@article{Barnes_E-2023_140969,
title = {SARS-CoV-2-specific immune responses and clinical outcomes after COVID-19 vaccination in patients with immune-suppressive disease},
author = {Barnes, E. and Goodyear, C. and Willicombe, M. and Gaskell, C. and Siebert, S. and de Silva, T. and Murray, S. and Rea, D. and Snowden, J. and Carroll, M. and Pirrie, S. and Bowden, S. and Dunachie, S. and Richter, A. and Lim, Z. and Satsangi, J. and Cook, G. and Pope, A. and Hughes, A. and Harrison, M. and Lim, S. and Miller, P. and Klenerman, P. and Richter, A. and Mentzer, A. and Deeks, A. and Jamsen, A. and Brown, A. and Conlon, C. and Dold, C. and Duncan, C. and Skelly, D. and Kronsteiner, B. and Abraham, P. and Phillips, E. and Jeffery, K. and Turtle, L. and Frending, L. and Stafford, L. and Ali, M. and Rongkard, P. and Payne, R. and Adele, S. and Travis, S. and Gardiner, S. and Dobson, S. and Malone, T. and Bibi, S. and Carroll, M. and Faustini, S. and Foulkes, S. and Frater, J. and Hall, V. and Hopkins, S. and Islam, J. and Lambe, T. and Longet, S. and Moore, S. and Otter, A. and Rowland-Jones, S. and Thaventhir, J. and Wootton, D. and Basu, N. and Gilmour, A. and Irwin, S. and Meacham, G. and Marjot, T. and Dimitriadis, S. and Kelleher, P. and Prendecki, M. and Clarke, C. and Mortimer, P. and McIntyre, S. and Selby, R. and Meardon, N. and Nguyen, D. and Tipton, T. and Longet, S. and Laidlaw, S. and Orchard, K. and Ireland, G. and Brown, K. and Amirthalingam, G. and Thomas, D. and Kearns, P. and Kirkham, A. and McInnes, I. and Beesley, R. and Churchill, V. and Loughton, H. and Insch, E. and MacDonald, E. and Middleton, G. and Billingham, L. and Lowe, F. and Magwaro, S. and Al-Taei, S. and Arnott, M. and Bennett, L. and Brock, J. and Keillor, V. and Melville, A. and Melville, L. and Miller, S. and Najm, A. and Paterson, C. and Rodgers, L. and Rutherford, M. and Rundell, S. and Smith, E. and Stewart, L. and Sunzini, F. and Tong, A. and Woolcock, K. and Basheer, F. and Crawley, C. and Malladi, R. and King, A. and Lockey, S. and Uttenthal, B. and Koh, M. and Hansford, S. and Sandhar, G. and Kesavan, M. and Moore, C. and Manousou, P. and Hahn, G. and Mullish, B. and Atta, M. and Gleeson, S. and Lightstone, L. and Martin, P. and McAdoo, S. and Thomson, T. and Avenoso, D. and Sanderson, R. and Taylor, C. and Bhandal, K. and Hull, D. and Trivedi, P. and Filer, A. and Hurst, E. and Publicover, A. and Scouse, K. and Chalk, J. and Hanke, D. and Hanke, J. and Healy, S. and Provine, N. and Thomas, S. and Walker, V. and Win, Z. and Trown, D. and Faria, P. and Chackathayil, J. and Hutchison, C. and Richardson, D.},
month = {jul},
year = {2023},
abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immune responses and infection outcomes were evaluated in 2,686 patients with varying immune-suppressive disease states after administration of two Coronavirus Disease 2019 (COVID-19) vaccines. Overall, 255 of 2,204 (12%) patients failed to develop anti-spike antibodies, with an additional 600 of 2,204 (27%) patients generating low levels (&lt;380 AU ml−1). Vaccine failure rates were highest in ANCA-associated vasculitis on rituximab (21/29, 72%), hemodialysis on immunosuppressive therapy (6/30, 20%) and solid organ transplant recipients (20/81, 25% and 141/458, 31%). SARS-CoV-2-specific T cell responses were detected in 513 of 580 (88%) patients, with lower T cell magnitude or proportion in hemodialysis, allogeneic hematopoietic stem cell transplantation and liver transplant recipients (versus healthy controls). Humoral responses against Omicron (BA.1) were reduced, although cross-reactive T cell responses were sustained in all participants for whom these data were available. BNT162b2 was associated with higher antibody but lower cellular responses compared to ChAdOx1 nCoV-19 vaccination. We report 474 SARS-CoV-2 infection episodes, including 48 individuals with hospitalization or death from COVID-19. Decreased magnitude of both the serological and the T cell response was associated with severe COVID-19. Overall, we identified clinical phenotypes that may benefit from targeted COVID-19 therapeutic strategies.},
journal = {Nature Medicine},
publisher = {Springer Nature},
url = {https://doi.org/10.1038/s41591-023-02414-4},
}
