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COVID-19 Severity, Cardiological Outcome, and Immunogenicity of mRNA Vaccine on Adult Patients With 22q11.2 DS.
Pulvirenti, Federica; Mortari, Eva Piano; Putotto, Carolina; Terreri, Sara; Fernandez Salinas, Ane; Cinicola, Bianca Laura; Cimini, Eleonora; Di Napoli, Giulia; Sculco, Eleonora; Milito, Cinzia; Versacci, Paolo; Agrati, Chiara; Marino, Bruno; Carsetti, Rita; Quinti, Isabella.
  • Pulvirenti F; Reference Center for Primary Immune Deficiencies, AOU Policlinico Umberto I, Rome, Italy. Electronic address: Federica.pulvirenti.md@gmail.com.
  • Mortari EP; B Cell Unit, Immunology Research Area, Bambino Gesù Children's Hospital, IRCCS, Viale di San Paolo, Rome, Italy; Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
  • Putotto C; Pediatric Cardiology Unit, Department of Pediatrics, Obstetrics and Gynecology, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy.
  • Terreri S; B Cell Unit, Immunology Research Area, Bambino Gesù Children's Hospital, IRCCS, Viale di San Paolo, Rome, Italy.
  • Fernandez Salinas A; B Cell Unit, Immunology Research Area, Bambino Gesù Children's Hospital, IRCCS, Viale di San Paolo, Rome, Italy.
  • Cinicola BL; Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy; Department of Maternal Sciences, Sapienza University of Rome, Italy Viale Regina Elena, 324 00161, Rome, Italy.
  • Cimini E; Cellular Immunology Laboratory, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
  • Di Napoli G; Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
  • Sculco E; Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
  • Milito C; Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
  • Versacci P; Pediatric Cardiology Unit, Department of Pediatrics, Obstetrics and Gynecology, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy.
  • Agrati C; Cellular Immunology Laboratory, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.
  • Marino B; Pediatric Cardiology Unit, Department of Pediatrics, Obstetrics and Gynecology, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy.
  • Carsetti R; B Cell Unit, Immunology Research Area, Bambino Gesù Children's Hospital, IRCCS, Viale di San Paolo, Rome, Italy.
  • Quinti I; Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
J Allergy Clin Immunol Pract ; 2022 Oct 21.
Article in English | MEDLINE | ID: covidwho-2234577
ABSTRACT

BACKGROUND:

The contemporaneous presence of immune defects and heart diseases in patients with 22q11.2 deletion syndrome (22q11.3DS) might represent risk factors for severe coronavirus 2019 disease (COVID-19).

OBJECTIVE:

To analyze severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outcome in 22q11.2DS patients and immunogenicity of different doses of mRNA SARS-CoV-2 vaccine.

METHODS:

Longitudinal observational study on SARS-CoV-2 outcome in 60 adults with 22q11.2DS (March 2020-June 2022). Anti-Spike, and anti-receptor binding domain (RBD) antibody responses, generation of Spike-specific memory B cells (MBCs) and Spike-specific T cells at different time points before and after the mRNA BNT162b2 vaccination were evaluated in 16 22q11.2DS patients.

RESULTS:

We recorded a 95% rate of vaccination, with almost all patients being immunized with the booster dose. Twenty-one patients had SARS-CoV-2 infection. Three patients were infected before vaccine availability, 6 after receiving 2 doses of vaccine, and 12 after one booster dose. The SARS-CoV-2- infection had a mild course, except in one unvaccinated patient with several comorbidities who died from acute respiratory distress syndrome (fatality rate 5%). Infected patients had more frequently moderate/severe intellectual disability, lymphopenia, and lower CD4+ count. Despite major congenital heart diseases, COVID-19 did not impact cardiological conditions. The BNT162b2 vaccine induced S1-immunoglobulin G (IgG) responses, low serum S1-IgA, and slightly impaired specific MBCs response. Specific T-cell responses observed were related to lymphocytes and CD4+ T cell counts.

CONCLUSIONS:

The SARS-CoV-2 infection had a mild course in most patients with 22q11.2DS, even in patients with major cardiovascular diseases. Immunization induced Spike-specific IgG responses and generated specific MBCs and memory T cells. The weaker memory responses in patients with lymphopenia suggested the need for additional doses.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Language: English Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study Topics: Vaccines Language: English Year: 2022 Document Type: Article