ABSTRACT
Wu et al. report that patients with hematologic malignancies have reduced immunity against SARS-CoV-2 Omicron subvariants and Sotrovimab retains neutralizing capacity against all tested Omicron subvariants.
ABSTRACT
Patients with blood cancer continue to have a greater risk of inadequate immune responses following three COVID-19 vaccine doses and risk of severe COVID-19 disease. In the context of the CAPTURE study (NCT03226886), we report immune responses in 80 patients with blood cancer who received a fourth dose of BNT162b2. We measured neutralizing antibody titers (NAbTs) using a live virus microneutralization assay against wild-type (WT), Delta, and Omicron BA.1 and BA.2 and T cell responses against WT and Omicron BA.1 using an activation-induced marker (AIM) assay. The proportion of patients with detectable NAb titers and T cell responses after the fourth vaccine dose increased compared with that after the third vaccine dose. Patients who received B cell-depleting therapies within the 12 months before vaccination have the greatest risk of not having detectable NAbT. In addition, we report immune responses in 57 patients with breakthrough infections after vaccination.
Subject(s)
COVID-19 Vaccines , COVID-19 , Neoplasms , Humans , Antibodies, Neutralizing , Antibodies, Viral , BNT162 Vaccine , Clinical Studies as Topic , COVID-19/prevention & control , COVID-19 Vaccines/immunology , Immunity , SARS-CoV-2Subject(s)
Antibodies, Neutralizing/biosynthesis , Antibodies, Viral/biosynthesis , COVID-19 Vaccines/immunology , COVID-19/prevention & control , Hematologic Neoplasms/immunology , Immunization, Secondary , SARS-CoV-2/immunology , Antibodies, Neutralizing/blood , Antibodies, Viral/blood , COVID-19/complications , COVID-19/epidemiology , Hematologic Neoplasms/complications , Humans , Immunogenicity, Vaccine , Neoplasms/complications , Neoplasms/immunology , Symptom AssessmentABSTRACT
CAPTURE (NCT03226886) is a prospective cohort study of COVID-19 immunity in patients with cancer. Here we evaluated 585 patients following administration of two doses of BNT162b2 or AZD1222 vaccines, administered 12 weeks apart. Seroconversion rates after two doses were 85% and 59% in patients with solid and hematological malignancies, respectively. A lower proportion of patients had detectable neutralizing antibody titers (NAbT) against SARS-CoV-2 variants of concern (VOCs) vs wildtype (WT). Patients with hematological malignancies were more likely to have undetectable NAbT and had lower median NAbT vs solid cancers against both WT and VOCs. In comparison with individuals without cancer, patients with haematological, but not solid, malignancies had reduced NAb responses. Seroconversion showed poor concordance with NAbT against VOCs. Prior SARS-CoV-2 infection boosted NAb response including against VOCs, and anti-CD20 treatment was associated with undetectable NAbT. Vaccine-induced T-cell responses were detected in 80% of patients, and were comparable between vaccines or cancer types. Our results have implications for the management of cancer patients during the ongoing COVID-19 pandemic.
Subject(s)
Adaptive Immunity/immunology , Antibodies, Neutralizing/immunology , COVID-19 Vaccines/immunology , COVID-19/immunology , Carcinoma, Renal Cell/complications , Kidney Neoplasms/complications , SARS-CoV-2/immunology , Adult , Aged , Aged, 80 and over , BNT162 Vaccine/administration & dosage , BNT162 Vaccine/immunology , COVID-19/complications , COVID-19/epidemiology , COVID-19 Vaccines/administration & dosage , ChAdOx1 nCoV-19/administration & dosage , ChAdOx1 nCoV-19/immunology , Female , Humans , Immunogenicity, Vaccine/immunology , Longitudinal Studies , Male , Middle Aged , Pandemics/prevention & control , Prospective Studies , SARS-CoV-2/genetics , SARS-CoV-2/physiology , T-Lymphocytes/immunology , T-Lymphocytes/virology , Vaccination/methodsABSTRACT
We report the case of a 35-year-old male with COVID-19 encephalitis presenting as a stroke mimic with sudden-onset expressive and receptive dysphasia, mild confusion and right arm incoordination. The patient received thrombolysis for a suspected ischaemic stroke, but later became febrile and SARS-CoV-2 was detected in cerebrospinal fluid. Electroencephalography demonstrated excess in slow waves, but neuroimaging was reported as normal. Respiratory symptoms were absent throughout and nasopharyngeal swab was negative for SARS-CoV-2. At the most recent follow-up, the patient had made a full neurological recovery. Clinicians should therefore consider testing for SARS-CoV-2 in CSF in patients who present with acute focal neurology, confusion and fever during the pandemic, even when there is no evidence of respiratory infection.
Subject(s)
COVID-19 Nucleic Acid Testing , COVID-19/diagnosis , Encephalitis, Viral/diagnosis , Ischemic Stroke/diagnosis , RNA, Viral/cerebrospinal fluid , SARS-CoV-2/genetics , Adult , COVID-19/cerebrospinal fluid , COVID-19/virology , Diagnosis, Differential , Electroencephalography , Encephalitis, Viral/cerebrospinal fluid , Encephalitis, Viral/virology , Humans , Magnetic Resonance Imaging , Male , Predictive Value of Tests , Tomography, X-Ray ComputedABSTRACT
The inaugural "Microbiome for Mars" virtual workshop took place on July 13, 2020. This event assembled leaders in microbiome research and development to discuss their work and how it may relate to long-duration human space travel. The conference focused on surveying current microbiome research, future endeavors, and how this growing field could broadly impact human health and space exploration. This report summarizes each speaker's presentation in the order presented at the workshop.