RESUMO
Background: The COVID-19 pandemic's global impact was mitigated through rapid vaccine development, leading to a mix of natural and vaccination-derived immunity. Immunological profile in hybrid immunity remains less studies, especially in regions where non-mRNA vaccines were used. This study focuses on the immunological profiles and predictors of immune response in one such population. Methods: This was a cross-sectional study to assess their humoral and cellular immune responses based on vaccination and infection history. Immunological assays were performed to measure anti-spike protein and neutralizing antibodies as well as interferon-γ release assay. Multivariable linear regression model was used to estimate predictors of immune response. Results: The study revealed significant differences in immune response among participants based on their hybrid immunity status, vaccination, and infection history. Higher antibody titres and cellular responses were observed in individuals with hybrid immunity, especially those with dual pre-Omicron and Omicron infections (3326 BAU/ml, IQR: 770.25-5678.25 and 4.92 IU of IFN-γ/mL, IQR:3.74-16.98 respectively, p <0.001). Age and comorbidities such as diabetes and hypertension were associated with lower antibody levels and cellular response, while vaccination and hybrid immunity correlated with higher immune responses. Conclusion: The prevalence of hybrid immunity was high, yet a substantial portion of the population lacks it, indicating the necessity for targeted immunization strategies. The findings underscore the importance of prioritizing high-risk individuals, such as elderly and individuals with comorbidities, for booster vaccinations to enhance community-level protection against COVID-19.
Assuntos
Diabetes Mellitus , Hipertensão , COVID-19RESUMO
Background: The administration of Remdesivir/Dexamethasone combination on T and B cell responses in patients with COVID-19 is sparse. To compare cell mediated immune response in patients treated with only Remdesivir and Remdesivir/dexamethasone combination Study Design Prospective, cohort study Methods: RT-PCR positive SARS-CoV-2 patients (n=49) were enrolled. Patients not requiring O2-supplementation were on remdesivir and those requiring were on remdesivir/dexamethasone. Baseline parameters (complete blood picture, inflammatory markers), T and B cells (flow cytometry: day 5 and 30) and neutralizing antibodies (chemiluminescence: day 30) were estimated. Students “t’’ test was used to evaluate the differences. Results: Of the 49 patients, 26 (Mean age-44.68±13.45) were treated with remdesivir and 23 (Mean age-48.33±14.76) with remdesivir/dexamethasone combination. While blood counts and immune cells increased, inflammatory markers decreased post treatment in both the groups. A significant increase in WBC (6357±981Vs10700±1363; p=0.01), absolute neutrophil counts (4578±711Vs8256±1323; p=0.01) with decrease in levels of CRP (31±7.1Vs10±4.2; p=0.01), D-Dimer (172.3±8Vs118.1±12; p=0.0005), IL6 (17.6±3.8Vs1.72±0.2; p=0.0001), CD4 cells (2681±86Vs1256±369; p=0.0003), CD8 cells (1749±88 Vs 1256±221; p=0.01) and neutralizing antibodies were seen post treatment in the combination group. Correction of hypoxia and maintenance of oxygen >95% was also noted. Conclusion: Remdesivir/dexamethasone combination given to patients requiring oxygen supplementation is safe at 4-6mg/day and showed a marked decrease in inflammation and no immune dysregulation.