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. 2024 Jun 14;13(6):506.
doi: 10.3390/pathogens13060506.

The Effect of Exposure to SARS-CoV-2 Vaccination and Infection on Humoral and Cellular Immunity in a Cohort of Patients with Immune-Mediated Diseases: A Pilot Study

Giulia Anna Maria Luigia Costanzo  1 , Giuseppina Sanna  2 , Francesco Pes  1 , Carla Maria Deiana  1 , Andrea Giovanni Ledda  1 , Andrea Perra  3 , Vanessa Palmas  2 , Valeria Manca  2 , Michela Miglianti  1 , Ferdinando Coghe  4 , Aldo Manzin  2 , Stefano Del Giacco  1 , Luchino Chessa  1 , Davide Firinu  1
Affiliations

The Effect of Exposure to SARS-CoV-2 Vaccination and Infection on Humoral and Cellular Immunity in a Cohort of Patients with Immune-Mediated Diseases: A Pilot Study

Giulia Anna Maria Luigia Costanzo et al. Pathogens. .

Abstract

Immunization against COVID-19 is needed in patients with immune-mediated inflammatory diseases (IMIDs). However, data on long-term immunity kinetics remain scarce. This study aimed to compare the humoral and cellular response to COVID-19 in patients with immune-mediated inflammatory diseases (IMIDs) compared to healthy controls. We compared the humoral and cellular response to SARS-Cov-2 elicited by vaccination and/or infection in a prospective cohort of 20 IMID patients compared with a group of 21 healthcare workers (HCWs). We assessed immunity before and after the third and fourth dose of BNT162b2 or after COVID-19 infection using quantitative IgG anti-SARS-CoV-2 Spike antibody (anti-S-IgG), neutralization assay, and specific interferon-gamma (IFN-g) release assay (IGRA). The responses were compared with those of healthy controls. The two groups were similar in age and total exposure, becoming infected for the first time, mainly after the third dose. Neutralizing antibodies and IGRA were negative in 9.5% of IMID patients but not in any HCWs. No significant difference was found between neutralization titers to BA.1 in the IMID and the HCW groups. The study highlights the SARS-CoV-2 immunological responses in healthy controls and IMID patients, suggesting that the combined stimuli of vaccination and infection in IMID patients could promote a more profound immunological response.

Keywords: COVID–19; immune-mediated diseases; infections; interferon-gamma release assay; vaccine.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study design. Legend: IMIDs: immune-mediated inflammatory diseases; Neutralizing ab: serum neutralizing antibody titer assessed by SARS-CoV-2 microneutralization assay (90% protective activity of neutralizing Ab against the CPE induced by the virus); IGRA: Interferon-gamma (IFN-g) release assay to SARS-CoV-2 Spike protein (Wuhan/Hu-1/2019 and 20J/501Y.V3 “gamma” variant).
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