Serological response to vaccination in post-acute sequelae of COVID

被引：7

作者：

Joung, Sandy ^{[1
]}

Weber, Brittany ^{[2
]}

Wu, Min ^{[1
]}

Liu, Yunxian ^{[1
]}

Tang, Amber B. B. ^{[3
]}

Driver, Matthew ^{[1
]}

Sternbach, Sarah ^{[1
]}

Wynter, Timothy ^{[1
]}

Hoang, Amy ^{[1
]}

Barajas, Denisse ^{[1
]}

Kao, Yu Hung ^{[1
]}

Khuu, Briana ^{[1
]}

Bravo, Michelle ^{[1
]}

Masoom, Hibah ^{[1
]}

Tran, Teresa ^{[1
]}

Sun, Nancy ^{[1
]}

Botting, Patrick G. ^{[1
]}

Claggett, Brian L. ^{[2
]}

Prostko, John C. ^{[4
]}

Frias, Edwin C. ^{[4
]}

Stewart, James L. ^{[4
]}

Robertson, Jackie ^{[5
]}

Kwan, Alan C. ^{[1
]}

Torossian, Mariam ^{[6
]}

Pedraza, Isabel ^{[6
]}

Sterling, Carina ^{[6
]}

Goldzweig, Caroline ^{[7
]}

Oft, Jillian ^{[5
]}

Zabner, Rachel ^{[5
]}

Fert-Bober, Justyna ^{[1
]}

Ebinger, Joseph E. ^{[1
]}

Sobhani, Kimia ^{[8
]}

Cheng, Susan ^{[1
]}

Le, Catherine N. N. ^{[5
]}

机构：

[1] Cedars Sinai Med Ctr, Smidt Heart Inst, Dept Cardiol, Los Angeles, CA 90048 USA

[2] Brigham & Womens Hosp, Cardiovasc Div, Boston, MA USA

[3] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA

[4] Abbott Diagnost, Abbott Pk, IL USA

[5] Cedars Sinai Med Ctr, Dept Med, Div Infect Dis, Los Angeles, CA 90048 USA

[6] Cedars Sinai Med Ctr, Div Pulm & Crit Care Med, Los Angeles, CA USA

[7] Cedars Sinai Med Ctr, Cedars Sinai Med Care Fdn, Los Angeles, CA USA

[8] Cedars Sinai Med Ctr, Dept Pathol & Lab Med, Los Angeles, CA USA

来源：

BMC INFECTIOUS DISEASES | 2023年 / 23卷 / 01期

基金：

美国国家卫生研究院;

关键词：

SARS-CoV-2; Post-acute sequelae; Immune activation; Serological response; Anti-spike antibody;

D O I：

10.1186/s12879-023-08060-y

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

BackgroundIndividuals with post-acute sequelae of COVID (PASC) may have a persistence in immune activation that differentiates them from individuals who have recovered from COVID without clinical sequelae. To investigate how humoral immune activation may vary in this regard, we compared patterns of vaccine-provoked serological response in patients with PASC compared to individuals recovered from prior COVID without PASC.MethodsWe prospectively studied 245 adults clinically diagnosed with PASC and 86 adults successfully recovered from prior COVID. All participants had measures of humoral immunity to SARS-CoV-2 assayed before or after receiving their first-ever administration of COVID vaccination (either single-dose or two-dose regimen), including anti-spike (IgG-S and IgM-S) and anti-nucleocapsid (IgG-N) antibodies as well as IgG-S angiotensin-converting enzyme 2 (ACE2) binding levels. We used unadjusted and multivariable-adjusted regression analyses to examine the association of PASC compared to COVID-recovered status with post-vaccination measures of humoral immunity.ResultsIndividuals with PASC mounted consistently higher post-vaccination IgG-S antibody levels when compared to COVID-recovered (median log IgG-S 3.98 versus 3.74, P < 0.001), with similar results seen for ACE2 binding levels (median 99.1 versus 98.2, P = 0.044). The post-vaccination IgM-S response in PASC was attenuated but persistently unchanged over time (P = 0.33), compared to in COVID recovery wherein the IgM-S response expectedly decreased over time (P = 0.002). Findings remained consistent when accounting for demographic and clinical variables including indices of index infection severity and comorbidity burden.ConclusionWe found evidence of aberrant immune response distinguishing PASC from recovered COVID. This aberrancy is marked by excess IgG-S activation and ACE2 binding along with findings consistent with a delayed or dysfunctional immunoglobulin class switching, all of which is unmasked by vaccine provocation. These results suggest that measures of aberrant immune response may offer promise as tools for diagnosing and distinguishing PASC from non-PASC phenotypes, in addition to serving as potential targets for intervention.

引用

页数：9

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