Anti-spike antibody level is associated with the risk of clinical progression among subjects hospitalized with COVID-19 pneumonia: results from a retrospective cohort study.

Purpose: Antibodies against SARS-CoV-2 spike (anti-S) may confer protection against symptomatic COVID-19. Whether their level predicts progression among those with COVID-19 pneumonia remains unclear. Methods: We conducted a retrospective cohort study to assess predictors of anti-S levels and whether...

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Publicado en:Infection Vol. 52; no. 4; pp. 1499 - 1510
Autores principales: Lapadula, Giuseppe, Mezzadri, Luca, Lo Cascio, Giustina, Antolini, Laura, Malandrin, Sergio, Ranzani, Alice, Limonta, Silvia, Cavallero, Annalisa, Bonfanti, Paolo
Formato: research tables/charts Journal Article
Publicado: Springer Nature Aug2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2024
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s15010-024-02250-9
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        atl: Anti-spike antibody level is associated with the risk of clinical progression among subjects hospitalized with COVID-19 pneumonia: results from a retrospective cohort study.
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          Lapadula, Giuseppe
          Mezzadri, Luca
          Lo Cascio, Giustina
          Antolini, Laura
          Malandrin, Sergio
          Ranzani, Alice
          Limonta, Silvia
          Cavallero, Annalisa
          Bonfanti, Paolo
        affil: Infectious Diseases Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
      sug:
        subj:
          COVID-19 Immunology
          COVID-19 Mortality
          Antibodies, Viral
          Vaccination Status
          Disease Progression Risk Factors
          Hospitalization
          Pneumonia, Viral Immunology
          Risk Assessment
          Human
          Male
          Aged
          Aged, 80 and Over
          Retrospective Design
          Record Review
          Prospective Studies
          Sex Factors
          COVID-19 Vaccines
          Respiration, Artificial
          Logistic Regression
          Hematologic Neoplasms
          Immunosuppressive Agents
          Odds Ratio
          Confidence Intervals
          SARS-CoV-2
          COVID-19 Prevention and Control
          Aged: 65+ years
          Aged, 80 & over
          Male
      ab: Purpose: Antibodies against SARS-CoV-2 spike (anti-S) may confer protection against symptomatic COVID-19. Whether their level predicts progression among those with COVID-19 pneumonia remains unclear. Methods: We conducted a retrospective cohort study to assess predictors of anti-S levels and whether anti-S titer is associated with death or mechanical ventilation (MV). Adults hospitalized for COVID-19 pneumonia between July 2021 and July 2022 were enrolled if anti-S had been measured within 72 h of admission. Predictors of anti-S level were explored using multivariable quantile regression. The association between anti-S levels and 30-day death/MV was investigated via multivariable logistic regression. Analyses were stratified by vaccine status. Results: The median anti-S level was 1370 BAU/ml in 328 vaccinated and 15.5 BAU/ml in 206 unvaccinated individuals. Among the vaccinated, shorter symptom duration (p = 0.001), hematological malignancies (p = 0.002), and immunosuppressive therapy (p = 0.004) were associated with lower anti-S levels. In the unvaccinated group, symptom duration was the only predictor of anti-S levels (p < 0.001). After 30 days, 134 patients experienced death or MV. Among vaccinated individuals, higher anti-S levels correlated significantly with lower death/MV risk (per log2 increase, OR 0.88, 95%CI 0.81–0.97), irrespective of age and solid malignancies. Among unvaccinated, a marginally protective effect was observed (OR 0.86, 95%CI 0.73–1.01), independent of age, immunosuppressive therapy, and diabetes. Adjustment for monoclonal antibody treatment strengthened the association (OR 0.81, 95%CI 0.68–0.96). Conclusion: This study suggests that levels of anti-S antibodies can predict critical or fatal outcomes in COVID-19 pneumonia patients, regardless of vaccination. Whether anti-S Ab could guide risk assessment and vaccination boosting merits further evaluation.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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