| Title: |
Time-Dependent Effects of Clinical Interventions on SARS-CoV-2 Immunity in Patients with Lung Cancer |
| Authors: |
Philip C. Mack, Chih-Yuan Hsu, Ananda M. Rodilla, Jorge E. Gomez, Jazz Cagan, Yuanhui Huang, Sooyun Tavolacci, Rajesh M. Valanparambil, Nicholas Rohs, Rachel Brody, Brittney Nichols, Juan Manuel Carreño, Sheena Bhalla, Christian Rolfo, David E. Gerber, Amy Moore, Jennifer C. King, Rafi Ahmed, John D. Minna, Paul A. Bunn, Adolfo García-Sastre, Florian Krammer, Fred R. Hirsch, Yu Shyr |
| Source: |
Vaccines, Vol 12, Iss 7, p 713 (2024) |
| Publisher Information: |
MDPI AG, 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Medicine |
| Subject Terms: |
SARS-CoV-2 antibody levels, lung cancer therapies, time-dependent regression model, Medicine |
| More Details: |
In patients with lung cancer (LC), understanding factors that impact the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike antibody (SAb) titers over time is critical, but challenging, due to evolving treatments, infections, vaccinations, and health status. The objective was to develop a time-dependent regression model elucidating individual contributions of factors influencing SAb levels in LC patients using a prospective, longitudinal, multi-institutional cohort study initiated in January 2021. The study evaluated 296 LC patients—median age 69; 55% female; 50% stage IV. Blood samples were collected every three months to measure SAb levels using FDA-approved ELISA. Asymptomatic and unreported infections were documented through measurement of anti-nucleocapsid Ab levels (Meso Scale Discovery). Associations between clinical characteristics and titers were evaluated using a time-dependent linear regression model with a generalized estimating equation (GEE), considering time-independent variables (age, sex, ethnicity, smoking history, histology, and stage) and time-dependent variables (booster vaccinations, SARS-CoV-2 infections, cancer treatment, steroid use, and influenza vaccination). Significant time-dependent effects increasing titer levels were observed for prior SARS-CoV-2 infection (p < 0.001) and vaccination/boosters (p < 0.001). Steroid use (p = 0.043) and chemotherapy (p = 0.033) reduced titer levels. Influenza vaccination was associated with increased SAb levels (p < 0.001), independent of SARS-CoV-2 vaccine boosters. Prior smoking significantly decreased titers in females (p = 0.001). Age showed no association with titers. This GEE-based linear regression model unveiled the nuanced impact of multiple variables on patient anti-spike Ab levels over time. After controlling for the major influences of vaccine and SARS-CoV-2 infections, chemotherapy and steroid use were found to have negatively affected titers. Smoking in females significantly decreased titers. Surprisingly, influenza vaccinations were also significantly associated, likely indirectly, with improved SARS-CoV-2 titers. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2076-393X |
| Relation: |
https://www.mdpi.com/2076-393X/12/7/713; https://doaj.org/toc/2076-393X |
| DOI: |
10.3390/vaccines12070713 |
| Access URL: |
https://doaj.org/article/c8cc0c60eaba4193bcab4968d29b9d80 |
| Accession Number: |
edsdoj.8cc0c60eaba4193bcab4968d29b9d80 |
| Database: |
Directory of Open Access Journals |
