Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study

Objectives: Highly effective vaccines against severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) have been developed but variants of concerns are worrisome, especially B.1.617.2 (Delta) which has rapidly spread across the world. We aim to study if vaccination alters virological and serologi...

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Main Authors: Chia, Po Ying, Ong, Sean Wei Xiang, Chiew, Calvin J., Ang, Li Wei, Chavatte, Jean-Marc, Mak, Tze-Minn, Cui, Lin, Kalimuddin, Shirin, Chia, Wan Ni, Tan, Chee Wah, Chai, Louis Yi Ann, Tan, Seow Yen, Zheng, Shuwei, Lin, Raymond Tzer Pin, Wang, Linfa, Leo, Yee Sin, Lee, Vernon J., Lye, David C., Young, Barnaby Edward
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2022
Subjects:
Online Access:https://hdl.handle.net/10356/163851
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Institution: Nanyang Technological University
Language: English
id sg-ntu-dr.10356-163851
record_format dspace
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Science::Medicine
Breakthrough Infection
COVID-19
spellingShingle Science::Medicine
Breakthrough Infection
COVID-19
Chia, Po Ying
Ong, Sean Wei Xiang
Chiew, Calvin J.
Ang, Li Wei
Chavatte, Jean-Marc
Mak, Tze-Minn
Cui, Lin
Kalimuddin, Shirin
Chia, Wan Ni
Tan, Chee Wah
Chai, Louis Yi Ann
Tan, Seow Yen
Zheng, Shuwei
Lin, Raymond Tzer Pin
Wang, Linfa
Leo, Yee Sin
Lee, Vernon J.
Lye, David C.
Young, Barnaby Edward
Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study
description Objectives: Highly effective vaccines against severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) have been developed but variants of concerns are worrisome, especially B.1.617.2 (Delta) which has rapidly spread across the world. We aim to study if vaccination alters virological and serological kinetics in breakthrough infections. Methods: We conducted a multicentre retrospective cohort study of patients in Singapore who had received a licensed mRNA vaccine and been admitted to hospital with B.1.617.2 SARS-CoV-2 infection. We compared clinical features, virological and serological kinetics (anti-nucleocapsid, anti-spike and surrogate virus neutralization titres) between fully vaccinated and unvaccinated individuals. Results: Out of 218 individuals with B.1.617.2 infection, 84 received an mRNA vaccine of which 71 were fully vaccinated, 130 were unvaccinated and four received a non-mRNA vaccine. Despite significantly older age in the vaccine breakthrough group, only 2.8% (2/71) developed severe COVID-19 requiring oxygen supplementation compared with 53.1% (69/130) in the unvaccinated group (p < 0.001). Odds of severe COVID-19 following vaccination were significantly lower (adjusted odds ratio 0.07 95% CI 0.015 e0.335, p 0.001). PCR cycle threshold values were similar between vaccinated and unvaccinated groups at diagnosis, but viral loads decreased faster in vaccinated individuals. Early, robust boosting of anti-spike protein antibodies was observed in vaccinated patients; however, these titres were significantly lower against B.1.617.2 than the wildtype vaccine strain. Discussion: The mRNA vaccines are highly effective at preventing symptomatic and severe COVID-19 associated with B.1.617.2 infection. Vaccination is associated with faster decline in viral RNA load and a robust serological response. Vaccination remains a key strategy for control of the COVID-19 pandemic.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Chia, Po Ying
Ong, Sean Wei Xiang
Chiew, Calvin J.
Ang, Li Wei
Chavatte, Jean-Marc
Mak, Tze-Minn
Cui, Lin
Kalimuddin, Shirin
Chia, Wan Ni
Tan, Chee Wah
Chai, Louis Yi Ann
Tan, Seow Yen
Zheng, Shuwei
Lin, Raymond Tzer Pin
Wang, Linfa
Leo, Yee Sin
Lee, Vernon J.
Lye, David C.
Young, Barnaby Edward
format Article
author Chia, Po Ying
Ong, Sean Wei Xiang
Chiew, Calvin J.
Ang, Li Wei
Chavatte, Jean-Marc
Mak, Tze-Minn
Cui, Lin
Kalimuddin, Shirin
Chia, Wan Ni
Tan, Chee Wah
Chai, Louis Yi Ann
Tan, Seow Yen
Zheng, Shuwei
Lin, Raymond Tzer Pin
Wang, Linfa
Leo, Yee Sin
Lee, Vernon J.
Lye, David C.
Young, Barnaby Edward
author_sort Chia, Po Ying
title Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study
title_short Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study
title_full Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study
title_fullStr Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study
title_full_unstemmed Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study
title_sort virological and serological kinetics of sars-cov-2 delta variant vaccine breakthrough infections: a multicentre cohort study
publishDate 2022
url https://hdl.handle.net/10356/163851
_version_ 1759853347551051776
spelling sg-ntu-dr.10356-1638512023-03-05T16:52:44Z Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study Chia, Po Ying Ong, Sean Wei Xiang Chiew, Calvin J. Ang, Li Wei Chavatte, Jean-Marc Mak, Tze-Minn Cui, Lin Kalimuddin, Shirin Chia, Wan Ni Tan, Chee Wah Chai, Louis Yi Ann Tan, Seow Yen Zheng, Shuwei Lin, Raymond Tzer Pin Wang, Linfa Leo, Yee Sin Lee, Vernon J. Lye, David C. Young, Barnaby Edward Lee Kong Chian School of Medicine (LKCMedicine) National Centre for Infectious Diseases Tan Tock Seng Hospital Yong Loo Lin School of Medicine, NUS Science::Medicine Breakthrough Infection COVID-19 Objectives: Highly effective vaccines against severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) have been developed but variants of concerns are worrisome, especially B.1.617.2 (Delta) which has rapidly spread across the world. We aim to study if vaccination alters virological and serological kinetics in breakthrough infections. Methods: We conducted a multicentre retrospective cohort study of patients in Singapore who had received a licensed mRNA vaccine and been admitted to hospital with B.1.617.2 SARS-CoV-2 infection. We compared clinical features, virological and serological kinetics (anti-nucleocapsid, anti-spike and surrogate virus neutralization titres) between fully vaccinated and unvaccinated individuals. Results: Out of 218 individuals with B.1.617.2 infection, 84 received an mRNA vaccine of which 71 were fully vaccinated, 130 were unvaccinated and four received a non-mRNA vaccine. Despite significantly older age in the vaccine breakthrough group, only 2.8% (2/71) developed severe COVID-19 requiring oxygen supplementation compared with 53.1% (69/130) in the unvaccinated group (p < 0.001). Odds of severe COVID-19 following vaccination were significantly lower (adjusted odds ratio 0.07 95% CI 0.015 e0.335, p 0.001). PCR cycle threshold values were similar between vaccinated and unvaccinated groups at diagnosis, but viral loads decreased faster in vaccinated individuals. Early, robust boosting of anti-spike protein antibodies was observed in vaccinated patients; however, these titres were significantly lower against B.1.617.2 than the wildtype vaccine strain. Discussion: The mRNA vaccines are highly effective at preventing symptomatic and severe COVID-19 associated with B.1.617.2 infection. Vaccination is associated with faster decline in viral RNA load and a robust serological response. Vaccination remains a key strategy for control of the COVID-19 pandemic. National Medical Research Council (NMRC) Published version B.E.Y. reports personal fees from Roche, Sanofi and Gilead, outside the submitted work. All other authors declare no competing interests. This study was funded by grants from the Singapore National Medical Research Council (COVID19RF-001, COVID19RF-008). The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication. 2022-12-20T02:37:26Z 2022-12-20T02:37:26Z 2022 Journal Article Chia, P. Y., Ong, S. W. X., Chiew, C. J., Ang, L. W., Chavatte, J., Mak, T., Cui, L., Kalimuddin, S., Chia, W. N., Tan, C. W., Chai, L. Y. A., Tan, S. Y., Zheng, S., Lin, R. T. P., Wang, L., Leo, Y. S., Lee, V. J., Lye, D. C. & Young, B. E. (2022). Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study. Clinical Microbiology and Infection, 28(4), 612.e1-612.e7. https://dx.doi.org/10.1016/j.cmi.2021.11.010 1198-743X https://hdl.handle.net/10356/163851 10.1016/j.cmi.2021.11.010 34826623 2-s2.0-85122147119 4 28 612.e1 612.e7 en COVID19RF-001 COVID19RF-008 Clinical Microbiology and Infection © 2021 The Author(s). Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/). application/pdf