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SAS Journal of Medicine | Volume-9 | Issue-09
Assessment of COVID-19 Vaccine Immunogenicity Over One Year in Patients Receiving Immunomodulators/Immunosuppressants or Polychemotherapy
Kaoutar Meliani, Widad Rhandour, Mohammed Omari, Ibtissam El Harch, Zina Lebbar, Sara Kouara, Samira el fakir, Zineb Khammar, Mustapha Mahomoud, Rhizlane Berrady
Published: Sept. 15, 2023 | 121 139
DOI: 10.36347/sasjm.2023.v09i09.014
Pages: 989-996
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Abstract
Objective: The aim of the study is to evaluate the immunogenicity of the covid-19 vaccine in patients receiving immunomodulators/immunosuppressants or polychemotherapies based on the treatment of the underlying pathology in an internal medicine and onco-hematology department over a period of one year. Materials and methods: Our study was prospective. We included 61 patients. They were all undergoing immunosuppressive therapy or polychemotherapy and had been vaccinated against covid. We performed a series of 9 serological tests before vaccination and 21 days after vaccination, at d+49 after a 1st boost, at 3 months, 6 months, 9 months and 12 months. Only 21% of our patients received a 2nd boost. We divided our population into 4 groups according to the treatments received. Results: The results show a mean age of 50 years +/- 14.85. The sex ratio F/M was +/- 1.10. To better characterize vaccine responders, we compared them with non-responders based on several parameters: age, sex, comorbidities, whether or not the third booster dose had been received, biological work-up, specifically anemia, neutropenia, lymphopenia, hypogammaglobulinemia, and treatments divided into four groups: A lack of vaccine response was not significantly correlated with the use of rituximab at S4, i.e., 3 months (p=0.01), at S6, i.e., 9 months (p=0.034), and at S7, i.e., 12 months (p=0.009). Lack of vaccine response at 12 months was significantly correlated with patients receiving polychemotherapy (p=0.02) or immunosuppressive therapy (p=0.043). Multivariate analysis showed an association between lack of vaccine response at S3 in patients receiving rituximab (p=0.024) and corticosteroid therapy (p=0.02) and in leukopenic patients (p=0.04). At 12 months, i.e., S7, a strong association was found between lack of vaccine response in patients on immunosuppressants (p=0.002) and multidrug therapy (p=0.001).