Antibody prevalence after 3 or more COVID-19 vaccine doses in 23,000 immunosuppressed individuals: a cross-sectional study from MELODY
Antibody prevalence after 3 or more COVID-19 vaccine doses in 23,000 immunosuppressed individuals: a cross-sectional study from MELODY
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23,000 名免疫抑制个体接种 3 剂或以上 COVID-19 疫苗后的抗体流行率：MELODY 的一项横断面研究
DOI：
10.1101/2023.02.09.23285649
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Pearce F
中科院分区：
文献类型：
--
作者：
Pearce F
目的调查免疫功能低下人群接种至少3剂COVID-19疫苗后刺蛋白抗体的流行情况。横断面研究使用英国国家疾病登记处的实体器官移植（SOT）、罕见自身免疫性风湿性疾病（RAIRD）和淋巴细胞恶性肿瘤（LM）患者。通过访问接受过SOT的英国人的NHS血液和移植登记处，确定、邀请和招募参与者；以及NHS Digital的国家疾病登记服务，用于识别英格兰境内患有RAIRD或LM的个人。参与者共邀请了101972人，招募了28411人，其中23036人提供了血清学数据，其中SOT接受者9927人，RAIRD患者6516人，LM患者6593人。干预措施：参与者接受了刺状蛋白抗体的横向流动免疫测定，并在家中进行在线问卷调查。根据受试者人口统计学、疾病类型和治疗相关特征测量了免疫抑制队列中至少三个COVID-19疫苗剂量后可检测到的IgG spike-protein抗体的情况。结果SOT、RAIRD和LM队列中分别有23.3%、14.1%和20.7%的IgG spike-protein抗体未检测到。在测试时，分别有28.5%、61.8%和9.6%的参与者接种了三剂、四剂或≥五剂疫苗。在所有组中，血清阳性与年龄较小、疫苗剂量较多和既往COVID-19感染有关。免疫抑制药物降低了血清阳性的可能性：在RAIRD和LM队列中，同时接受抗增殖药物、钙调磷酸酶抑制剂和类固醇治疗的SOT受体以及接受抗cd20治疗的患者中，血清阳性的可能性最低。结论：大约五分之一的SOT、RAIRD和LM患者尽管接种了三种或三种以上的疫苗，但仍未检测到IgG刺突蛋白抗体，但这一比例随着连续加强剂量的增加而降低。免疫抑制剂和疾病类型的选择与血清学反应密切相关。抗体检测可以快速识别最有可能从额外的COVID-19干预措施中受益的个体。临床试验网站，NCT05148806
ObjectivesTo investigate the prevalence of spike-protein antibodies following at least 3 COVID-19 vaccine doses in immunocompromised individuals.DesignCross-sectional study using UK national disease registries of individuals with solid organ transplants (SOT), rare autoimmune rheumatic diseases (RAIRD) and lymphoid malignancies (LM).SettingParticipants were identified, invited and recruited at home by accessing the NHS Blood and Transplant Registry for those UK individuals who had received a SOT; and the National Disease Registration Service at NHS Digital for identifying individuals within England with RAIRD or LM.Participants101972 people were invited, 28411 recruited, and 23036 provided serological data, comprising 9927 SOT recipients, 6516 with RAIRD, and 6593 with LM.InterventionsParticipants received a lateral flow immunoassay for spike-protein antibodies to perform at home together with an online questionnaire.Main outcome measuresOdds of detectable IgG spike-protein antibodies in immunosuppressed cohorts following at least three COVID-19 vaccine doses by participant demographic, disease type, and treatment related characteristicsResultsIgG spike-protein antibodies were undetectable in 23.3%, 14.1% and 20.7% of the SOT, RAIRD and LM cohorts, respectively. Participants had received three, four or ≥five vaccine doses at the time of testing in 28.5%, 61.8%, and 9.6%, respectively. In all groups, seropositivity was associated with younger age, higher number of vaccine doses and previous COVID-19 infection. Immunosuppressive medication reduced the likelihood of seropositivity: the lowest odds of seropositivity were found in SOT recipients receiving an anti-proliferative agent, calcineurin inhibitor and steroid concurrently, and those treated with anti-CD20 in the RAIRD and LM cohorts.ConclusionsApproximately one in five individuals with SOT, RAIRD and LM have no detectable IgG spike-protein antibodies despite three or more vaccines, but this proportion reduces with sequential booster doses. Choice of immunosuppressant and disease-type is strongly associated with serological response. Antibody testing could enable rapid identification of individuals who are most likely to benefit from additional COVID-19 interventions.Trial registrationClinicaltrials.gov, NCT05148806
影响因子：
25.8
作者：
Ranger, Tom Alan;Clift, Ash Kieran;Patone, Martina;Coupland, Carol A. C.;Hatch, Robert;Thomas, Karen;Watkinson, Peter;Hippisley-Cox, Julia
通讯作者：
Hippisley-Cox, Julia
2020 年 COVID-19 大流行期间，罕见自身免疫性疾病患者与英格兰普通人群相比的死亡风险
影响因子：
5.5
作者：
E. Peach;M. Rutter;P. Lanyon;M. Grainge;R. Hubbard;J. Aston;M. Bythell;Sarah Stevens;F. Pearce
通讯作者：
F. Pearce