ABSTRACT
BACKGROUND: Patients with cancer are considered a priority group for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccination given their high risk of contracting severe Coronavirus Disease 2019 (COVID-19). However, limited data exist regarding the efficacy of immunisation in this population. In this study, we assess the immunologic response after COVID-19 vaccination of cancer versus non-cancer population. METHODS: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases were searched from 01st March 2020 through 12th August 12 2021. Primary end-points were anti-SARS-CoV-2 spike protein (S) immunoglobulin G (IgG) seroconversion rates, T-cell response, and documented SARS-CoV-2 infection after COVID-19 immunisation. Data were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Overall effects were pooled using random-effects models. RESULTS: This systematic review and meta-analysis included 35 original studies. Overall, 51% (95% confidence interval [CI], 41-62) and 73% (95% CI, 64-81) of patients with cancer developed anti-S IgG above the threshold level after partial and complete immunisation, respectively. Patients with haematologic malignancies had a significantly lower seroconversion rate than those with solid tumours after complete immunisation (65% vs 94%; P < 0.0001). Compared with non-cancer controls, oncological patients were less likely to attain seroconversion after incomplete (risk ratio [RR] 0.45 [95% CI 0.35-0.58]) and complete (RR 0.69 [95% CI 0.56-0.84]) COVID-19 immunisation schemes. Patients with cancer had a higher likelihood of having a documented SARS-CoV-2 infection after partial (RR 3.21; 95% CI 0.35-29.04) and complete (RR 2.04; 95% CI 0.38-11.10) immunisation. CONCLUSIONS: Patients with cancer have an impaired immune response to COVID-19 vaccination compared with controls. Strategies that endorse the completion of vaccination schemes are warranted. Future studies should aim to evaluate different approaches that enhance oncological patients' immune response.
Subject(s)
Antibodies, Viral/immunology , COVID-19 Drug Treatment , COVID-19 Vaccines/adverse effects , Neoplasms/immunology , SARS-CoV-2/drug effects , T-Lymphocytes/immunology , Vaccination/adverse effects , Antibodies, Viral/blood , COVID-19/virology , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Neoplasms/chemically induced , Neoplasms/drug therapy , Neoplasms/virology , SARS-CoV-2/immunology , Seroconversion , Spike Glycoprotein, Coronavirus/immunologyABSTRACT
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly pathogenic virus that causes severe pneumonia and acute respiratory distress syndrome. On March 11, 2020, this novel coronavirus was declared a pandemic by the World Health Organization. To date, millions of patients have been infected. Recent reports indicate that a substantial proportion of cases present with neurological symptoms. However, it remains to be elucidated whether these manifestations are secondary to direct nervous system invasion, indirect damage mediated by a systemic inflammatory response, or a combination of both. In this review, we explore the potential routes for central nervous system involvement, the possible pathogenic mechanisms in the nervous system and the conceivable neurological long-term sequoia of infection by SARS-CoV-2 infection. Future efforts should concentrate on clarifying the pathophysiology of the neurological component of COVID-19.