Risk of waning humoral responses after inactivated or subunit recombinant SARS-CoV-2 vaccination in patients with chronic diseases: Findings from a prospective observational study in China
Risk of waning humoral responses after inactivated or subunit recombinant SARS-CoV-2 vaccination in patients with chronic diseases: Findings from a prospective observational study in China
复制标题
慢性病患者接种灭活或亚单位重组 SARS-CoV-2 疫苗后体液反应减弱的风险：中国一项前瞻性观察研究的结果
DOI：
10.1002/jmv.28434
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发表时间：
2023-01-01
影响因子：
12.7
通讯作者：
Ren, Hong
中科院分区：
文献类型：
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作者：
Li, Hu;Cai, Dachuan;Ren, Hong
在有基础疾病的SARS-CoV-2疫苗接种者中已报告了抗体应答的异质性。我们研究了合并症的存在对慢性疾病（PWCD）患者SARS-CoV-2疫苗接种体液反应的影响，并评估了合并症数量对疫苗接种体液反应的影响。在本研究中，在全程疫苗接种后监测中和抗体（NAb）和针对受体结合域的IgG抗体（RBD-IgG）。共纳入1400名PWCD（82.7%，灭活疫苗; 17.3%，亚单位重组疫苗）和245名健康对照（65.7%灭活疫苗，34.3%亚单位重组疫苗）接种灭活或亚单位重组SARS-CoV-2疫苗。PWCD组NAb和RBD-IgG抗体阳转率及抗体水平与对照组比较差异有统计学意义（P <0.05）。慢性B型肝炎（比值比[OR]：0.65; 95%置信区间[CI]：0.46-0.93）、癌症（OR：0.65; 95% CI：0.42-0.99）和糖尿病（OR：0.50; 95% CI：0.28-0.89）与NAb血清转换较低相关。慢性肾脏疾病（OR：0.29; 95%可信区间：0.11-0.76）、癌症（OR：0.38; 95%CI：0.23-0.62）和糖尿病（OR：0.37; 95%CI：0.20-0.69）与较低的RBD-IgG血清转化相关。只有自身免疫性疾病的存在显示出显着较低的NAbs和RBD-IgG滴度。大多数慢性病患者的反应与对照组相似，但体液反应仍与≥ 2种共存疾病的存在显著相关。我们的研究表明，SARS-CoV-2疫苗接种后的体液反应在某些慢性疾病患者中受损。
Heterogeneity of antibody responses has been reported in SARS-CoV-2 vaccination recipients with underlying diseases. We investigated the impact of the presence of comorbidities on the humoral response to SARS-CoV-2 vaccination in patients with chronic disease (PWCD) and assessed the effect of the number of comorbidities on the humoral response to vaccination. In this study, neutralizing antibodies (NAbs) and IgG antibodies against the receptor-binding domain (RBD-IgG) were monitored following a full-course vaccination. In total, 1400 PWCD (82.7%, inactivated vaccines; 17.3%, subunit recombinant vaccine) and 245 healthy controls (65.7% inactivated vaccines, 34.3% subunit recombinant vaccine) vaccinated with inactivated or subunit recombinant SARS-CoV-2 vaccines, were included. The seroconversion and antibody levels of the NAbs and RBD-IgG were different in the PWCD group compared with those in the control group. Chronic hepatitis B (odds ratio [OR]: 0.65; 95% confidence interval [CI]: 0.46-0.93), cancer (OR: 0.65; 95% CI: 0.42-0.99), and diabetes (OR: 0.50; 95% CI: 0.28-0.89) were associated with lower seroconversion of NAbs. Chronic kidney disease (OR: 0.29; 95% CI: 0.11-0.76), cancer (OR: 0.38; 95% CI: 0.23-0.62), and diabetes (OR: 0.37; 95% CI: 0.20-0.69) were associated with lower seroconversion of RBD-IgG. Only the presence of autoimmune disease showed significantly lower NAbs and RBD-IgG titers. Patients with most types of chronic diseases showed similar responses to the controls, but humoral responses were still significantly associated with the presence of >= 2 coexisting diseases. Our study suggested that humoral responses following SARS-CoV-2 vaccination are impaired in patients with certain chronic diseases.