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On-line Access: 2022-11-15

Received: 2022-02-07

Revision Accepted: 2022-06-12

Crosschecked: 2022-11-16

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Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Yusheng SHU

https://orcid.org/0000-0001-7270-0012

Ju GAO

https://orcid.org/0000-0001-7063-7574

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Journal of Zhejiang University SCIENCE B 2022 Vol.23 No.11 P.899-914

http://doi.org/10.1631/jzus.B2200054


Clinical and immune response characteristics among vaccinated persons infected with SARS-CoV-2 delta variant: a retrospective study


Author(s):  Cunjin WANG, Yong LI, Yuchen PAN, Luojing ZHOU, Xi ZHANG, Yan WEI, Fang GUO, Yusheng SHU, Ju GAO

Affiliation(s):  Department of Anesthesiology, Northern Jiangsu People’s Hospital, Yangzhou 225001, China; more

Corresponding email(s):   shuyusheng65@163.com, gaoju_003@163.com

Key Words:  Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Delta variant, Vaccine, Hospitalization, Immune response


Cunjin WANG, Yong LI, Yuchen PAN, Luojing ZHOU, Xi ZHANG, Yan WEI, Fang GUO, Yusheng SHU, Ju GAO. Clinical and immune response characteristics among vaccinated persons infected with SARS-CoV-2 delta variant: a retrospective study[J]. Journal of Zhejiang University Science B, 2022, 23(11): 899-914.

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author="Cunjin WANG, Yong LI, Yuchen PAN, Luojing ZHOU, Xi ZHANG, Yan WEI, Fang GUO, Yusheng SHU, Ju GAO",
journal="Journal of Zhejiang University Science B",
volume="23",
number="11",
pages="899-914",
year="2022",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B2200054"
}

%0 Journal Article
%T Clinical and immune response characteristics among vaccinated persons infected with SARS-CoV-2 delta variant: a retrospective study
%A Cunjin WANG
%A Yong LI
%A Yuchen PAN
%A Luojing ZHOU
%A Xi ZHANG
%A Yan WEI
%A Fang GUO
%A Yusheng SHU
%A Ju GAO
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%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2200054

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T1 - Clinical and immune response characteristics among vaccinated persons infected with SARS-CoV-2 delta variant: a retrospective study
A1 - Cunjin WANG
A1 - Yong LI
A1 - Yuchen PAN
A1 - Luojing ZHOU
A1 - Xi ZHANG
A1 - Yan WEI
A1 - Fang GUO
A1 - Yusheng SHU
A1 - Ju GAO
J0 - Journal of Zhejiang University Science B
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PB - Zhejiang University Press & Springer
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DOI - 10.1631/jzus.B2200054


Abstract: 
ObjectiveThis study aimed to observe the clinical and immune response characteristics of vaccinated persons infected with the delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Yangzhou, China.
MethodsWe extracted the medical data of 129 patients with delta-variant infection who were admitted to Northern Jiangsu People’s Hospital (Yangzhou, China) between August and September, 2021. The patients were grouped according to the number of vaccine doses received into an unvaccinated group: a one-dose group and a two-dose group. The vaccine used was SARS-CoV-2-inactivated vaccine developed by Sinovac. We retrospectively analyzed the patients’ epidemiological, clinical, laboratory, and imaging data.
ResultsAlmost all patients with delta-variant infection in Yangzhou were elderly, and patients with severe/critical illness were over 70 years of age. The rates of severe/critical illness (P=0.006), fever (P=0.025), and dyspnea (P=0.045) were lower in the two-dose group than in the unvaccinated group. Compared to the unvaccinated group, the two-dose group showed significantly higher lymphocyte counts and significantly lower levels of C-reactive protein (CRP), interleukin-6 (IL-6), and D-dimer during hospitalization and a significantly higher positive rate of immunoglobulin G (IgG) antibodies at admission (all P<0.05). The cumulative probabilities of hospital discharge and negative virus conversion were also higher in the two-dose group than in the unvaccinated group (P<0.05).
ConclusionsTwo doses of the SARS-CoV-2-inactivated vaccine were highly effective at limiting symptomatic disease and reducing immune response, while a single dose did not seem to be effective.

新冠疫苗对SARS-CoV-2 Delta感染者临床症状和免疫应答反应的影响:一项回顾性研究

王存金1,2,李勇1,2,潘昱辰3,周罗晶2,张曦2,4,魏艳1,2,郭芳1,2,束余声2,5,高巨1,2
1苏北人民医院麻醉科,中国扬州市,225001
2扬州大学临床医学院,中国扬州市,225001
3中国人民武装警察部队江苏省总队医院神经内科,中国扬州市,225000
4苏北人民医院中医科,中国扬州市,225001
5苏北人民医院心胸外科,中国扬州市,225001
目的:观察扬州地区疫苗接种对德尔塔(Delta)变异型冠状病毒(SARS-CoV-2)感染者临床和免疫应答特征的影响。
方法:提取2021年8-9月苏北人民医院收治的129例Delta变异株感染患者的病例资料。根据接种疫苗的剂量将患者分为未接种组、一针组和两针组。所用疫苗为北京科兴公司研制的SARS-CoV-2灭活疫苗。我们回顾性分析了患者的流行病学、临床、实验室和影像学资料。
结果:扬州地区Delta变异感染患者多数为老年人,重症/危重患者年龄均在70岁以上。两针组重症/危重症(P=0.006)患者人数、发热(P=0.025)和呼吸困难(P=0.045)发生率均低于未接种组。与未接种组相比,两针组住院期间淋巴细胞计数显著升高,C反应蛋白(CRP)、白细胞介素-6(IL-6)和D-二聚体水平显著降低,入院时免疫球蛋白G(IgG)抗体阳性率显著升高(P<0.05)。两针组的累计出院概率和病毒转阴概率也高于未接种组(P<0.05)。
结论:接种两针SARS-CoV-2灭活疫苗在减轻新冠肺炎患者症状和降低免疫应答方面效果显著,接种一针疫苗效果不明显。

关键词:冠状病毒(SARS-CoV-2);德尔塔(Delta)变异株;疫苗;住院;免疫反应

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Abu-RaddadLJ, ChemaitellyH, ButtAA, et al., 2021. Effectiveness of the BNT162b2 Covid-19 vaccine against the B.1.1.7 and B.1.351 variants. N Engl J Med, 385(2):187-189.

[2]BadenLR, el SahlyHM, EssinkB, et al., 2021. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med, 384(5):403-416.

[3]BajA, NovazziF, FerranteFD, et al., 2021. Spike protein evolution in the SARS-CoV-2 Delta variant of concern: a case series from Northern Lombardy. Emerg Microbes Infect, 10(1):2010-2015.

[4]BeňováK, HanckováM, KočiK, et al., 2020. T cells and their function in the immune response to viruses. Acta Virol, 64(2):131-143.

[5]ChenL, LiuHG, LiuW, et al., 2020. Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia. Chin J Tuberc Respir Dis, 43(3):203-208 (in Chinese).

[6]DharMS, MarwalR, VsR, et al., 2021. Genomic characterization and epidemiology of an emerging SARS-CoV-2 variant in Delhi, India. Science, 374(6570):eabj9932.

[7]GabarreP, DumasG, DupontT, et al., 2020. Acute kidney injury in critically ill patients with COVID-19. Intensive Care Med, 46(7):1339-1348.

[8]GhoshAK, KaiserM, MollaMA, et al., 2021. Molecular and serological characterization of the SARS-CoV-2 delta variant in Bangladesh in 2021. Viruses, 13(11):2310.

[9]GlowackaI, BertramS, MullerMA, et al., 2011. Evidence that TMPRSS2 activates the severe acute respiratory syndrome coronavirus spike protein for membrane fusion and reduces viral control by the humoral immune response. J Virol, 85(9):4122-4134.

[10]GuptaN, KaurH, YadavPD, et al., 2021. Clinical characterization and genomic analysis of samples from COVID-19 breakthrough infections during the second wave among the various states of India. Viruses, 13(9):1782.

[11]HaileamlakA, 2021. After a year, SARS-CoV-2 is not well known. Ethiop J Health Sci, 31(2):212.

[12]HallVJ, FoulkesS, SaeiA, et al., 2021. COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study. Lancet, 397(10286):1725-1735.

[13]HammingI, TimensW, BulthuisMLC, et al., 2004. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol, 203(2):631-637.

[14]HansrivijitP, QianCC, BoonphengB, et al., 2020. Incidence of acute kidney injury and its association with mortality in patients with COVID-19: a meta-analysis. J Investig Med, 68(7):1261-1270.

[15]HoffmannM, Kleine-WeberH, SchroederS, et al., 2020. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell, 181(2):271-280.E8.

[16]HuXF, ChenJF, JiangXM, et al., 2020. CT imaging of two cases of one family cluster 2019 novel coronavirus (2019-nCoV) pneumonia: inconsistency between clinical symptoms amelioration and imaging sign progression. Quant Imaging Med Surg, 10(2):508-510.

[17]HuangCL, WangYM, LiXW, et al., 2020. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 395(10223):497-506.

[18]JalkanenP, KolehmainenP, HäkkinenHK, et al., 2021. COVID-19 mRNA vaccine induced antibody responses against three SARS-CoV-2 variants. Nat Commun, 12:3991.

[19]KempSA, CollierDA, DatirR, et al., 2020. Neutralising antibodies in Spike mediated SARS-CoV-2 adaptation. medRxiv, preprint.

[20]Kleine-WeberH, ElzayatMT, HoffmannM, et al., 2018. Functional analysis of potential cleavage sites in the MERS-coronavirus spike protein. Sci Rep, 8:16597.

[21]KongWF, AgarwalPP, 2020. Chest imaging appearance of COVID-19 infection. Radiol Cardiothorac Imaging, 2(1):e200028.

[22]LeiJQ, LiJF, LiX, et al., 2020. CT imaging of the 2019 novel coronavirus (2019-nCoV) pneumonia. Radiology, 295(1):18.

[23]LiRF, HouYL, HuangJC, et al., 2020. Lianhuaqingwen exerts anti-viral and anti-inflammatory activity against novel coronavirus (SARS-CoV-2). Pharmacol Res, 156:104761.

[24]LiZT, YiYX, LuoXM, et al., 2020. Development and clinical application of a rapid IgM-IgG combined antibody test for SARS-CoV-2 infection diagnosis. J Med Virol, 92(9):1518-1524.

[25]LiangYW, WangML, ChienCS, et al., 2020. Highlight of immune pathogenic response and hematopathologic effect in SARS-CoV, MERS-CoV, and SARS-CoV-2 infection. Front Immunol, 11:1022.

[26]LiuY, LiuJY, XiaHJ, et al., 2021. Neutralizing activity of BNT162b2-elicited serum. N Engl J Med, 384(15):‍1466-1468.

[27]LongQX, LiuBZ, DengHJ, et al., 2020. Antibody responses to SARS-CoV-2 in patients with COVID-19. Nat Med, 26(6):845-848.

[28]LuHH, ShiY, ChenKL, et al., 2021. Impact of antitumor regimens on the outcomes of cancer patients with COVID-19: a pooled analysis. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 22(10):876-884.

[29]LuRJ, ZhaoX, LiJ, et al., 2020. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet, 395(10224):565-574.

[30]MalikJA, MullaAH, FarooqiT, et al., 2021. Targets and strategies for vaccine development against SARS-CoV-2. Biomed Pharmacother, 137:111254.

[31]MudatsirM, FajarJK, WulandariL, et al., 2020. Predictors of COVID-19 severity: a systematic review and meta-analysis. F1000Res, 9:1107.

[32]National Health Commission of the People’s Republic of China, 2020. Technical guidance for laboratory testing of 2019-nCoV infection (Third Edition). Biosaf Health, 2(1):3-5.

[33]National Health Commission of the People’s Republic of China, National Administration of Tranditional Chinese Medicine, 2022. Diagnosis and treatment protocol for COVID-19 (trial version 9). http://www.nhc.gov.cn/yzygj/s7653p/202203/b74ade1ba4494583805a3d2e40093d88.shtml(in Chinese).

[34]NovelliG, ColonaVL, PandolfiPP, 2021. A focus on the spread of the delta variant of SARS-CoV-2 in India. Indian J Med Res, 153(5-6):537-541.

[35]PanF, YeTH, SunP, et al., 2020. Time course of lung changes at chest CT during recovery from coronavirus disease 2019 (COVID-19). Radiology, 295(3):715-721.

[36]ParumsDV, 2021. Editorial: Revised World Health Organization (WHO) terminology for variants of concern and variants of interest of SARS-CoV-2. Med Sci Monit, 27:e933622.

[37]ShiHS, HanXY, JiangNC, et al., 2020. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis, 20(4):425-434.

[38]ShiY, WangG, CaiXP, et al., 2020. An overview of COVID-19. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 21(5):343-360.

[39]ShindeV, BhikhaS, HoosainZ, et al., 2021. Efficacy of NVX-CoV2373 COVID-19 vaccine against the B.1.351 variant. N Engl J Med, 384(20):1899-1909.

[40]SkowronskiDM, de SerresG, 2021. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med, 384(16):1576-1577.

[41]SultanaJ, MazzagliaG, LuxiN, et al., 2020. Potential effects of vaccinations on the prevention of COVID-19: rationale, clinical evidence, risks, and public health considerations. Expert Rev Vaccines, 19(10):919-936.

[42]TangN, BaiH, ChenX, et al., 2020. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost, 18(5):1094-1099.

[43]VoyseyM, ClemensSAC, MadhiSA, et al., 2021. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet, 397(10269):99-111.

[44]WanZK, ZhouZF, LiuY, et al., 2020. Regulatory T cells and T helper 17 cells in viral infection. Scand J Immunol, 91(5):e12873.

[45]WangJ, JiangMM, ChenX, et al., 2020. Cytokine storm and leukocyte changes in mild versus severe SARS-CoV-2 infection: review of 3939 COVID-19 patients in China and emerging pathogenesis and therapy concepts. J Leukoc Biol, 108(1):17-41.

[46]WangZF, SuF, LinXJ, et al., 2011. Serum D-dimer changes and prognostic implication in 2009 novel influenza A(H1N1). Thromb Res, 127(3):198-201.

[47]WuXJ, WuP, ShenYF, et al., 2018. CD8+ resident memory T cells and viral infection. Front Immunol, 9:2093.

[48]WuZY, McGooganJM, 2020. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 323(13):1239-1242.

[49]XiongY, LiuY, CaoL, et al., 2020. Transcriptomic characteristics of bronchoalveolar lavage fluid and peripheral blood mononuclear cells in COVID-19 patients. Emerg Microbes Infect, 9(1):761-770.

[50]XuX, SunJ, NieS, et al., 2020. Seroprevalence of immunoglobulin M and G antibodies against SARS-CoV-2 in China. Nat Med, 26(8):1193-1195.

[51]XuXT, ChenP, WangJF, et al., 2020. Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. Sci China Life Sci, 63(3):457-460.

[52]YanSM, WuG, 2021. Is lymphopenia different between SARS and COVID-19 patients? FASEB J, 35(2):e21245.

[53]ZhangGM, ZhangJ, WangBW, et al., 2020. Analysis of clinical characteristics and laboratory findings of 95 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a retrospective analysis. Respir Res, 21:74.

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