Clinical outcomes and immunological features of COVID-19 patients receiving B-cell depletion therapy during the Omicron era
Background: The clinical outcomes and immunological features of coronavirus disease 2019 (COVID-19) patients receiving B-cell depletion therapy (BCDT), especially in Omicron variant era, have not been fully elucidated. We aimed to investigate the outcomes and immune responses of COVID-19 patients receiving BCDT during the Omicron period.Methods: We retrospectively compared clinical outcomes between COVID-19 patients treated with BCDT (the BCDT group) and those with the same underlying diseases not treated with BCDT (the non-BCDT group). For immunological analyses, we prospectively enrolled COVID-19 patients receiving BCDT and immunocompetent COVID-19 patients as controls. We measured humoral and cellular immune responses using the enzyme-linked immunosorbent assay and flow cytometry.Results: Severe to critical COVID-19 was more frequent in the BCDT group than in the non-BCDT group (41.9% vs. 28.3%, p = .030). BCDT was an independent risk factor for severe to critical COVID-19 (adjusted odds ratio [aOR] 2.21, 95% confidence interval [CI] 1.21-4.04, p = .010) as well as for COVID-19-related mortality (aOR 4.03, 95% CI 1.17-13.86, p = .027). Immunological analyses revealed that patients receiving BCDT had lower anti-S1 IgG titres and a tendency to higher proportions of activated CD4+ T-cells than the controls.Conclusions: BCDT was associated with worse COVID-19 outcomes in the Omicron period. Humoral immune response impairment and T-cell hyperactivation were the main immunological features of COVID-19 patients treated with BCDT, which may have contributed to the worse outcomes of COVID-19 in this population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 2023 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:56 |
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| Enthalten in: |
Infectious diseases (London, England) - 56(2023), 2 vom: 18. Feb., Seite 116-127 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lee, Chan Mi [VerfasserIn] |
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| Links: |
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| Themen: |
Antibody |
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| Anmerkungen: |
Date Completed 19.12.2023 Date Revised 19.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/23744235.2023.2276784 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM364087439 |
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| 520 | |a Background: The clinical outcomes and immunological features of coronavirus disease 2019 (COVID-19) patients receiving B-cell depletion therapy (BCDT), especially in Omicron variant era, have not been fully elucidated. We aimed to investigate the outcomes and immune responses of COVID-19 patients receiving BCDT during the Omicron period.Methods: We retrospectively compared clinical outcomes between COVID-19 patients treated with BCDT (the BCDT group) and those with the same underlying diseases not treated with BCDT (the non-BCDT group). For immunological analyses, we prospectively enrolled COVID-19 patients receiving BCDT and immunocompetent COVID-19 patients as controls. We measured humoral and cellular immune responses using the enzyme-linked immunosorbent assay and flow cytometry.Results: Severe to critical COVID-19 was more frequent in the BCDT group than in the non-BCDT group (41.9% vs. 28.3%, p = .030). BCDT was an independent risk factor for severe to critical COVID-19 (adjusted odds ratio [aOR] 2.21, 95% confidence interval [CI] 1.21-4.04, p = .010) as well as for COVID-19-related mortality (aOR 4.03, 95% CI 1.17-13.86, p = .027). Immunological analyses revealed that patients receiving BCDT had lower anti-S1 IgG titres and a tendency to higher proportions of activated CD4+ T-cells than the controls.Conclusions: BCDT was associated with worse COVID-19 outcomes in the Omicron period. Humoral immune response impairment and T-cell hyperactivation were the main immunological features of COVID-19 patients treated with BCDT, which may have contributed to the worse outcomes of COVID-19 in this population | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Kang, Chang Kyung |e verfasserin |4 aut | |
| 700 | 1 | |a Choe, Pyoeng Gyun |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Nam Joong |e verfasserin |4 aut | |
| 700 | 1 | |a Jo, Hyeon Jae |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Hyun Mu |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Chang-Han |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Hang-Rae |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Wan Beom |e verfasserin |4 aut | |
| 700 | 1 | |a Oh, Myoung-Don |e verfasserin |4 aut | |
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