Çalık Şebnem, Demir İsmail, Uzeken Eren, Tosun Selma, Özkan Özdemir Hülya, Coşkuner Seher Ayten, Demir Seval
University of Health Sciences İzmir Bozyaka Training and Research Hospital, Clinic of Infectious Diseases and Clinical Microbiology, İzmir, Türkiye.
University of Health Sciences İzmir Bozyaka Training and Research Hospital, Clinic of Internal Diseases, İzmir, Türkiye.
Mikrobiyol Bul. 2022 Oct;56(4):729-739. doi: 10.5578/mb.20229610.
Worldwide vaccination is the best strategy to limit the Coronavirus disease-2019 (COVID-19) pandemic. The aim of this study was to investigate the antibody levels and hemogram parameters and the prediction of T-helper, T-cytotoxic and B lymphocyte subtypes in the peripheral blood for the development of these antibodies in the selected group of healthcare workers who were vaccinated with CoronaVac® (Sinovac, China). In a previous study with the same researchers, blood samples were taken from healthcare workers one month after the second vaccination, and anti-RBD anti-severe acute respiratory syndrome coronavirus-2 (anti-SARS-CoV-2) IgG antibodies were measured by enzyme linked immunosorbent assay (ELISA) method. Test results were classified as binding antibody <25.6 BAU/mL unresponsive, 25.6-35.1 BAU/mL weak response, <35.2 BAU/mL strong response, according to the assay manufacturer's recommendations. According to these criteria, it was determined that 22 (8.3%) people had no response, 25 (9.5%) people had a moderate response, and 217 (82.2%) people had a strong response. According to these results, 30 people from each group were invited. The results of three individuals were excluded from the evaluation due to chronic illness. A total of 87 health workers were included in the study. Twenty-two of these people had no response, 25 had a moderate response, and 40 had a good response. Flow cytometry was used to examine the peripheral blood lymphocyte percentage distribution. Statistical analyzes were performed with SPSS 26 software. The conformity of the variables to the normal distribution was examined using analytical methods (Kolmogorov-Smirnov/ Shapiro-Wilk tests). Pearson's Chi-square test was used to compare categorical variables. The correlation between the antibody level and the measurement results of hemogram parameters and lymphocyte indicators was evaluated by Pearson's correlation analysis. The model was established by performing linear regression analysis with the variables correlated with the antibody level. Cases with a p value below 0.05 were considered statistically significant. The age range of the participants in the study was 22-69. The mean age was 45.5 ± 10.4 years. Antibodies against SARS-CoV-2 virus were detected by ELISA method in 65 (74.7%) of the healthcare professionals, while no antibodies were detected in 22 (25.3%) of them. Lymphocyte count (p= 0.002), CD3 count (p= 0.0004), CD4 count (p= 0.0001), CD3/CD19 ratio (p= 0.011), CD4 percentage (p= 0.004) in the antibody positive group was found to be significant. According to the level of correlation between antibody level and lymphocyte indicators, a statistically significant negative correlation was found in CD3, CD4, CD8 and CD19 positive lymphocytes, respectively, and the best correlation was observed in CD3 positive lymphocytes. The formula f (Antibody level)= y= 358002 -0.176 x CD3 + 0.469 x CD19 was created using the linear regression model. In the light of the data of this study, the central role of T and B cells in COVID-19 immunization emerges. The vaccine-related antibody level-related formula may be useful for healthcare professionals in patient follow-up. It is thought that conducting vaccine related immune response studies involving larger populations will contribute more to the literature.
全球疫苗接种是限制2019冠状病毒病(COVID-19)大流行的最佳策略。本研究的目的是调查接种科兴新冠疫苗(中国科兴)的特定医护人员群体外周血中的抗体水平、血常规参数以及T辅助细胞、T细胞毒性细胞和B淋巴细胞亚群,以预测这些抗体的产生情况。在同一研究人员之前的一项研究中,在第二次接种疫苗一个月后采集医护人员的血样,并通过酶联免疫吸附测定(ELISA)法检测抗严重急性呼吸综合征冠状病毒2(抗SARS-CoV-2)IgG抗体。根据检测试剂盒制造商的建议,检测结果分类如下:结合抗体<25.6 BAU/mL为无反应,25.6 - 35.1 BAU/mL为弱反应,>35.2 BAU/mL为强反应。根据这些标准,确定22人(8.3%)无反应,25人(9.5%)有中度反应,217人(82.2%)有强反应。根据这些结果,每组邀请30人。由于慢性病,3人的结果被排除在评估之外。共有87名医护人员纳入研究。其中22人无反应,25人有中度反应,40人有良好反应。采用流式细胞术检测外周血淋巴细胞百分比分布。使用SPSS 26软件进行统计分析。使用分析方法(Kolmogorov-Smirnov/Shapiro-Wilk检验)检查变量是否符合正态分布。使用Pearson卡方检验比较分类变量。通过Pearson相关分析评估抗体水平与血常规参数及淋巴细胞指标测量结果之间的相关性。通过对与抗体水平相关的变量进行线性回归分析建立模型。p值低于0.05的情况被认为具有统计学意义。研究参与者的年龄范围为22 - 69岁。平均年龄为45.5±10.4岁。65名(74.7%)医护人员通过ELISA法检测到抗SARS-CoV-2病毒抗体,而22名(25.3%)未检测到抗体。抗体阳性组的淋巴细胞计数(p = 0.002)、CD3计数(p = 0.0004)、CD4计数(p = 0.0001)、CD3/CD19比值(p = 0.011)、CD4百分比(p = 0.004)具有统计学意义。根据抗体水平与淋巴细胞指标的相关程度,发现CD3、CD4、CD8和CD19阳性淋巴细胞分别存在统计学意义的负相关,且在CD3阳性淋巴细胞中观察到最佳相关性。使用线性回归模型创建公式f(抗体水平)= y = 358002 - 0.176×CD3 + 0.469×CD19。根据本研究的数据,T细胞和B细胞在COVID-19免疫中发挥核心作用。与疫苗相关抗体水平相关的公式可能对医护人员进行患者随访有用。认为开展涉及更多人群的疫苗相关免疫反应研究将为该文献做出更多贡献。