精神分裂症和分裂情感性障碍患者对SARS-CoV-2 mRNA疫苗的抗刺突抗体反应。

Anti-spike antibody responses to SARS-CoV-2 mRNA vaccines in people with schizophrenia and schizoaffective disorder.

作者信息

Nemani Katlyn, De Picker Livia, Dickerson Faith, Leboyer Marion, Santacatterina Michele, Ando Fumika, Capichioni Gillian, Smith Thomas E, Kammer Jamie, El Abdellati Kawtar, Morrens Manuel, Coppens Violette, Katsafanas Emily, Origoni Andrea, Khan Sabahat, Rowe Kelly, Ziemann R Sarah, Tamouza Ryad, Yolken Robert H, Goff Donald C

机构信息

Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA.

Department of Psychiatry, New York University Langone Medical Center, New York, NY, USA.

出版信息

Brain Behav Immun Health. 2024 Jun 3;38:100802. doi: 10.1016/j.bbih.2024.100802. eCollection 2024 Jul.

DOI:10.1016/j.bbih.2024.100802

PMID:39021438

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11252076/

Abstract

IMPORTANCE

Individuals with schizophrenia are at higher risk for severe COVID-19 illness and severe breakthrough infection following vaccination. It is unclear whether immune response to vaccination differs in this population.

OBJECTIVE

To assess whether anti-SARS-CoV-2 spike antibody titers after vaccination differ in people with a diagnosis of schizophrenia or schizoaffective disorder (SZ) compared to controls without a psychiatric disorder.

DESIGN

This cohort study assessed antibody response following the first and second dose of mRNA vaccines at longitudinal timepoints, up to 7 weeks following the first dose of vaccine.

SETTING

A multi-center study including psychiatric healthcare settings in the United States and Europe.

PARTICIPANTS

205 adults with no history of COVID-19 infection, including 106 individuals with SZ and 99 controls without a psychiatric disorder, who received their first dose of SARS-CoV-2 mRNA vaccine between December 20, 2020 and May 27, 2021.

MAIN OUTCOMES AND MEASURES

Mean SARS-CoV-2 anti-Spike IgG antibody levels within 7 weeks after the first dose of vaccination.

RESULTS

A total of 205 individuals (mean [SD] age, 44.7 [12.0] years; 90 [43.9%] male) were included, of which 106 (51.7%) were diagnosed with SZ. SZ was associated with lower mean log antibody levels (-0.15; 95% CI, -0.27 to -0.03, = 0.016) after adjusting for age, sex, body mass index, smoking, days since vaccination, and vaccine manufacturer. In secondary analyses of dose-specific responses, SZ was associated with a lower mean log antibody level after the second dose of vaccine (-0.23; 95% CI -0.39 to -0.06, = 0.006), but not the first dose of vaccine (0.00; 95% CI -0.18- 0.19, = 0.96).

CONCLUSIONS AND RELEVANCE

In this cohort study of individuals with SZ and a control group without psychiatric disorders, SZ was associated with lower SARS-CoV-2 anti-spike antibody levels following 2 doses of SARS-CoV-2 mRNA vaccination. This highlights the need for further studies assessing vaccine immunogenicity in individuals with schizophrenia.

摘要

重要性

精神分裂症患者患重症 COVID-19 疾病及疫苗接种后发生严重突破性感染的风险更高。尚不清楚该人群对疫苗的免疫反应是否存在差异。

目的

评估诊断为精神分裂症或分裂情感性障碍（SZ）的人群与无精神疾病的对照组在接种疫苗后抗 SARS-CoV-2 刺突抗体滴度是否存在差异。

设计

这项队列研究在纵向时间点评估了第一剂和第二剂 mRNA 疫苗接种后的抗体反应，直至第一剂疫苗接种后 7 周。

地点

一项多中心研究，包括美国和欧洲的精神科医疗环境。

参与者

205 名无 COVID-19 感染史的成年人，其中包括 106 名 SZ 患者和 99 名无精神疾病的对照组，他们在 2020 年 12 月 20 日至 2021 年 5 月 27 日期间接种了第一剂 SARS-CoV-2 mRNA 疫苗。

主要结局和指标

第一剂疫苗接种后 7 周内的平均 SARS-CoV-2 抗刺突 IgG 抗体水平。

结果

共纳入 205 人（平均[标准差]年龄，44.7[12.0]岁；90[43.9%]为男性），其中 106 人（51.7%）被诊断为 SZ。在调整年龄、性别、体重指数、吸烟、接种疫苗后的天数和疫苗制造商后，SZ 与较低的平均对数抗体水平相关（-0.15；95%置信区间，-0.27 至-0.03，P = 0.016）。在针对特定剂量反应的二次分析中，SZ 与第二剂疫苗接种后的较低平均对数抗体水平相关（-0.23；95%置信区间-0.39 至-0.06，P = 0.006），但与第一剂疫苗接种后无关（0.00；95%置信区间-0.18 至 0.19，P = 0.96）。