CLC number:
On-line Access: 2024-08-27
Received: 2023-10-17
Revision Accepted: 2024-05-08
Crosschecked: 2022-11-16
Cited: 0
Clicked: 1421
Citations: Bibtex RefMan EndNote GB/T7714
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.
@article{title="Clinical and immune response characteristics among vaccinated persons infected with SARS-CoV-2 delta variant: a retrospective study",
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
%J Journal of Zhejiang University SCIENCE B
%V 23
%N 11
%P 899-914
%@ 1673-1581
%D 2022
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B2200054
TY - JOUR
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
VL - 23
IS - 11
SP - 899
EP - 914
%@ 1673-1581
Y1 - 2022
PB - Zhejiang University Press & Springer
ER -
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.
[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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