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Dynamic Antibody Response in SARS-CoV-2 Infected Patients and COVID-19 Vaccine Recipients, and Vaccine Effectiveness in Comorbid and Multimorbid Patients
26 Pages Posted: 4 Nov 2022 Publication Status: Published
Abstract
Objectives: Underlying medical conditions are critical risk factors for COVID-19 susceptibility and its rapid clinical manifestation. Therefore, the preexisting burden of non-communicable diseases (NCDs) makes the preparedness for COVID-19 more challenging for low-and middle-income countries (LTMICs). These countries have relied on vaccination campaigns as an effective measure to tackle COVID-19. In this study, we investigated the impact of comorbidities on humoral antibody response against the specific receptor-binding domain (RBD) of SARS-CoV2.
Methods: SARS-CoV-2 specific IgG and total antibody (TAb) response were assessed within a cohort consisting of 1005 patients. Among the study subjects, patients with multimorbidity (N= 72) were selected for follow-up studies and IgG and TAb responses were measured at multiple time points after the second dose of vaccination. Siemens Dimension Vista SARS-CoV-2 IgG (CV2G) and SARS-CoV-2 TAb assay (CV2T) were used to carry out the serology test.
Results: Out of the total 1005 participants, vaccinated individuals (N=743) had detectable antibody response up to 7-8 months. We also studied the synergistic effect of natural infection and vaccine response. Participants who were naturally infected before receiving the 1st dose of vaccine (N=137) mounted greater antibody response compared to individuals with normal vaccination response (N=414) and breakthrough infection (N=54). Investigation of the impact of comorbidities revealed that Diabetes mellitus (DM) (N=168) (28.82%), and kidney disease (N=94) (16.12%) had a significant negative impact on the decline of humoral antibody response against SARS-CoV-2. IgG and TAb declined more rapidly in diabetic and kidney disease patients compared to the other four comorbid groups. Follow-up studies demonstrated that antibody response declined within 4 months after receiving 2nd dose.
Conclusion: Generalized immunization schedule for COVID-19 needs to be adjusted for high-risk comorbid groups and a booster dose must be administered early (4 months after 2nd dose).
Funding Information: This research was funded by Central Police Hospital, Dhaka, Bangladesh.
Declaration of Interests: The authors declare no conflict of interest.
Ethics Approval Statement: The protocols were approved by the institutional ethics committee at Central Police Hospital, Dhaka, and complied with the International Conference on Harmonisation Guideline for Good Clinical Practice and the Declaration of Helsinki. All patients provided written informed consent according to local guidelines. Reference number- CPHERC/R/02/2021.
Keywords: IgG, antibody, sars-cov-2, COVID-19, multimorbidity, kidney disease, Diabetes
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