Previous SARS-CoV-2 Infection, Age, and Frailty Are Associated With 6-Month Vaccine-Induced Anti-Spike Antibody Titer in Nursing Home Residents

被引：22

作者：

Dyer, Adam H. ^{[1
,2
,3
]}

Noonan, Claire ^{[1
]}

McElheron, Matt ^{[2
,3
]}

Batten, Isabella ^{[2
,3
]}

Reddy, Conor ^{[2
,3
]}

Connolly, Emma ^{[2
,3
]}

Pierpoint, Rachel ^{[1
]}

Murray, Caroline ^{[4
,5
]}

Leonard, Ann ^{[4
,5
,6
]}

Higgins, Catriona ^{[4
,5
]}

Reilly, Phyllis ^{[4
,5
]}

Boran, Gerard ^{[4
,5
,6
]}

Phelan, Thomas ^{[7
]}

McCormack, William ^{[7
]}

O'Neill, Desmond ^{[1
,3
]}

Fallon, Aoife ^{[1
]}

Brady, Gareth ^{[7
]}

O'Farrelly, Cliona ^{[8
]}

Bourke, Nollaig M. ^{[2
,3
]}

Kennelly, Sean P. ^{[1
,2
,3
]}

机构：

[1] Tallaght Univ Hosp, Age Related Healthcare, Dublin, Ireland

[2] Trinity Translat Med Inst, Inflammaging Res Grp, St Jamess Hosp Campus, Dublin, Ireland

[3] Trinity Coll Dublin, Sch Med, Dept Med Gerontol, Dublin, Ireland

[4] Tallaght Univ Hosp, Dept Clin Chem, Dublin, Ireland

[5] Tallaght Univ Hosp, Dept Lab Med, Dublin, Ireland

[6] Trinity Coll Dublin, Sch Med, Clin Biochem Unity, Dublin, Ireland

[7] Trinity Coll Dublin, Sch Med, Trinity Translat Med Inst, Clin Med, Dublin, Ireland

[8] Trinity Biomed Sci Inst, Comparat Immunol Res Grp, Dublin, Ireland

来源：

JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION | 2022年 / 23卷 / 03期

基金：

爱尔兰科学基金会; 英国惠康基金;

关键词：

Nursing homes; long-term care; vaccine; SARS-CoV-2.0; COVID-19; antibody;

D O I：

10.1016/j.jamda.2021.12.001

中图分类号：

R592 [老年病学]; C [社会科学总论];

学科分类号：

03 ; 0303 ; 100203 ;

摘要：

Objectives: Older nursing home residents make up the population at greatest risk of morbidity and mortality from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. No studies have examined the determinants of long-term antibody responses post vaccination in this group. Design: Longitudinal cohort study. Setting and Participants: Residents from 5 nursing homes assessed before vaccination, and 5 weeks and 6 months post vaccination, with the BNT162b2 messenger RNA SARS-CoV-2 vaccine. Methods: Comprehensive clinical assessment was performed, including assessment for comorbidity, frailty, and SARS-CoV-2 infection history. Serum nucleocapsid and anti-spike receptor binding domain (RBD) antibodies were analyzed at all timepoints. An in vitro angiotensin-converting enzyme (ACE2) receptor-spike RBD neutralization assay assessed serum neutralization capacity. Results: Of 86 participants (81.1 +/- 10.8 years; 65% female), just under half (45.4%; 39 of 86) had evidence of previous SARS-CoV-2 infection. All participants demonstrated a significant antibody response to vaccination at 5 weeks and a significant decline in this response by 6 months. SARS-CoV-2 infection history was the strongest predictor of antibody titer (log-transformed) at both 5 weeks [beta: 3.00; 95% confidence interval (CI): 2.32-3.70; P < .001] and 6 months (beta: 3.59; 95% CI: 2.89-4.28; P < .001). Independent of SARS-CoV-2 infection history, both age in years (beta: -0.05; 95% CI: -0.08 to -0.02; P < .001) and frailty (beta: -0.22; 95% CI: -0.33 to -0.11; P < .001) were associated with a significantly lower antibody titer at 6 months. Anti-spike antibody titers at both 5 weeks and 6 months significantly correlated with in vitro neutralization capacity. Conclusions and Implications: In older nursing home residents, SARS-CoV-2 infection history was the strongest predictor of anti-spike antibody titers at 6 months, whereas age and frailty were independently associated with lower titers at 6 months. Antibody titers significantly correlated with in vitro neutralization capacity. Although older SARS-CoV-2 naive nursing home residents may be particularly vulnerable to breakthrough SARS-CoV-2 infection, the relationship between antibody titers, SARS-CoV-2 infection, and clinical outcomes remains to be fully elucidated in this vulnerable population. (C) 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

引用

页码：434 / 439

页数：6