Randomized clinical trial of BCG vaccine in patients with convalescent COVID-19: Clinical evolution, adverse events, and humoral immune response.
J Intern Med
; 292(4): 654-666, 2022 10.
Article
in English
| MEDLINE | ID: covidwho-1861450
ABSTRACT
BACKGROUND:
The Bacillus Calmette-Guérin (BCG) vaccine may confer cross-protection against viral diseases in adults. This study evaluated BCG vaccine cross-protection in adults with convalescent coronavirus disease 2019 (COVID-19).METHOD:
This was a multicenter, prospective, randomized, placebo-controlled, double-blind phase III study (ClinicalTrials.gov NCT04369794).SETTING:
University Community Health Center and Municipal Outpatient Center in South America. PATIENTS a total of 378 adult patients with convalescent COVID-19 were included. INTERVENTION single intradermal BCG vaccine (n = 183) and placebo (n = 195). MEASUREMENTS the primary outcome was clinical evolution. Other outcomes included adverse events and humoral immune responses for up to 6 months.RESULTS:
A significantly higher proportion of BCG patients with anosmia and ageusia recovered at the 6-week follow-up visit than placebo (anosmia 83.1% vs. 68.7% healed, p = 0.043, number needed to treat [NNT] = 6.9; ageusia 81.2% vs. 63.4% healed, p = 0.032, NNT = 5.6). BCG also prevented the appearance of ageusia in the following weeks seven in 113 (6.2%) BCG recipients versus 19 in 126 (15.1%) placebos, p = 0.036, NNT = 11.2. BCG did not induce any severe or systemic adverse effects. The most common and expected adverse effects were local vaccine lesions, erythema (n = 152; 86.4%), and papules (n = 111; 63.1%). Anti-severe acute respiratory syndrome coronavirus 2 humoral response measured by N protein immunoglobulin G titer and seroneutralization by interacting with the angiotensin-converting enzyme 2 receptor suggest that the serum of BCG-injected patients may neutralize the virus at lower specificity; however, the results were not statistically significant.CONCLUSION:
BCG vaccine is safe and offers cross-protection against COVID-19 with potential humoral response modulation.LIMITATIONS:
No severely ill patients were included.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Ageusia
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Topics:
Vaccines
Limits:
Adult
/
Humans
Language:
English
Journal:
J Intern Med
Journal subject:
Internal Medicine
Year:
2022
Document Type:
Article
Affiliation country:
Joim.13523
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