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Dynamics of inflammatory responses after SARS-CoV-2 infection by vaccination status in the USA: a prospective cohort study.
Zhu, Xianming; Gebo, Kelly A; Abraham, Alison G; Habtehyimer, Feben; Patel, Eshan U; Laeyendecker, Oliver; Gniadek, Thomas J; Fernandez, Reinaldo E; Baker, Owen R; Ram, Malathi; Cachay, Edward R; Currier, Judith S; Fukuta, Yuriko; Gerber, Jonathan M; Heath, Sonya L; Meisenberg, Barry; Huaman, Moises A; Levine, Adam C; Shenoy, Aarthi; Anjan, Shweta; Blair, Janis E; Cruser, Daniel; Forthal, Donald N; Hammitt, Laura L; Kassaye, Seble; Mosnaim, Giselle S; Patel, Bela; Paxton, James H; Raval, Jay S; Sutcliffe, Catherine G; Abinante, Matthew; Broderick, Patrick; Cluzet, Valerie; Cordisco, Marie Elena; Greenblatt, Benjamin; Petrini, Joann; Rausch, William; Shade, David; Lane, Karen; Gawad, Amy L; Klein, Sabra L; Pekosz, Andrew; Shoham, Shmuel; Casadevall, Arturo; Bloch, Evan M; Hanley, Daniel; Sullivan, David J; Tobian, Aaron A R.
Affiliation
  • Zhu X; Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • Gebo KA; Department of Medicine, Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • Abraham AG; Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
  • Habtehyimer F; Department of Medicine, Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • Patel EU; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
  • Laeyendecker O; Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Washington, DC, USA.
  • Gniadek TJ; Department of Pathology and Laboratory Medicine, Northshore University Health System, Evanston, IL, USA.
  • Fernandez RE; Department of Medicine, Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • Baker OR; Department of Medicine, Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • Ram M; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
  • Cachay ER; Department of Medicine, Division of Infectious Diseases, University of California, San Diego, San Diego, CA, USA.
  • Currier JS; Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, CA, USA.
  • Fukuta Y; Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, TX, USA.
  • Gerber JM; Department of Medicine, Division of Hematology and Oncology, University of Massachusetts Chan Medical School, Worcester, MA, USA.
  • Heath SL; Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA.
  • Meisenberg B; Department of Medicine and Research Institute of Luminis Health, Annapolis, MD, USA.
  • Huaman MA; Department of Medicine, Division of Infectious Diseases University of Cincinnati, Cincinnati, OH, USA.
  • Levine AC; Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA.
  • Shenoy A; Division of Hematology, Medstar DC Hospital, Washington, DC, USA.
  • Anjan S; Department of Medicine, Division of Infectious Diseases, University of Miami, Miller School of Medicine, Miami, FL, USA.
  • Blair JE; Department of Medicine, Division of Infectious Diseases, Mayo Clinic Hospital, Phoenix, AZ, USA.
  • Cruser D; Department of Pathology, Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY, USA.
  • Forthal DN; Department of Medicine, Division of Infectious Diseases, University of California, Irvine, CA, USA.
  • Hammitt LL; Department of International Health, Johns Hopkins University, Baltimore, MD, USA.
  • Kassaye S; Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC, USA.
  • Mosnaim GS; Division of Allergy and Immunology, Department of Medicine, Northshore University Health System, Evanston, IL, USA.
  • Patel B; Department of Medicine, Divisions of Pulmonary and Critical Care Medicine, University of Texas Health Science Center, Houston, TX, USA.
  • Paxton JH; Department of Emergency Medicine, Wayne State University, Detroit, MI, USA.
  • Raval JS; Department of Pathology, University of New Mexico, Albuquerque, NM, USA.
  • Sutcliffe CG; Department of International Health, Johns Hopkins University, Baltimore, MD, USA.
  • Abinante M; Ascada Research, Los Angeles, CA, USA.
  • Broderick P; Department of Emergency Medicine, Nuvance Health Danbury Hospital, Danbury, CT, USA.
  • Cluzet V; Department of Infectious Disease, Nuvance Health Vassar Brothers Medical Center, Poughkeepsie, NY, USA.
  • Cordisco ME; Department of Emergency Medicine, Nuvance Health Danbury Hospital, Danbury, CT, USA.
  • Greenblatt B; Department of Emergency Medicine, Nuvance Health Norwalk Hospital, Norwark, CT, USA.
  • Petrini J; Department of Emergency Medicine, Nuvance Health Danbury Hospital, Danbury, CT, USA.
  • Rausch W; Department of Emergency Medicine, Nuvance Health Danbury Hospital, Danbury, CT, USA.
  • Shade D; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA.
  • Lane K; Department of Neurology, Brain Injury Outcomes Division, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • Gawad AL; Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA.
  • Klein SL; Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA.
  • Pekosz A; Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA.
  • Shoham S; Department of Medicine, Division of Infectious Diseases, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • Casadevall A; Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA.
  • Bloch EM; Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • Hanley D; Department of Neurology, Brain Injury Outcomes Division, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • Sullivan DJ; Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA.
  • Tobian AAR; Department of Pathology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. Electronic address: atobian1@jhmi.edu.
Lancet Microbe ; 4(9): e692-e703, 2023 09.
Article in En | MEDLINE | ID: mdl-37659419
ABSTRACT

BACKGROUND:

Cytokines and chemokines play a critical role in the response to infection and vaccination. We aimed to assess the longitudinal association of COVID-19 vaccination with cytokine and chemokine concentrations and trajectories among people with SARS-CoV-2 infection.

METHODS:

In this longitudinal, prospective cohort study, blood samples were used from participants enrolled in a multi-centre randomised trial assessing the efficacy of convalescent plasma therapy for ambulatory COVID-19. The trial was conducted in 23 outpatient sites in the USA. In this study, participants (aged ≥18 years) were restricted to those with COVID-19 before vaccination or with breakthrough infections who had blood samples and symptom data collected at screening (pre-transfusion), day 14, and day 90 visits. Associations between COVID-19 vaccination status and concentrations of 21 cytokines and chemokines (measured using multiplexed sandwich immunoassays) were examined using multivariate linear mixed-effects regression models, adjusted for age, sex, BMI, hypertension, diabetes, trial group, and COVID-19 waves (pre-alpha or alpha and delta).

FINDINGS:

Between June 29, 2020, and Sept 30, 2021, 882 participants recently infected with SARS-CoV-2 were enrolled, of whom 506 (57%) were female and 376 (43%) were male. 688 (78%) of 882 participants were unvaccinated, 55 (6%) were partly vaccinated, and 139 (16%) were fully vaccinated at baseline. After adjusting for confounders, geometric mean concentrations of interleukin (IL)-2RA, IL-7, IL-8, IL-15, IL-29 (interferon-λ), inducible protein-10, monocyte chemoattractant protein-1, and tumour necrosis factor-α were significantly lower among the fully vaccinated group than in the unvaccinated group at screening. On day 90, fully vaccinated participants had approximately 20% lower geometric mean concentrations of IL-7, IL-8, and vascular endothelial growth factor-A than unvaccinated participants. Cytokine and chemokine concentrations decreased over time in the fully and partly vaccinated groups and unvaccinated group. Log10 cytokine and chemokine concentrations decreased faster among participants in the unvaccinated group than in other groups, but their geometric mean concentrations were generally higher than fully vaccinated participants at 90 days. Days since full vaccination and type of vaccine received were not correlated with cytokine and chemokine concentrations.

INTERPRETATION:

Initially and during recovery from symptomatic COVID-19, fully vaccinated participants had lower concentrations of inflammatory markers than unvaccinated participants suggesting vaccination is associated with short-term and long-term reduction in inflammation, which could in part explain the reduced disease severity and mortality in vaccinated individuals.

FUNDING:

US Department of Defense, National Institutes of Health, Bloomberg Philanthropies, State of Maryland, Mental Wellness Foundation, Moriah Fund, Octapharma, HealthNetwork Foundation, and the Shear Family Foundation.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: COVID-19 Type of study: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Female / Humans / Male Country/Region as subject: America do norte Language: En Journal: Lancet Microbe Year: 2023 Document type: Article Affiliation country: Estados Unidos
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: COVID-19 Type of study: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Female / Humans / Male Country/Region as subject: America do norte Language: En Journal: Lancet Microbe Year: 2023 Document type: Article Affiliation country: Estados Unidos