Precision protection: antibody testing offers insights into predicting SARS-CoV-2 infection risk in immunocompromised patients TheLancet SARSCoV2 immunocompromised covid COVID19
By Neha MathurJul 3 2023Reviewed by Lily Ramsey, LLM In a recent article published in The Lancet, researchers used antibody testing to predict the risk of severe acute respiratory syndrome coronavirus 2 infection in immunocompromised people.
About the study In the present study, researchers enrolled 592 participants with malignant lymphoma, a type of blood cancer, between March 11, 2021, and September 9, 2022, for longitudinal peripheral blood sampling before and post-COVID-19 vaccination from nine hospitals in England. They also collected each participant's demographic and clinical data.
Furthermore, the team performed receiver operating curve analyses to establish the optimal antibody threshold that best discriminated between participants with and without breakthrough infection. Among 334 two vaccine dose recipients, 20 developed a breakthrough infection, i.e., a SARS-CoV-2 infection two weeks or more after vaccination confirmed by a rapid antigen test or reverse transcription-polymerase chain reaction .
Even after three and four vaccine doses, 13% of participants with breakthrough infections sought hospital admission. Five of nine participants under treatment in the hospital did not exhibit T-cell responses versus 16% of 45 participants who were not, highlighting the significance of risk stratification by cellular testing.
Likewise, their anti-spike IgG levels were not markedly different after two vaccine doses with a geomean of 80·4 binding antibody units /mL vs. 38·1 BAU/mL. Likewise, pseudo-neutralization titers after the third and fourth doses had ORs of 2·41 and 3·77, respectively. Accordingly, after three and four vaccine doses, the breakthrough infection risk was 1·6 and 2.3 times less for every 10-fold higher anti-S IgG titers.
Furthermore, a higher proportion of hospitalized patients had undetectable antibodies and cellular response versus those who did not [44% vs. 4%].
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