Display options
Cite
Ferri C, Ursini F, Gragnani L, et al. Impaired immunogenicity to COVID-19 vaccines in autoimmune systemic diseases. High prevalence of non-response in different patients' subgroups. J Autoimmun. 2021;125:102744doi: 10.1016/j.jaut.2021.102744.
Ferri, C., Ursini, F., Gragnani, L., Raimondo, V., Giuggioli, D., Foti, R., Caminiti, M., Olivo, D., Cuomo, G., Visentini, M., Cacciapaglia, F., Pellegrini, R., Pigatto, E., Urraro, T., Naclerio, C., Tavoni, A., Puccetti, L., Varcasia, G., Cavazzana, I., L'Andolina, M., Ruscitti, P., Vadacca, M., Gigliotti, P., La Gualana, F., Cozzi, F., Spinella, A., Visalli, E., Dal Bosco, Y., Amato, G., Masini, F., Pagano Mariano, G., Brittelli, R., Aiello, V., Caminiti, R., Scorpiniti, D., Rechichi, G., Ferrari, T., Monti, M., Elia, G., Franceschini, F., Meliconi, R., Casato, M., Iannone, F., Giacomelli, R., Fallahi, P., Santini, S. A., Zignego, A. L., & Antonelli, A. (2021). Impaired immunogenicity to COVID-19 vaccines in autoimmune systemic diseases. High prevalence of non-response in different patients' subgroups. Journal of autoimmunity, 125102744. https://doi.org/10.1016/j.jaut.2021.102744
Ferri, Clodoveo, et al. "Impaired immunogenicity to COVID-19 vaccines in autoimmune systemic diseases. High prevalence of non-response in different patients' subgroups." Journal of autoimmunity vol. 125 (2021): 102744. doi: https://doi.org/10.1016/j.jaut.2021.102744
Ferri C, Ursini F, Gragnani L, Raimondo V, Giuggioli D, Foti R, Caminiti M, Olivo D, Cuomo G, Visentini M, Cacciapaglia F, Pellegrini R, Pigatto E, Urraro T, Naclerio C, Tavoni A, Puccetti L, Varcasia G, Cavazzana I, L'Andolina M, Ruscitti P, Vadacca M, Gigliotti P, La Gualana F, Cozzi F, Spinella A, Visalli E, Dal Bosco Y, Amato G, Masini F, Pagano Mariano G, Brittelli R, Aiello V, Caminiti R, Scorpiniti D, Rechichi G, Ferrari T, Monti M, Elia G, Franceschini F, Meliconi R, Casato M, Iannone F, Giacomelli R, Fallahi P, Santini SA, Zignego AL, Antonelli A. Impaired immunogenicity to COVID-19 vaccines in autoimmune systemic diseases. High prevalence of non-response in different patients' subgroups. J Autoimmun. 2021 Dec;125:102744. doi: 10.1016/j.jaut.2021.102744. Epub 2021 Nov 10. PMID: 34781162; PMCID: PMC8577991.
Copy Download .nbib Format: NLM
Share it on

J Autoimmun. 2021 Dec;125:102744. doi: 10.1016/j.jaut.2021.102744. Epub 2021 Nov 10.

Impaired immunogenicity to COVID-19 vaccines in autoimmune systemic diseases. High prevalence of non-response in different patients' subgroups.

Journal of autoimmunity

Clodoveo Ferri, Francesco Ursini, Laura Gragnani, Vincenzo Raimondo, Dilia Giuggioli, Rosario Foti, Maurizio Caminiti, Domenico Olivo, Giovanna Cuomo, Marcella Visentini, Fabio Cacciapaglia, Roberta Pellegrini, Erika Pigatto, Teresa Urraro, Caterina Naclerio, Antonio Tavoni, Lorenzo Puccetti, Giuseppe Varcasia, Ilaria Cavazzana, Massimo L'Andolina, Piero Ruscitti, Marta Vadacca, Pietro Gigliotti, Francesca La Gualana, Franco Cozzi, Amelia Spinella, Elisa Visalli, Ylenia Dal Bosco, Giorgio Amato, Francesco Masini, Giuseppa Pagano Mariano, Raffaele Brittelli, Vincenzo Aiello, Rodolfo Caminiti, Daniela Scorpiniti, Giovanni Rechichi, Tommaso Ferrari, Monica Monti, Giusy Elia, Franco Franceschini, Riccardo Meliconi, Milvia Casato, Florenzo Iannone, Roberto Giacomelli, Poupak Fallahi, Stefano Angelo Santini, Anna Linda Zignego, Alessandro Antonelli

Affiliations

  1. Rheumatology Unit, University of Modena and Reggio Emilia, School of Medicine, Modena, Italy; Rheumatology Clinic 'Madonna Dello Scoglio' Cotronei, Crotone, Italy. Electronic address: [email protected].
  2. Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
  3. MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence Center, Center for Research and Innovation CRIA-MASVE, Firenze, Italy.
  4. Rheumatology Clinic 'Madonna Dello Scoglio' Cotronei, Crotone, Italy.
  5. Rheumatology Unit, University of Modena and Reggio Emilia, School of Medicine, Modena, Italy.
  6. Rheumatology Unit AOU Policlinico G. Rodolico - S. Marco, Catania. Italy.
  7. UOD Reumatologia- Grande Ospedale Metropolitano, Reggio Calabria, Italy.
  8. Rheumatology Outpatient Clinic, San Giovanni di Dio Hospital, Crotone, Italy.
  9. University of Campania Luigi Vanvitelli, Department of Precision Medicine, Napoli, Italy.
  10. Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy.
  11. UO Reumatologia - DETO, Università di Bari, Bari, Italy.
  12. U.O.C. Medicina Interna "M.Valentini" P.O. Annunziata, Cosenza, Italy.
  13. Ospedale "Villa Salus", Mestre, Italy.
  14. Rheumatology Unit, "M. Scarlato" Hospital, Scafati, SA, Italy.
  15. Clinical Immunology, University of Pisa, Pisa, Italy.
  16. U.O.S. Reumatologia, Ospedale Castrovillari, Cosenza, Italy.
  17. Rheumatology, Spedali Civili di Brescia, Brescia, Italy.
  18. Rheumatology Outpatient Clinic, ASP- Vibo Valentia-Tropea Hospital, Italy.
  19. Rheumatology Unit, Department of Biotechnological & Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
  20. Unità Operativa di Immunoreumatologia-Area Medicina Clinica Policlinico Universitario Campus Bio-Medico di Roma, Roma, Italy.
  21. U.O.T. Specialistica Ambulatoriale, ASP 201, Cosenza, Italy.
  22. Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, School of Medicine, Pisa, Italy.
  23. Department of Translational Research & New Technologies in Medicine and Surgery, University of Pisa, School of Medicine, Pisa, Italy.
  24. Department of Basic, Clinical, Intensive and Perioperative Biotechnological Sciences, Catholic University School of Medicine, Rome, Italy; Synlab Italia, Monza, MB, Italy.

PMID: 34781162 PMCID: PMC8577991 DOI: 10.1016/j.jaut.2021.102744

Abstract

Autoimmune systemic diseases (ASD) may show impaired immunogenicity to COVID-19 vaccines. Our prospective observational multicenter study aimed to evaluate the seroconversion after the vaccination cycle and at 6-12-month follow-up, as well the safety and efficacy of vaccines in preventing COVID-19. The study included 478 unselected ASD patients (mean age 59 ± 15 years), namely 101 rheumatoid arthritis (RA), 38 systemic lupus erythematosus (SLE), 265 systemic sclerosis (SSc), 61 cryoglobulinemic vasculitis (CV), and a miscellanea of 13 systemic vasculitis. The control group included 502 individuals from the general population (mean age 59 ± 14SD years). The immunogenicity of mRNA COVID-19 vaccines (BNT162b2 and mRNA-1273) was evaluated by measuring serum IgG-neutralizing antibody (NAb) (SARS-CoV-2 IgG II Quant antibody test kit; Abbott Laboratories, Chicago, IL) on samples obtained within 3 weeks after vaccination cycle. The short-term results of our prospective study revealed significantly lower NAb levels in ASD series compared to controls [286 (53-1203) vs 825 (451-1542) BAU/mL, p < 0.0001], as well as between single ASD subgroups and controls. More interestingly, higher percentage of non-responders to vaccine was recorded in ASD patients compared to controls [13.2% (63/478), vs 2.8% (14/502); p < 0.0001]. Increased prevalence of non-response to vaccine was also observed in different ASD subgroups, in patients with ASD-related interstitial lung disease (p = 0.009), and in those treated with glucocorticoids (p = 0.002), mycophenolate-mofetil (p < 0.0001), or rituximab (p < 0.0001). Comparable percentages of vaccine-related adverse effects were recorded among responder and non-responder ASD patients. Patients with weak/absent seroconversion, believed to be immune to SARS-CoV-2 infection, are at high risk to develop COVID-19. Early determination of serum NAb after vaccination cycle may allow to identify three main groups of ASD patients: responders, subjects with suboptimal response, non-responders. Patients with suboptimal response should be prioritized for a booster-dose of vaccine, while a different type of vaccine could be administered to non-responder individuals.

Copyright © 2021 Elsevier Ltd. All rights reserved.

Keywords: Autoimmune systemic diseases; COVID-19 vaccine; Cryoglobulinemic vasculitis; Neutralizing antibodies; Rheumatoid arthritis; Systemic lupus; Systemic sclerosis; Systemic vasculitis

Publication Types