tetano
Editor, Senior Moderator
J Intern Med
. 2023 Jan 22.
doi: 10.1111/joim.13606. Online ahead of print.
Evaluation of SARS-CoV-2 antibody levels on hospital admission as a correlate of protection against mortality
Sylvia Mink[SUP] 1 2 [/SUP], Wolfgang List[SUP] 3 [/SUP], Guenter Hoefle[SUP] 4 [/SUP], Matthias Frick[SUP] 3 [/SUP], Alois Suessenbacher[SUP] 5 [/SUP], Thomas Winder[SUP] 3 [/SUP], Cornelia Fetz[SUP] 1 [/SUP], Andreas Boesl[SUP] 6 [/SUP], Christoph H Saely[SUP] 2 7 [/SUP], Heinz Drexel[SUP] 7 8 [/SUP], Peter Fraunberger[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: Millions of people have now been vaccinated against SARS-CoV-2. However, it is still unclear which antibody levels provide protection against mortality. It is further unknown whether measuring antibody concentrations on hospital admission allows identifying patients with a high risk of mortality.
Objectives: To evaluate whether anti-SARS-CoV2-spike antibodies on hospital admission predict in-hospital mortality in patients with COVID-19.
Methods: We conducted a prospective, multicenter cohort study on 1152 hospitalised patients who tested positive for SARS-CoV-2 with a PCR-based assay. Patients were classified by vaccination status. Anti-SARS-CoV-2 spike antibodies were determined on hospital admission. The investigated endpoint was in-hospital mortality for any cause.
Results: Spike antibodies on hospital admission were significantly lower in non-survivors in both non-vaccinated (73U/ml, 95%CI 0-164 vs. 175U/ml, 95%CI 124-235, p = 0.002) and vaccinated patients (1056U/ml, 95%CI 701-1411 vs. 1668U/ml, 95%CI 1580-1757, p<0.001). Further, spike antibodies were significantly lower in fully vaccinated and boostered patients who died compared to those who survived (mean 883 U/ml, 95%CI 406-1359 vs. 1292 U/ml, 95%CI 1152-1431, p = 0.017 and 1485 U/ml, 95%CI 836-2133 vs. 2050 U/ml, 95%CI 1952-2149, p = 0.036). Patients infected with the currently prevailing Omicron variant were three times more likely to die if spike antibodies were <1200U/ml (OR 3.458, 95%CI 1.562-7.656, p = 0.001). After adjusting for potential confounders, this value increased to an aOR of 4.079 (95%CI 1.809-9.198, p<0.001).
Conclusion: Anti-SARS-CoV2-spike-antibody levels on hospital admission are inversely associated with in-hospital mortality. Hospitalised patients with lower antibody levels have a higher risk of mortality. This article is protected by copyright. All rights reserved.
Keywords: SARS-CoV2; coronavirus disease; mortality; prognosis; spike antibodies; vaccination.
. 2023 Jan 22.
doi: 10.1111/joim.13606. Online ahead of print.
Evaluation of SARS-CoV-2 antibody levels on hospital admission as a correlate of protection against mortality
Sylvia Mink[SUP] 1 2 [/SUP], Wolfgang List[SUP] 3 [/SUP], Guenter Hoefle[SUP] 4 [/SUP], Matthias Frick[SUP] 3 [/SUP], Alois Suessenbacher[SUP] 5 [/SUP], Thomas Winder[SUP] 3 [/SUP], Cornelia Fetz[SUP] 1 [/SUP], Andreas Boesl[SUP] 6 [/SUP], Christoph H Saely[SUP] 2 7 [/SUP], Heinz Drexel[SUP] 7 8 [/SUP], Peter Fraunberger[SUP] 1 2 [/SUP]
Affiliations
- PMID: 36682036
- DOI: 10.1111/joim.13606
Abstract
Background: Millions of people have now been vaccinated against SARS-CoV-2. However, it is still unclear which antibody levels provide protection against mortality. It is further unknown whether measuring antibody concentrations on hospital admission allows identifying patients with a high risk of mortality.
Objectives: To evaluate whether anti-SARS-CoV2-spike antibodies on hospital admission predict in-hospital mortality in patients with COVID-19.
Methods: We conducted a prospective, multicenter cohort study on 1152 hospitalised patients who tested positive for SARS-CoV-2 with a PCR-based assay. Patients were classified by vaccination status. Anti-SARS-CoV-2 spike antibodies were determined on hospital admission. The investigated endpoint was in-hospital mortality for any cause.
Results: Spike antibodies on hospital admission were significantly lower in non-survivors in both non-vaccinated (73U/ml, 95%CI 0-164 vs. 175U/ml, 95%CI 124-235, p = 0.002) and vaccinated patients (1056U/ml, 95%CI 701-1411 vs. 1668U/ml, 95%CI 1580-1757, p<0.001). Further, spike antibodies were significantly lower in fully vaccinated and boostered patients who died compared to those who survived (mean 883 U/ml, 95%CI 406-1359 vs. 1292 U/ml, 95%CI 1152-1431, p = 0.017 and 1485 U/ml, 95%CI 836-2133 vs. 2050 U/ml, 95%CI 1952-2149, p = 0.036). Patients infected with the currently prevailing Omicron variant were three times more likely to die if spike antibodies were <1200U/ml (OR 3.458, 95%CI 1.562-7.656, p = 0.001). After adjusting for potential confounders, this value increased to an aOR of 4.079 (95%CI 1.809-9.198, p<0.001).
Conclusion: Anti-SARS-CoV2-spike-antibody levels on hospital admission are inversely associated with in-hospital mortality. Hospitalised patients with lower antibody levels have a higher risk of mortality. This article is protected by copyright. All rights reserved.
Keywords: SARS-CoV2; coronavirus disease; mortality; prognosis; spike antibodies; vaccination.