"Introduction
... Initially, vaccines were prioritized for high-risk populations (elderly and those with comorbidities); however, emerging evidence suggests that vaccination may not benefit or may even represent an additional risk for subsets of patients, highlighting the need for further investigation. Here, we studied the impact of COVID-19 mRNA vaccines on protection against COVID-19-associated acute respiratory failure (ARF) in the context of SARS-CoV-2 antibody (Ab) responses...
Results
In our cohort of COVID-19 patients admitted to the hospital between May 2020 and November 2022, we accrued 112 individuals, including Vax 23 and 89 NVax individuals. Of the 66 patients admitted to the hospital with severe COVID-19 between December 2020 and November 2022 (after vaccines became available), 23 were Vax and 43 were NVax (Figure 1). Interestingly, mortality among Vax patients in this cohort was 70% compared with 37% in the NVax group, and overall survival rate was ~2 times higher in the NVax patients... Although the number of patients in this study is limited, these results suggest that among hospitalized patients, prior vaccination may not always be indicative of protection against mortality...
To evaluate the role of SARS-CoV-2/CCCoV-specific Abs in severe COVID-19 pathogenesis and immunity, we analyzed plasma levels of SARS-CoV-2/CCCoV IgG, IgA and IgM Abs of the SARS-CoV-2 infected patients... the SARS-CoV-2-N specific IgG/IgA/IgM Abs titers of the NVax patients were significantly higher than those of the Vax patients (Figure 3C). Interestingly, NVax patients with comorbidities had higher SARS-CoV-2 specific Ab levels compared to their Vax counterparts (Supplementary Figure 3), suggesting that the presence of comorbidities was not the sole contributing factor to the decreased Ab response.
Thus, contrary to our expectations, we observed decreased Ab levels in the Vax compared to the NVax group."
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