Antibody responses and risk factors associated with impaired immunological outcomes following two doses of BNT162b2 COVID-19 vaccination in patients with chronic pulmonary diseases. Issue 1 (6th July 2022)

• Record Type: Journal Article
• Authors: Harboe, Zitta Barrella; Hamm, Sebastian Rask; Pérez-Alós, Laura; Sivapalan, Pradeesh; Priemé, Helene; Wilcke, Torgny; Kjeldgaard, Peter; Shaker, Saher; Svorre Jordan, Alexander; Møller, Dina Leth; Heftdal, Line Dam; Madsen, Johannes Roth; Bayarri-Olmos, Rafael; Hansen, Cecilie Bo; Pries-Heje, Mia Marie; Hasselbalch, Rasmus Bo; Fogh, Kamille; Armenteros, Jose Juan Almagro; Hilsted, Linda; Sørensen, Erik; Lindegaard, Birgitte; Browatzki, Andrea; Biering-Sørensen, Tor; Frikke-Schmidt, Ruth; Ostrowski, Sisse Rye; Iversen, Kasper Karmark; Bundgaard, Henning; Nielsen, Susanne Dam; Garred, Peter; Jensen, Jens-Ulrik Stæhr
• Is Part Of: BMJ open respiratory research. Volume 9:Issue 1(2022)
• Publication Date: 2022-07-06
• Subjects: COVID-19 -- copd epidemiology -- asthma -- bronchiectasis -- interstitial fibrosis; Respiratory organs -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Treatment -- Periodicals; Respiratory therapy -- Periodicals; 616.2005
• DOI: 10.1136/bmjresp-2022-001268
• Languages: English
• ISSNs: 2052-4439

Abstract

Abstract : Introduction: Responses to COVID-19 vaccination in patients with chronic pulmonary diseases are poorly characterised. We aimed to describe humoral responses following two doses of BNT162b2 mRNA COVID-19 vaccine and identify risk factors for impaired responses. Methods: Prospective cohort study including adults with chronic pulmonary diseases and healthcare personnel as controls (1:1). Blood was sampled at inclusion, 3 weeks, 2 and 6 months after first vaccination. We reported antibody concentrations as geometric means with 95% CI of receptor binding domain (RBD)-IgG and neutralising antibody index of inhibition of ACE-2/RBD interaction (%). A low responder was defined as neutralising index in the lowest quartile (primary outcome) or RBD-IgG <225 AU/mL plus neutralising index <25% (secondary outcome), measured at 2 months. We tested associations using Poisson regression. Results: We included 593 patients and 593 controls, 75% of all had neutralising index ≥97% at 2 months. For the primary outcome, 34.7% of patients (n=157/453) and 12.9% of controls (n=46/359) were low responders (p<0.0001). For the secondary outcome, 8.6% of patients (n=39/453) and 1.4% of controls (n=5/359) were low responders (p<0.001). Risk factors associated with low responder included increasing age (per decade, adjusted risk ratio (aRR) 1.17, 95% CI 1.03 to 1.32), Charlson Comorbidity Index (per point) (aRR 1.15, 95% CI 1.05 to 1.26), use of prednisolone (aRR 2.08, 95% CI 1.55 to 2.77) and other immunosuppressives (aRR 2.21, 95% CI 1.65 to 2.97). Discussion: Patients with chronic pulmonary diseases established functional humoral responses to vaccination, however lower than controls. Age, comorbidities and immunosuppression were associated with poor immunological responses.