Robust long-term immunity to SARS-CoV-2 in patients recovered from severe COVID-19 after interleukin-6 blockade
Summary: Background: Whether interleukin-6 (IL-6) blockade in patients with COVID-19 will affect the protective immunity against SARS-CoV-2 has become an important concern for anti-IL-6 therapy. We aimed to investigate the effects of IL-6 blockade on long-term immunity to SARS-CoV-2. Methods: Prosp...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | EBioMedicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352396422003346 |
| _version_ | 1811322804217315328 |
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| author | Mar Masiá Marta Fernández-González José Alberto García Sergio Padilla Javier García-Abellán Ángela Botella Paula Mascarell Vanesa Agulló Félix Gutiérrez |
| author_facet | Mar Masiá Marta Fernández-González José Alberto García Sergio Padilla Javier García-Abellán Ángela Botella Paula Mascarell Vanesa Agulló Félix Gutiérrez |
| author_sort | Mar Masiá |
| collection | DOAJ |
| description | Summary: Background: Whether interleukin-6 (IL-6) blockade in patients with COVID-19 will affect the protective immunity against SARS-CoV-2 has become an important concern for anti-IL-6 therapy. We aimed to investigate the effects of IL-6 blockade on long-term immunity to SARS-CoV-2. Methods: Prospective, longitudinal cohort study conducted in patients hospitalized for severe or critical COVID-19 with laboratory confirmed SARS-CoV-2 infection. We assessed humoral (anti-S1 domain of the spike [S], anti-nucleocapsid [N], anti-trimeric spike [TrimericS] IgG, and neutralizing antibodies [Nab]) and T-cell (interferon-γ release assay [IGRA]) responses and evaluated the incidence of reinfections over one year after infection in patients undergoing IL-6 blockade with tocilizumab and compared them with untreated subjects. Findings: From 150 adults admitted with confirmed SARS-CoV-2 infection, 78 were 1:1 propensity score-matched. Patients receiving anti-IL6 therapy showed a shorter time to S-IgG seropositivity and stronger S-IgG and N-IgG antibody responses. Among unvaccinated subjects one year after infection, median (Q1-Q3) levels of TrimericS-IgG (295 vs 121 BAU/mL; p = 0.011) and Nab (74.7 vs 41.0 %IH; p = 0.012) were higher in those undergoing anti-IL6 therapy, and a greater proportion of them had Nab (80.6% vs 57.7%; p = 0.028). T-cell immunity was also better in those treated with anti-IL6, with higher median (Q1-Q3) interferon-γ responses (1760 [702–3992] vs 542 [35–1716] mIU/mL; p = 0.013) and more patients showing positive T-cell responses in the IGRA one year after infection. Patients treated with anti-IL6 had fewer reinfections during follow-up and responded to vaccination with robust increase in both antibody and T-cell immunity. Interpretation: IL-6 blockade in patients with severe COVID-19 does not have deleterious effects on long-term immunity to SARS-CoV-2. The magnitude of both antibody and T-cell responses was stronger than the observed in non-anti-cytokine-treated patients with no increase in the risk of reinfections. Funding: Instituto de Salud Carlos-III (Spain). |
| first_indexed | 2024-04-13T13:41:34Z |
| format | Article |
| id | doaj.art-b3f7b82121e84e37938b1b8db5b4717e |
| institution | Directory Open Access Journal |
| issn | 2352-3964 |
| language | English |
| last_indexed | 2024-04-13T13:41:34Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EBioMedicine |
| spelling | doaj.art-b3f7b82121e84e37938b1b8db5b4717e2022-12-22T02:44:37ZengElsevierEBioMedicine2352-39642022-08-0182104153Robust long-term immunity to SARS-CoV-2 in patients recovered from severe COVID-19 after interleukin-6 blockadeMar Masiá0Marta Fernández-González1José Alberto García2Sergio Padilla3Javier García-Abellán4Ángela Botella5Paula Mascarell6Vanesa Agulló7Félix Gutiérrez8Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Clinical Medicine Department, Universidad Miguel Hernández de Elche, Alicante, Spain; Corresponding authors at: Infectious Diseases Unit, Hospital General Universitario de Elche and Universidad Miguel Hernández, Camí de la Almazara 11, Elche 03203, Alicante, Spain.Infectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, SpainInfectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, SpainInfectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Clinical Medicine Department, Universidad Miguel Hernández de Elche, Alicante, SpainInfectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, SpainInfectious Diseases Unit, Hospital General Universitario de Elche, Alicante, SpainInfectious Diseases Unit, Hospital General Universitario de Elche, Alicante, SpainInfectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, SpainInfectious Diseases Unit, Hospital General Universitario de Elche, Alicante, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain; Clinical Medicine Department, Universidad Miguel Hernández de Elche, Alicante, Spain; Corresponding authors at: Infectious Diseases Unit, Hospital General Universitario de Elche and Universidad Miguel Hernández, Camí de la Almazara 11, Elche 03203, Alicante, Spain.Summary: Background: Whether interleukin-6 (IL-6) blockade in patients with COVID-19 will affect the protective immunity against SARS-CoV-2 has become an important concern for anti-IL-6 therapy. We aimed to investigate the effects of IL-6 blockade on long-term immunity to SARS-CoV-2. Methods: Prospective, longitudinal cohort study conducted in patients hospitalized for severe or critical COVID-19 with laboratory confirmed SARS-CoV-2 infection. We assessed humoral (anti-S1 domain of the spike [S], anti-nucleocapsid [N], anti-trimeric spike [TrimericS] IgG, and neutralizing antibodies [Nab]) and T-cell (interferon-γ release assay [IGRA]) responses and evaluated the incidence of reinfections over one year after infection in patients undergoing IL-6 blockade with tocilizumab and compared them with untreated subjects. Findings: From 150 adults admitted with confirmed SARS-CoV-2 infection, 78 were 1:1 propensity score-matched. Patients receiving anti-IL6 therapy showed a shorter time to S-IgG seropositivity and stronger S-IgG and N-IgG antibody responses. Among unvaccinated subjects one year after infection, median (Q1-Q3) levels of TrimericS-IgG (295 vs 121 BAU/mL; p = 0.011) and Nab (74.7 vs 41.0 %IH; p = 0.012) were higher in those undergoing anti-IL6 therapy, and a greater proportion of them had Nab (80.6% vs 57.7%; p = 0.028). T-cell immunity was also better in those treated with anti-IL6, with higher median (Q1-Q3) interferon-γ responses (1760 [702–3992] vs 542 [35–1716] mIU/mL; p = 0.013) and more patients showing positive T-cell responses in the IGRA one year after infection. Patients treated with anti-IL6 had fewer reinfections during follow-up and responded to vaccination with robust increase in both antibody and T-cell immunity. Interpretation: IL-6 blockade in patients with severe COVID-19 does not have deleterious effects on long-term immunity to SARS-CoV-2. The magnitude of both antibody and T-cell responses was stronger than the observed in non-anti-cytokine-treated patients with no increase in the risk of reinfections. Funding: Instituto de Salud Carlos-III (Spain).http://www.sciencedirect.com/science/article/pii/S2352396422003346SARS-CoV-2COVID-19Interleukin-6 blockadeTocilizumabAntibody responsesT-cell responses |
| spellingShingle | Mar Masiá Marta Fernández-González José Alberto García Sergio Padilla Javier García-Abellán Ángela Botella Paula Mascarell Vanesa Agulló Félix Gutiérrez Robust long-term immunity to SARS-CoV-2 in patients recovered from severe COVID-19 after interleukin-6 blockade EBioMedicine SARS-CoV-2 COVID-19 Interleukin-6 blockade Tocilizumab Antibody responses T-cell responses |
| title | Robust long-term immunity to SARS-CoV-2 in patients recovered from severe COVID-19 after interleukin-6 blockade |
| title_full | Robust long-term immunity to SARS-CoV-2 in patients recovered from severe COVID-19 after interleukin-6 blockade |
| title_fullStr | Robust long-term immunity to SARS-CoV-2 in patients recovered from severe COVID-19 after interleukin-6 blockade |
| title_full_unstemmed | Robust long-term immunity to SARS-CoV-2 in patients recovered from severe COVID-19 after interleukin-6 blockade |
| title_short | Robust long-term immunity to SARS-CoV-2 in patients recovered from severe COVID-19 after interleukin-6 blockade |
| title_sort | robust long term immunity to sars cov 2 in patients recovered from severe covid 19 after interleukin 6 blockade |
| topic | SARS-CoV-2 COVID-19 Interleukin-6 blockade Tocilizumab Antibody responses T-cell responses |
| url | http://www.sciencedirect.com/science/article/pii/S2352396422003346 |
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