Has the risk of severe COVID-19 in the UK immunocompromised population changed after the vaccination rollout?

In a recent study published in The forefront of immunology¸ Researchers assessed the changing risk of severe coronavirus disease 2019 (COVID-19) outcome in individuals with primary and secondary immunodeficiency in relation to COVID-19 vaccination.

Background

Although COVID-19 vaccination dramatically altered the risk of mortality and morbidity from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the risk of mortality and morbidity from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was reduced in populations with primary and secondary Most are still vulnerable.

Studies show that immunocompromised populations have higher morbidity and mortality from SARS-CoV-2 infection. Impaired vaccine responses have been observed in this group, and information on vaccine immunogenicity and its immunogenicity is lacking. Effectiveness For severe outcomes of COVID-19 in immunocompromised populations. In addition, severe COVID-9 outcome changes associated with vaccines, monoclonal antibody therapy, and emerging SARS-CoV-2 variants remain unexplored.

About research

The current study recruited patients from two United Kingdom (UK) studies examining SARS-CoV-2 infection and vaccination-related immune responses in patients with primary and secondary immunodeficiency. National COVID-19 case series from the UK Primary Immunodeficiency Network (UK PIN).

In the COV-AD study, primary and second-line Antibody-deficient participants were recruited. Participants were followed up with serological analysis after vaccination or SARS-CoV-2 infection.

The UK PIN COVID-19 data consisted of anonymized SARS-CoV-2 infection outcome information collected routinely from primary and secondary immunocompromised patients undergoing treatment in the UK. .

This study was based on two cohorts. Cohort A used data from the UK PIN COVID-19 study on patients infected between March 2020 and July 2020, before vaccination and broad antiviral treatment became available. Cohort B is a patient enrolled in the COV-AD study and a participant in the UK PIN COVID-19 study who was infected between January 2021 and April 2022 when vaccines and interventions are readily available. It consisted of

In addition, demographic factors, COVID-19 outcomes, hospitalization rates, and comorbidities were compared between the two cohorts. Comorbidities included pulmonary, cardiovascular, rheumatic, hepatic, renal, and gastrointestinal disease, diabetes mellitus, and organ-specific autoimmune disease. Ethnicity and body mass index data were not included in the analysis because uniform information was not available.

result

As a result, a significant reduction in mortality (20% vs. 3.4%) and hospitalization (53.5% vs. 17.9%) due to SARS-CoV-2 infection in primary immunocompromised patients was reported between Cohort A and Cohort B. but still high. compared to the general public. Moreover, almost 70% of the general population had been infected with SARS-CoV-2 at least once, whereas the proportion was much lower among immunocompromised individuals (22.7%).

According to the authors, this decline in mortality and morbidity is due to a combination of vaccines, antiviral therapy, precautions such as social distancing and mask-wearing, and the emergence of less pathogenic SARS-CoV-2 variants. could be the result.

Given the fact that asymptomatic SARS-CoV-2 infection is very unlikely among immunocompromised persons, the authors estimated that more than 75% of immunocompromised persons in the UK were infected with SARS-CoV-2. I concluded that I didn’t. Adherence to non-pharmacological interventions such as social distancing and wearing face masks is believed to have reduced the frequency of COVID-19 in immunocompromised populations.

Furthermore, since most infections in immunocompromised populations occurred during a period when SARS-CoV-2 omicron variants predominated, strict adherence to non-pharmacological measures could prevent SARS-CoV infection in individuals with primary and secondary immunocompromises. -2 Infection is believed to be delayed.

SARS-CoV-2 viral ribonucleic acid (RNA) carriage in the nasopharynx of immunocompromised COVID-19 patients was of a shorter duration, which was thought to result from a serological response to vaccination. , did not produce significant differences in mortality or hospitalization rates. price.

Conclusion

In summary, this study investigated changes in severity and mortality associated with SARS-CoV-2 infection in immunocompromised patients given the advances and availability of vaccines and antiviral therapies.

Overall, the results show that the widespread availability of vaccination and antiviral treatment options in the UK has reduced hospitalization and mortality among immunocompromised COVID-19 patients. However, compared to the general population, an immunocompromised person continues to be at increased risk of worsening her COVID-19 outcome. The authors believe that mitigation strategies, vaccination, and treatment options should be optimized for immunocompromised populations.