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. 2021 Aug;41(8):1429-1440.
doi: 10.1007/s00296-021-04910-7. Epub 2021 Jun 9.

Antibody response to inactivated COVID-19 vaccine (CoronaVac) in immune-mediated diseases: a controlled study among hospital workers and elderly

Emire Seyahi  1 , Guldaran Bakhdiyarli  2 , Mert Oztas  3 , Mert Ahmet Kuskucu  4 , Yesim Tok  4 , Necdet Sut  5 , Guzin Ozcifci  6 , Ali Ozcaglayan  6 , Ilker Inanc Balkan  7 , Nese Saltoglu  7 , Fehmi Tabak  7 , Vedat Hamuryudan  3
Affiliations

Antibody response to inactivated COVID-19 vaccine (CoronaVac) in immune-mediated diseases: a controlled study among hospital workers and elderly

Emire Seyahi et al. Rheumatol Int. 2021 Aug.

Abstract

Objective: To assess antibody response to inactivated COVID-19 vaccine in patients with immune-mediated diseases (IMD) among hospital workers and people aged 65 and older.

Methods: In this cross-sectional study, we studied 82 hospital workers with IMD (mean age: 42.2 ± 10.0 years) and 300 (mean age: 41.7 ± 9.9 years) controls. Among + 65 aged population, we studied 22 (mean age: 71.4 ± 4.5 years) patients and 47 controls (mean age: 70.9 ± 4.8 years). All study subjects had a negative history for COVID-19. Sera were obtained after at least 21 days following the second vaccination. Anti-spike IgG antibody titers were measured quantitatively using a commercially available immunoassay method.

Results: Patients with IMD were significantly less likely to have detectable antibodies than healthy controls both among the hospital workers (92.7% vs 99.7%, p < 0.001) and elderly population (77.3% vs 97.9%, p = 0.011). Among patients with IMD, those using immunosuppressive or immune-modulating drugs (64/75, 85.3%) were significantly less likely to have detectable antibodies compared to those off treatment (29/29, 100%) (p = 0.029). Additionally, a negative association between age and the antibody titer categories among patients (r = - 0.352; p < 0.001) and controls (r = - 0.258; p < 0.001) were demonstrated.

Conclusions: Among hospital workers, the vast majority of patients with IMD and immunocompetent controls developed a significant humoral response following the administration of the second dose of inactivated COVID-19 vaccine. This was also true for the elderly population, albeit with lower antibody titers. Immunosuppressive use, particularly rituximab significantly reduced antibody titers. Antibody titers were significantly lower among those aged ≥ 60 years both in patient and control populations. Whether these individuals should get a booster dose warrants further studies.

Keywords: Antibody to S1 spike protein; COVID-19; CoronaVac; Elderly; Hospital workers; Inflammatory diseases; Seroprevalence; Vaccination.

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Conflict of interest statement

Guldaran Bakhdiyarli, MD, Mert Oztas, MD, Mert Ahmet Kuskucu, MD, Yesim Tok, MD, Necdet Sut, PhD, Guzin Ozcifci, Ms, Ali Ozcaglayan, Mr, Ilker Inanc Balkan, MD, Nese Saltoglu, MD, Fehmi Tabak, MD, Vedat Hamuryudan, MD, Emire Seyahi, MD, declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study enrollment
Fig. 2
Fig. 2
Distribution of categorized antibody titers in the study groups
Fig. 3
Fig. 3
Categorized antibody titers between disease subgroups (A) and different treatment regimens (B). RA rheumatoid arthritis, CTD connective tissue disease, SPA spondyloarthropathies, IBD inflammatory bowel diseases, BS Behcet’s syndrome, FMF familial Mediterranean fever, MS multiple sclerosis. Patient with kidney transplant recipient was excluded from disease subgroup analysis RTX rituximab, DMARD disease modifying anti-rheumatic drug. aOther immune-modulating drugs such as fingolimod and dimethyl fumarate
Fig. 4
Fig. 4
Categorized antibody titers according to decades among patients (A) and controls (B)
See this image and copyright information in PMC

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