COVID-19 vaccination in adults with congenital heart disease: Real-world data from an Italian tertiary centre.
ACHD
Adult congenital heart disease
Antibody response
COVID-19
IgG antispike
Vaccination
Journal
International journal of cardiology. Congenital heart disease
ISSN: 2666-6685
Titre abrégé: Int J Cardiol Congenit Heart Dis
Pays: Netherlands
ID NLM: 9918367981006676
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
27
09
2021
accepted:
25
10
2021
entrez:
1
4
2022
pubmed:
2
4
2022
medline:
2
4
2022
Statut:
ppublish
Résumé
real-world data on COVID-19 vaccine safety, immunogenicity and acceptance in adults with congenital heart disease (ACHD) are lacking. ACHD patients who were offered COVID-19 vaccination from January to June 2021 were included. Data on adverse events, on patients' attitude towards vaccination and antispike IgG titre were retrospectively collected. A group of healthy individuals with similar age and sex undergoing vaccination was included for comparison. 208 patients followed in a single ACHD tertiary centre (33.3 [26-45] years, 54% male) received COVID-19 vaccine, 65% vaccinated at our institution: 199 (96%) received Pfizer-BioNTech BNT162b2 vaccine, 4 (2%) Moderna-1273 and 5 (2%) AstraZeneca-ChAdOx1. Median follow-up after vaccination was 79 [57-96] days. No major adverse event was reported and the incidence of minor events was not different between ACHD patients and the control group. One patient was diagnosed with acute pericarditis. There were two deaths unrelated to the vaccine during follow-up. Three (1.5%) vaccinated patients tested positive for COVID-19. Antispike IgG titre, available in 159 (76%) patients, was 1334 [600-3401] BAU/ml, not significantly different from the control group (p=0.2). One patient with Fontan failure was seronegative. Advanced physiological stage was associated with lower antibody response, independently from previous viral exposure (p<0.0001). Fourteen percent refused COVID-19 vaccination at our institution. However, 50% of vaccinated patients declared to have been influenced by the discussion with the ACHD cardiologist and 66% of those vaccinated in situ reported that undergoing COVID-19 vaccination at the ACHD centre made them feel safer. COVID-19 vaccines appear safe in ACHD with satisfactory immunogenicity. However, the most vulnerable patients showed lower antibody response. ACHD team may play a key role in vaccine acceptance.
Sections du résumé
Background
UNASSIGNED
real-world data on COVID-19 vaccine safety, immunogenicity and acceptance in adults with congenital heart disease (ACHD) are lacking.
Methods
UNASSIGNED
ACHD patients who were offered COVID-19 vaccination from January to June 2021 were included. Data on adverse events, on patients' attitude towards vaccination and antispike IgG titre were retrospectively collected. A group of healthy individuals with similar age and sex undergoing vaccination was included for comparison.
Results
UNASSIGNED
208 patients followed in a single ACHD tertiary centre (33.3 [26-45] years, 54% male) received COVID-19 vaccine, 65% vaccinated at our institution: 199 (96%) received Pfizer-BioNTech BNT162b2 vaccine, 4 (2%) Moderna-1273 and 5 (2%) AstraZeneca-ChAdOx1. Median follow-up after vaccination was 79 [57-96] days. No major adverse event was reported and the incidence of minor events was not different between ACHD patients and the control group. One patient was diagnosed with acute pericarditis. There were two deaths unrelated to the vaccine during follow-up. Three (1.5%) vaccinated patients tested positive for COVID-19. Antispike IgG titre, available in 159 (76%) patients, was 1334 [600-3401] BAU/ml, not significantly different from the control group (p=0.2). One patient with Fontan failure was seronegative. Advanced physiological stage was associated with lower antibody response, independently from previous viral exposure (p<0.0001). Fourteen percent refused COVID-19 vaccination at our institution. However, 50% of vaccinated patients declared to have been influenced by the discussion with the ACHD cardiologist and 66% of those vaccinated in situ reported that undergoing COVID-19 vaccination at the ACHD centre made them feel safer.
Conclusion
UNASSIGNED
COVID-19 vaccines appear safe in ACHD with satisfactory immunogenicity. However, the most vulnerable patients showed lower antibody response. ACHD team may play a key role in vaccine acceptance.
Identifiants
pubmed: 35360668
doi: 10.1016/j.ijcchd.2021.100266
pii: S2666-6685(21)00190-7
pmc: PMC8552781
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100266Informations de copyright
© 2021 The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
Viruses. 2021 Mar 05;13(3):
pubmed: 33807957
J Allergy Clin Immunol Pract. 2016 May-Jun;4(3):491-6
pubmed: 26897303
Int J Cardiol Congenit Heart Dis. 2021 Aug;4:100186
pubmed: 35360449
Lancet. 2020 Aug 15;396(10249):479-488
pubmed: 32702299
J Am Coll Cardiol. 2021 Jul 27;78(4):408-411
pubmed: 34116145
Cardiol Young. 2020 Oct;30(10):1405-1408
pubmed: 32624052
Acad Emerg Med. 2021 Aug;28(8):918-921
pubmed: 34133825
J Am Geriatr Soc. 2021 Jun;69(6):1441-1447
pubmed: 33768521
Can J Cardiol. 2021 Oct;37(10):1665-1667
pubmed: 34118375
Circulation. 2019 Aug 6;140(6):e234-e284
pubmed: 31256636
Eur J Epidemiol. 2020 Aug;35(8):775-779
pubmed: 32785815
J Am Coll Cardiol. 2019 Apr 2;73(12):e81-e192
pubmed: 30121239
J Am Coll Cardiol. 2021 Apr 6;77(13):1644-1655
pubmed: 33795039
J Community Health. 2020 Dec;45(6):1270-1282
pubmed: 32918645
Nature. 2020 Oct;586(7830):594-599
pubmed: 32998157
Nature. 2020 Oct;586(7830):589-593
pubmed: 32785213
Eur Respir J. 2021 Jul 1;58(1):
pubmed: 33863748
Psychol Med. 2022 Oct;52(14):3127-3141
pubmed: 33305716
J Am Coll Cardiol. 2021 Apr 20;77(15):1938-1948
pubmed: 33587998