2022;Liew et al, 2022).…”

Section: Discussionmentioning

confidence: 99%

The Evolution in Pharmacology of Infectious Diseases: 2022

2024

Frontiers Research Topics

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Frontiers is more than just an open access publisher of scholarly articles: it is a pioneering approach to the world of academia, radically improving the way scholarly research is managed. The grand vision of Frontiers is a world where all people have an equal opportunity to seek, share and generate knowledge. Frontiers provides immediate and permanent online open access to all its publications, but this alone is not enough to realize our grand goals. Frontiers journal seriesThe Frontiers journal series is a multi-tier and interdisciplinary set of openaccess, online journals, promising a paradigm shift from the current review, selection and dissemination processes in academic publishing. All Frontiers journals are driven by researchers for researchers; therefore, they constitute a service to the scholarly community. At the same time, the Frontiers journal series operates on a revolutionary invention, the tiered publishing system, initially addressing specific communities of scholars, and gradually climbing up to broader public understanding, thus serving the interests of the lay society, too. Dedication to qualityEach Frontiers article is a landmark of the highest quality, thanks to genuinely collaborative interactions between authors and review editors, who include some of the world's best academicians. Research must be certified by peers before entering a stream of knowledge that may eventually reach the public -and shape society; therefore, Frontiers only applies the most rigorous and unbiased reviews. Frontiers revolutionizes research publishing by freely delivering the most outstanding research, evaluated with no bias from both the academic and social point of view. By applying the most advanced information technologies, Frontiers is catapulting scholarly publishing into a new generation. What are Frontiers Research Topics?Frontiers Research Topics are very popular trademarks of the Frontiers journals series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area.

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Section: Discussionmentioning

confidence: 99%

The Evolution in Pharmacology of Infectious Diseases: 2022

2024

Frontiers Research Topics

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“…( Cordtz et al, 2021 ; Dewanjee et al, 2021 ; England et al, 2021 ; Grainger et al, 2021 ; Bournia et al, 2023 ). The expected response to SARS-CoV-2 vaccination for many patients with RD receiving systemic immunomodulatory therapies is blunted in its magnitude and duration compared with that in the general population but nonetheless emphasizes the importance of vaccination ( Cordtz et al, 2022 ; Ammitzbøll et al, 2023 ; Curtis et al, 2023 ; Finckh et al, 2023 ). Moreover, other high-risk patients with RD who experience breakthrough infection (particularly among not fully vaccinated individuals infected with pre-Omicron variants) tend to have a worse prognosis ( Bakasis et al, 2022 ; Liew et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the efficacy and safety of nirmatrelvir/ritonavir co-administration inpatients with rheumatic disease infected with SARS-CoV-2: a real-world study

Zhong,

Wang,

Huang

et al. 2023

Front. Pharmacol.

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Background: The breakthrough development of novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccines and oral antivirals have played a critical role in curtailing the spread of the pandemic and dramatically reducing the morbidity and mortality rates among those infected. Among these oral antivirals, nirmatrelvir/ritonavir (NR) has been repurposed successfully for use against coronavirus disease-2019 (COVID-19) and is now readily available on the market with promising therapeutic effects. The availability of convenient and effective NR treatments for COVID-19 greatly mitigates the severity of the epidemic and contributes to an early end to the pandemic. Furthermore, certain patient subgroups, specifically those with rheumatic disease (RD) who are currently undergoing intensive immunodeficiency and/or immunosuppressive treatments, continue to be vulnerable and at a higher risk of experiencing severe consequences from COVID-19. Additionally, it has also been observed that NR exhibited prevalent drug-drug interactions of clinical significance, and more instances of COVID-19 rebound were being recognized with increasing frequency.Methods: A retrospective cohort study was conducted on a real-world RD population who were infected with SARS-CoV-2 and treated with NR. The time of symptom resolution, length of hospitalization, and response rate were assessed. Results were compared among the standard regimen and non-standard regimen groups, early NR regimen and late NR regimen groups, and the NR indication regimen and NR non-indication regimen groups. During the course, all grades of adverse drug reactions (ADRs) directly associated with NR administration and associated with drug-drug interactions (DDIs) were also monitored.Results: A total of 32 patients with RD, who were infected with SARS-CoV-2 and received NR, were retrospectively identified and divided into different groups. We found that the standard regimen group and the early NR regimen group had a shorter median time of symptom resolution compared to the control group [9.0 (interquartile range [IQR], 8.3-11.3) vs. 21.5 (IQR16.0-24.0) days, p < 0.001 and 9.0 (IQR 8.3-11.3) vs. 23.0 (IQR 18.0-24.0) days, p = 0.0]. We further found that even if the NR administration time exceeds 5 days, patients with RD who receive the NR indication regimen can still derive certain benefits from it. The proportion of patients who showed symptom improvement was higher in the NR indication regimen compared to the NR non-indication regimen group (n = 13/17 vs. 3/6, 76.5% vs. 50.0%) at the end of follow-up, and there was a statistical difference (p = 0.0) in the response rate of patients between the two groups. We also analyzed the effect of comorbidities on patient response rates and found that the percentage of patients who showed symptom improvement was higher in the group with <4 comorbidities compared to the group with ≥ 4 comorbidities (n = 7/7 vs. 16/25, 100.0% vs. 64.0%) at the end of follow-up. During the course, all grades of ADRs and grade ≥3ADRs directly associated with NR administration were not observed in any of the 32 cases. Despite discontinuing warfarin prior to NR application (using NR immediately on the first day of warfarin withdrawal), one patient still experienced an increased international normalized ratio [INR, 5.32(0.90-1.20)] and coagulation disorders (weak positive fecal occult blood test) on the second day after using NR. The INR levels decreased to nearly normal values, and coagulation disorders returned to normal after 2 days of discontinuing NR (the seventh day after the initial administration of NR).Conclusion: We showed NR therapy to be associated with a favorable outcome and an acceptable safety profile in an immunosuppressed population with RD during the Omicron surge. Early use of NR (within 5 days of symptom onset) could improve the prognosis of patients. NR administration for symptoms and confirmed SARS-CoV-2 infection after >5 days may also mitigate progression to severe disease and is a viable strategy. Our results highlight the importance of early utilization and/or NR indication, which may yield clinical advantages for patients with RD infected with SARS-CoV-2.

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Foreword: Preventing COVID-19 Among the Immunocompromised Population

Willicombe

2023

The Journal of Infectious Diseases

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The COVID-19 pandemic represented 1 of the more significant and unique public health challenges facing the global community, particularly afflicting those with compromised immune systems. These immunocompromised individuals were readily recognized as a group at high risk of infection by SARS-CoV-2 and the associated severe outcomes of COVID-19. Although preventive strategies such as vaccination are important, initial clinical vaccine trials did not enroll immunocompromised individuals; in-depth evaluations of the safety, immunogenicity, and real-world outcomes associated with these vaccines were conducted in this population thereafter. As immunogenicity data of COVID-19 vaccination among this disparate group of individuals emerged, vaccination strategies were adapted to address outstanding challenges and further protect the entirety of this population. This 8-part journal supplement characterizes in-depth the mRNA-based COVID-19 vaccination strategies across the spectrum of immunocompromised individuals, focusing on the ongoing approaches to challenges facing this group as the pandemic continues to evolve.

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Susceptibility to COVID-19 and Immunologic Response to Vaccination in Patients With Immune-Mediated Inflammatory Diseases

Cited by 3 publications

References 48 publications

The Evolution in Pharmacology of Infectious Diseases: 2022

The Evolution in Pharmacology of Infectious Diseases: 2022

Evaluation of the efficacy and safety of nirmatrelvir/ritonavir co-administration inpatients with rheumatic disease infected with SARS-CoV-2: a real-world study

Foreword: Preventing COVID-19 Among the Immunocompromised Population

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