Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients
The pandemic of COVID-19 caused by SARS-CoV-2 infection continues to spread around the world. Vaccines that elicit protective immunity have reduced infection and mortality, however new viral variants are arising that may evade vaccine-induced immunity or cause disease in individuals who are unable t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-09-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/13/9/1743 |
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| author | Xufang Deng Monika Evdokimova Amornrat O’Brien Cynthia L. Rowe Nina M. Clark Amanda Harrington Gail E. Reid Susan L. Uprichard Susan C. Baker |
| author_facet | Xufang Deng Monika Evdokimova Amornrat O’Brien Cynthia L. Rowe Nina M. Clark Amanda Harrington Gail E. Reid Susan L. Uprichard Susan C. Baker |
| author_sort | Xufang Deng |
| collection | DOAJ |
| description | The pandemic of COVID-19 caused by SARS-CoV-2 infection continues to spread around the world. Vaccines that elicit protective immunity have reduced infection and mortality, however new viral variants are arising that may evade vaccine-induced immunity or cause disease in individuals who are unable to develop robust vaccine-induced responses. Investigating the role of viral variants in causing severe disease, evading vaccine-elicited immunity, and infecting vulnerable individuals is important for developing strategies to control the pandemic. Here, we report fourteen breakthrough infections of SARS-CoV-2 in vaccinated individuals with symptoms ranging from asymptomatic/mild (6/14) to severe disease (8/14). High viral loads with a median C<i>t</i> value of 19.6 were detected in the nasopharyngeal specimens from subjects regardless of disease severity. Sequence analysis revealed four distinct virus lineages, including <i>alpha</i> and <i>gamma</i> variants of concern. Immunosuppressed individuals were more likely to be hospitalized after infection (<i>p</i> = 0.047), however no specific variant was associated with severe disease. Our results highlight the high viral load that can occur in asymptomatic breakthrough infections and the vulnerability of immunosuppressed individuals to post-vaccination infections by diverse variants of SARS-CoV-2. |
| first_indexed | 2024-03-10T07:08:26Z |
| format | Article |
| id | doaj.art-2c50f784e26d47099389b1e0c6851881 |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-10T07:08:26Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-2c50f784e26d47099389b1e0c68518812023-11-22T15:37:19ZengMDPI AGViruses1999-49152021-09-01139174310.3390/v13091743Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed PatientsXufang Deng0Monika Evdokimova1Amornrat O’Brien2Cynthia L. Rowe3Nina M. Clark4Amanda Harrington5Gail E. Reid6Susan L. Uprichard7Susan C. Baker8Department of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USADepartment of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USADepartment of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USADepartment of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USADepartment of Medicine, Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USAInfectious Disease and Immunology Research Institute, Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USADepartment of Medicine, Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USADepartment of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USADepartment of Microbiology and Immunology, Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USAThe pandemic of COVID-19 caused by SARS-CoV-2 infection continues to spread around the world. Vaccines that elicit protective immunity have reduced infection and mortality, however new viral variants are arising that may evade vaccine-induced immunity or cause disease in individuals who are unable to develop robust vaccine-induced responses. Investigating the role of viral variants in causing severe disease, evading vaccine-elicited immunity, and infecting vulnerable individuals is important for developing strategies to control the pandemic. Here, we report fourteen breakthrough infections of SARS-CoV-2 in vaccinated individuals with symptoms ranging from asymptomatic/mild (6/14) to severe disease (8/14). High viral loads with a median C<i>t</i> value of 19.6 were detected in the nasopharyngeal specimens from subjects regardless of disease severity. Sequence analysis revealed four distinct virus lineages, including <i>alpha</i> and <i>gamma</i> variants of concern. Immunosuppressed individuals were more likely to be hospitalized after infection (<i>p</i> = 0.047), however no specific variant was associated with severe disease. Our results highlight the high viral load that can occur in asymptomatic breakthrough infections and the vulnerability of immunosuppressed individuals to post-vaccination infections by diverse variants of SARS-CoV-2.https://www.mdpi.com/1999-4915/13/9/1743SARS-CoV-2variants of concernbreakthrough infectionspost-vaccination infectionsCOVID-19immunosuppression |
| spellingShingle | Xufang Deng Monika Evdokimova Amornrat O’Brien Cynthia L. Rowe Nina M. Clark Amanda Harrington Gail E. Reid Susan L. Uprichard Susan C. Baker Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients Viruses SARS-CoV-2 variants of concern breakthrough infections post-vaccination infections COVID-19 immunosuppression |
| title | Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients |
| title_full | Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients |
| title_fullStr | Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients |
| title_full_unstemmed | Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients |
| title_short | Breakthrough Infections with Multiple Lineages of SARS-CoV-2 Variants Reveals Continued Risk of Severe Disease in Immunosuppressed Patients |
| title_sort | breakthrough infections with multiple lineages of sars cov 2 variants reveals continued risk of severe disease in immunosuppressed patients |
| topic | SARS-CoV-2 variants of concern breakthrough infections post-vaccination infections COVID-19 immunosuppression |
| url | https://www.mdpi.com/1999-4915/13/9/1743 |
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