Antibody responses and risk factors associated with impaired immunological outcomes following two doses of BNT162b2 COVID-19 vaccination in patients with chronic pulmonary diseases.

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.

• Authors: Zitta Barrella Harboe, Sebastian Rask Hamm, Laura Pérez-Alós, Pradeesh Sivapalan, Helene Priemé, Torgny Wilcke, Peter Kjeldgaard, Saher Shaker, Alexander Svorre Jordan, Dina Leth Møller, Line Dam Heftdal, Johannes Roth Madsen, Rafael Bayarri-Olmos, Cecilie Bo Hansen, Mia Marie Pries-Heje, Rasmus Bo Hasselbalch, Kamille Fogh, Jose Juan Almagro Armenteros, Linda Hilsted, Erik Sørensen, Birgitte Lindegaard, Andrea Browatzki, Tor Biering-Sørensen, Ruth Frikke-Schmidt, Sisse Rye Ostrowski, Kasper Karmark Iversen, Henning Bundgaard, Susanne Dam Nielsen, Peter Garred, Jens-Ulrik Stæhr Jensen
• Journal: BMJ open respiratory research (BMJ Open Respir Res) Vol. 9 Issue 1 (07 2022) ISSN: 2052-4439 [Electronic] England
• PMID: 35793836 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• COVID-19 Vaccines
• Immunoglobulin G
• BNT162 Vaccine

Topics

• Adult
• Antibody Formation
• BNT162 Vaccine
• COVID-19 (prevention & control)
• COVID-19 Vaccines
• Humans
• Immunoglobulin G
• Lung Diseases
• Prospective Studies
• Risk Factors
• Vaccination