RESUMO
While mRNA vaccines are administrated worldwide in an effort to contain the COVID-19 pandemic, the heterogeneity of the humoral immune response they induce at the population scale remains unclear. Here, in a prospective, longitudinal, cohort-study, including 1245 hospital care workers and 146 nursing home residents scheduled for BNT162b2 vaccination, together covering adult ages from 19 to 99 years, we analyse seroconversion to SARS-CoV-2 spike protein and amount of spike-specific IgG, IgM and IgA before vaccination, and 3-5 weeks after each dose. We show that immunogenicity after a single vaccine dose is biased to IgG, heterogeneous and reduced with increasing age. The second vaccine dose normalizes IgG seroconversion in all age strata. These findings indicate two dose mRNA vaccines is required to reach population scale humoral immunity. The results advocate for the interval between the two doses not to be extended, and for serological monitoring of elderly and immunosuppressed vaccinees.
Assuntos
Anticorpos Antivirais/imunologia , Vacina BNT162/imunologia , COVID-19/imunologia , Imunização Secundária , SARS-CoV-2/imunologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Imunogenicidade da Vacina , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Portugal/epidemiologia , Estudos Prospectivos , Soroconversão , Vacinação , Adulto JovemRESUMO
Kidney transplant (KT) recipients are at an increased risk for severe COVID-19 because of their immunosuppressed state. A 42-year-old KT patient was diagnosed with COVID-19 three months after KT. Despite lymphopenia and several risk factors, he had a mild disease course. Nasopharyngeal real-time reverse transcriptase polymerase chain reaction for SARS-CoV-2 became negative 48 days after detection. SARS-CoV-2 IgG antibodies became negative after day 40. TTV DNA load increased with the onset COVID-19 and reduced after its resolution. This is the first report where TTV DNA load was measured during the course of COVID-19.
Assuntos
Anticorpos Antivirais/imunologia , COVID-19/imunologia , Infecções por Vírus de DNA/imunologia , DNA Viral/metabolismo , Hospedeiro Imunocomprometido , Imunoglobulina G/imunologia , Transplante de Rim , Torque teno virus/genética , Adulto , COVID-19/epidemiologia , Teste de Ácido Nucleico para COVID-19 , Teste Sorológico para COVID-19 , Comorbidade , Diabetes Mellitus/epidemiologia , Glucocorticoides/uso terapêutico , Rejeição de Enxerto/prevenção & controle , Humanos , Hipertensão/epidemiologia , Imunoglobulina M/imunologia , Imunossupressores/efeitos adversos , Cinética , Linfopenia/imunologia , Masculino , Ácido Micofenólico/efeitos adversos , Obesidade/epidemiologia , Prednisolona/uso terapêutico , SARS-CoV-2/imunologia , Índice de Gravidade de Doença , Tacrolimo/efeitos adversos , Carga ViralRESUMO
Recent studies have shown that obesity is an independent predictor of lower N-terminal pro-BNP (NT-proBNP) levels and raised concerns about the validity of this biomarker in obese subjects. We evaluated the influence of obesity (body mass index>or=30 kg/m(2)) on the correlation between exercise capacity and serum NT-proBNP levels in 100 chronic heart failure (CHF) patients referred for cardiopulmonary exercise testing. Circulating NT-proBNP levels correlated well with lean body mass-adjusted peak oxygen consumption (VO(2)) in the entire cohort (R=-0.72, p<0.001) and in the obese (R=-0.71, p<0.001) and non-obese (R=-0.72, p<0.001) subgroups. There was no significant difference between the correlation coefficients of the two subgroups (p=0.934). In conclusion NT-proBNP levels predict exercise capacity in CHF patients irrespective of the presence of obesity.
