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Absent or suboptimal response to booster dose of COVID-19 vaccine in patients with autoimmune systemic diseases.
Ferri, Clodoveo; Gragnani, Laura; Raimondo, Vincenzo; Visentini, Marcella; Giuggioli, Dilia; Lorini, Serena; Foti, Rosario; Cacciapaglia, Fabio; Caminiti, Maurizio; Olivo, Domenico; Cuomo, Giovanna; Pellegrini, Roberta; Pigatto, Erika; Urraro, Teresa; Naclerio, Caterina; Tavoni, Antonio; Puccetti, Lorenzo; Cavazzana, Ilaria; Ruscitti, Piero; Vadacca, Marta; La Gualana, Francesca; Cozzi, Franco; Spinella, Amelia; Visalli, Elisa; Bosco, Ylenia Dal; Amato, Giorgio; Masini, Francesco; Mariano, Giuseppa Pagano; Brittelli, Raffaele; Aiello, Vincenzo; Scorpiniti, Daniela; Rechichi, Giovanni; Varcasia, Giuseppe; Monti, Monica; Elia, Giusy; Franceschini, Franco; Casato, Milvia; Ursini, Francesco; Giacomelli, Roberto; Fallahi, Poupak; Santini, Stefano Angelo; Iannone, Florenzo; Salvarani, Carlo; Zignego, Anna Linda; Antonelli, Alessandro.
  • Ferri C; Rheumatology Unit, University of Modena and Reggio Emilia, School of Medicine, Modena, Italy; Rheumatology Clinic 'Madonna dello Scoglio' Cotronei, Crotone, Italy. Electronic address: clferri@unimore.it.
  • Gragnani L; MASVE Interdepartmental Hepatology Center, Department of Experimental and clinical Medicine, University of Florence Center, Center for Research and Innovation CRIA-MASVE, Firenze, Italy.
  • Raimondo V; Rheumatology Clinic 'Madonna dello Scoglio' Cotronei, Crotone, Italy.
  • Visentini M; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  • Giuggioli D; Rheumatology Unit, University of Modena and Reggio Emilia, School of Medicine, Modena, Italy.
  • Lorini S; MASVE Interdepartmental Hepatology Center, Department of Experimental and clinical Medicine, University of Florence Center, Center for Research and Innovation CRIA-MASVE, Firenze, Italy.
  • Foti R; AOU Policlinico Vittorio Emanuele, Catania, Italy.
  • Cacciapaglia F; UO Reumatologia - DETO, Università di Bari, Bari, Italy.
  • Caminiti M; UOD Reumatologia- Grande Ospedale Metropolitano, Reggio Calabria, Italy.
  • Olivo D; Rheumatology Outpatient Clinic, San Giovanni di Dio Hospital, Crotone, Italy.
  • Cuomo G; University of Campania, Luigi Vanvitelli, Napoli, Italy.
  • Pellegrini R; U.O.C. Medicina Interna "M.Valentini", P.O. Annunziata, Cosenza, Italy.
  • Pigatto E; Ospedale "Villa Salus", Mestre, Italy.
  • Urraro T; Rheumatology Unit, "M. Scarlato" Hospital, Scafati (SA), Italy.
  • Naclerio C; Rheumatology Unit, "M. Scarlato" Hospital, Scafati (SA), Italy.
  • Tavoni A; Clinical Immunology, University of Pisa, Pisa, Italy.
  • Puccetti L; Clinical Immunology, University of Pisa, Pisa, Italy.
  • Cavazzana I; Rheumatology, Spedali Civili di Brescia, Brescia, Italy.
  • Ruscitti P; Rheumatology Unit, Department of Biotechnological & Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
  • Vadacca M; Unità Operativa di Immunoreumatologia-Area Medicina Clinica Policlinico Universitario Campus Bio-Medico di Roma, Roma, Italy.
  • La Gualana F; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  • Cozzi F; Ospedale "Villa Salus", Mestre, Italy.
  • Spinella A; Rheumatology Unit, University of Modena and Reggio Emilia, School of Medicine, Modena, Italy.
  • Visalli E; AOU Policlinico Vittorio Emanuele, Catania, Italy.
  • Bosco YD; AOU Policlinico Vittorio Emanuele, Catania, Italy.
  • Amato G; AOU Policlinico Vittorio Emanuele, Catania, Italy.
  • Masini F; University of Campania, Luigi Vanvitelli, Napoli, Italy.
  • Mariano GP; UOD Reumatologia- Grande Ospedale Metropolitano, Reggio Calabria, Italy.
  • Brittelli R; Rheumatology Clinic 'Madonna dello Scoglio' Cotronei, Crotone, Italy.
  • Aiello V; Rheumatology Clinic 'Madonna dello Scoglio' Cotronei, Crotone, Italy.
  • Scorpiniti D; Rheumatology Clinic 'Madonna dello Scoglio' Cotronei, Crotone, Italy.
  • Rechichi G; Rheumatology Clinic 'Madonna dello Scoglio' Cotronei, Crotone, Italy.
  • Varcasia G; U.O.S. Reumatologia, Ospedale Castrovillari, Cosenza, Italy.
  • Monti M; MASVE Interdepartmental Hepatology Center, Department of Experimental and clinical Medicine, University of Florence Center, Center for Research and Innovation CRIA-MASVE, Firenze, Italy.
  • Elia G; Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, School of Medicine, Pisa, Italy.
  • Franceschini F; Rheumatology, Spedali Civili di Brescia, Brescia, Italy.
  • Casato M; Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  • Ursini F; Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
  • Giacomelli R; Unità Operativa di Immunoreumatologia-Area Medicina Clinica Policlinico Universitario Campus Bio-Medico di Roma, Roma, Italy.
  • Fallahi P; Department of Translational Research & New Technologies in Medicine and Surgery, University of Pisa, School of Medicine, Pisa, Italy.
  • Santini SA; Department of Basic, Clinical, Intensive and Perioperative Biotechnological Sciences, Catholic University School of Medicine, Rome, Italy; Synlab Italia, Monza (MB), Italy.
  • Iannone F; UO Reumatologia - DETO, Università di Bari, Bari, Italy.
  • Salvarani C; Rheumatology Unit, University of Modena and Reggio Emilia, School of Medicine, Modena, Italy.
  • Zignego AL; MASVE Interdepartmental Hepatology Center, Department of Experimental and clinical Medicine, University of Florence Center, Center for Research and Innovation CRIA-MASVE, Firenze, Italy.
  • Antonelli A; Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, School of Medicine, Pisa, Italy.
J Autoimmun ; 131: 102866, 2022 07.
Article in English | MEDLINE | ID: covidwho-2015569
ABSTRACT
Autoimmune systemic diseases (ASD) show impaired immunogenicity to COVID-19 vaccines. Our prospective observational multicenter study aimed at evaluating the seroconversion elicited by COVID-19 vaccine over the entire vaccination cycle including the booster dose. Among 478 unselected ASD patients originally evaluated at the end of the first vaccination cycle (time 1), 344 individuals were re-evaluated after a 6-month period (time 2), and 244 after the booster vaccine dose (time 3). The immunogenicity of mRNA COVID-19 vaccines (BNT162b2 and mRNA-1273) was assessed by measuring serum IgG-neutralizing antibody (NAb) on samples obtained at the three time points in both patients and 502 age-matched controls. In the 244 ASD group that received booster vaccine and monitored over the entire follow-up, the mean serum NAb levels (time 1, 2, and 3 696.8 ± 52.68, 370.8 ± 41.92, and 1527 ± 74.16SD BAU/mL, respectively; p < 0.0001) were constantly lower compared to controls (p < 0.0001), but they significantly increased after the booster dose compared to the first two measurements (p < 0.0001). The percentage of patients with absent/suboptimal response to vaccine significantly decreased after the booster dose compared to the first and second evaluations (time 1, 2, and 3 from 28.2% to 46.3%, and to 7.8%, respectively; p < 0.0001). Of note, the percentage of patients with absent/suboptimal response after the booster dose was significantly higher compared to controls (19/244, 7.8% vs 1/502, 0.2%; p < 0.0001). Similarly, treatment with immune-modifiers increased the percentage of patients exhibiting absent/suboptimal response (16/122, 13.1% vs 3/122, 2.46%; p = 0.0031). Overall, the above findings indicate the usefulness of booster vaccine administration in ASD patients. Moreover, the persistence of a significantly higher percentage of individuals without effective seroconversion (7.8%), even after the booster dose, warrants for careful monitoring of NAb levels in all ASD patients to identify those with increased risk of infection. In this particularly frail patients' setting, tailored vaccination and/or therapeutic strategy are highly advisable.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: J Autoimmun Journal subject: Allergy and Immunology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Vaccines / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: J Autoimmun Journal subject: Allergy and Immunology Year: 2022 Document Type: Article