Please use this identifier to cite or link to this item:
https://hdl.handle.net/2445/197264
Title: | Vaccine breakthrough hypoxemic COVID-19 pneumonia in patients with auto-Abs neutralizing type I IFNs |
Author: | Bastard, Paul Rocamora Blanch, Gemma Pujol Onofre, Aurora Martínez Picado, Francisco Javier Solanich, Xavier Anderson, Mark S. Casanova, Jean Laurent Derisi, Joseph L. Antolí, Arnau |
Keywords: | COVID-19 Pneumònia COVID-19 Pneumonia |
Issue Date: | 14-Jun-2022 |
Publisher: | Science Publishing Group |
Abstract: | Life-threatening `breakthrough' cases of critical COVID-19 are attributed to poor or waning antibody response to the SARS- CoV-2 vaccine in individuals already at risk. Pre-existing autoantibodies (auto-Abs) neutralizing type I IFNs underlie at least 15% of critical COVID-19 pneumonia cases in unvaccinated individuals; however, their contribution to hypoxemic breakthrough cases in vaccinated people remains unknown. Here, we studied a cohort of 48 individuals ( age 20-86 years) who received 2 doses of an mRNA vaccine and developed a breakthrough infection with hypoxemic COVID-19 pneumonia 2 weeks to 4 months later. Antibody levels to the vaccine, neutralization of the virus, and auto- Abs to type I IFNs were measured in the plasma. Forty-two individuals had no known deficiency of B cell immunity and a normal antibody response to the vaccine. Among them, ten (24%) had auto-Abs neutralizing type I IFNs (aged 43-86 years). Eight of these ten patients had auto-Abs neutralizing both IFN-a2 and IFN-., while two neutralized IFN-omega only. No patient neutralized IFN-ss. Seven neutralized 10 ng/mL of type I IFNs, and three 100 pg/mL only. Seven patients neutralized SARS-CoV-2 D614G and the Delta variant (B.1.617.2) efficiently, while one patient neutralized Delta slightly less efficiently. Two of the three patients neutralizing only 100 pg/mL of type I IFNs neutralized both D61G and Delta less efficiently. Despite two mRNA vaccine inoculations and the presence of circulating antibodies capable of neutralizing SARS-CoV-2, auto-Abs neutralizing type I IFNs may underlie a significant proportion of hypoxemic COVID-19 pneumonia cases, highlighting the importance of this particularly vulnerable population. |
Note: | Reproducció del document publicat a: https://doi.org/10.1126/sciimmunol.abp8966 |
It is part of: | Science Immunology, 2022 |
URI: | https://hdl.handle.net/2445/197264 |
Related resource: | https://doi.org/10.1126/sciimmunol.abp8966 |
ISSN: | 2470-9468 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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