Title-deterioration of vitiligo and de novo onset of Halo Naevi in two patie...VR Foundation
THIVI MARUTHAPPU
Introduction:
Anti-TNF drugs are widely prescribe by dermatologists as well as other specialists. With their use comes increasing awareness of potential adverse effects. Patient 1 had a 20 year history of stable vitiligo however 3 months after starting adalimumab for ankylosing spondylitis he developed rapid deterioration in his vitilgo which started to affect his face, hands and axillae in a symmetrical distribution. Adalimumab was stopped and he improved with potent topical steroids. Case 2 developed multiple halo naevi after commencing adalimumab. These were not dysplastic and he has remained on treatment.
The potential pathophysiological mechanism for developing immune mediated dermatoses with anti-tnf treatment are discussed.
Q1. Which of the following have not been described following use of anti-TNF drugs
1. Irreversible alopecia areata
2. Erythema elevatum diutunum
3. Systemic lupus erythematosus.
Q2. Which of the following is false
1.vitilgo can be cured with with anti-TNF
2. Vitiligo can improve with anti-TNF
3.vitiligo can deteriorate with anti-TNF
- Disclaimer-
This PPT is loaded as student material "as is", from the VRF Vitiligo Master Class Barcelona November 2011; VRF does not endorse or otherwise approve it.
Title-deterioration of vitiligo and de novo onset of Halo Naevi in two patie...VR Foundation
THIVI MARUTHAPPU
Introduction:
Anti-TNF drugs are widely prescribe by dermatologists as well as other specialists. With their use comes increasing awareness of potential adverse effects. Patient 1 had a 20 year history of stable vitiligo however 3 months after starting adalimumab for ankylosing spondylitis he developed rapid deterioration in his vitilgo which started to affect his face, hands and axillae in a symmetrical distribution. Adalimumab was stopped and he improved with potent topical steroids. Case 2 developed multiple halo naevi after commencing adalimumab. These were not dysplastic and he has remained on treatment.
The potential pathophysiological mechanism for developing immune mediated dermatoses with anti-tnf treatment are discussed.
Q1. Which of the following have not been described following use of anti-TNF drugs
1. Irreversible alopecia areata
2. Erythema elevatum diutunum
3. Systemic lupus erythematosus.
Q2. Which of the following is false
1.vitilgo can be cured with with anti-TNF
2. Vitiligo can improve with anti-TNF
3.vitiligo can deteriorate with anti-TNF
- Disclaimer-
This PPT is loaded as student material "as is", from the VRF Vitiligo Master Class Barcelona November 2011; VRF does not endorse or otherwise approve it.
Covid-19 Brief Review | A holistic review at pandemic Akhtar Hussain
Presentation holistically and briefly covers the technical aspects of global pandemic. To put things in perspective a comparison woth recent pandemics is also included.
I have tried to make the presentation as rational and unbiased. Though with the ever coming developments daily some things might become redundant even in 10 days only. would love to get suggestions for improvement.
Jonathan Corren, MD, and Monica Kraft, MD, prepared useful practice aids pertaining to severe asthma for this CME activity titled "A MasterClass on New Avenues in Asthma Management: Finding the Right Patients for Targeted Therapies." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2yC6zBd. CME credit will be available until November 6, 2019.
Zyvac tcv noida aug 2018 - Completely indigenous Typhoid Vaccine - with a QuizGaurav Gupta
Zyvac tcv noida aug 2018 - Completely indigenous Typhoid Vaccine - with a Quiz, presentation in NOIDA.
Lively discussion about the Clinical studies of various Typhoid vaccines
Know your COVID-19 Vaccine (Philippines)AxcelPerez1
The content aims to contribute spreading right information about COVID-19 Vaccine. The information are from World Health Organization and Philippine Department of Health. This may help my fellow Filipino to build his/her confidence to get vaccinated.
How Nutrition Can Help Fight Against the COVID-19 PandemicUN SPHS
By Dr. Randah Miqbil Alqurashi Assistant Professor, King Faisal University, delivered at the Global Forum 2020 Food Safety and Risk Assessment session.
These slides highlight the approved & widely used therapeutics for treating COVID-19 patients (end Q1 2021). At the time of writing, there are 5 therapeutics that have been granted Emergency Use Authorization by the US FDA, mostly being antivirals and monoclonal antibodies (mAbs). The use of corticosteroids and cytokine inhibitors are also showing promise in their ability to reduce case fatalities, progression as well as hospitalization time.
There are rare graphs and charts showing Covid-19 and Covid-19 Vaccination data together, which might be not political correct now for major medical or health organizations.
So I produced some such charts based on related worldwide open data.
The PPT just shows a set of charts about covid-19 and vaccination for different countries using world wide open data downloaded on 8-28, 2021.
Intravenous Immunoglobulin (IVIG) is a solution of highly purified immunoglobulin G, derived from large pools of human plasma that contains antibodies against a broad spectrum of bacterial and viral agents.
IVIG can be given safely in the convenience of your home. It can be given either intravenously (IV through the veins) or subcutaneously (under the skin).
NBN Infusions will send a nurse with all necessary supplies to complete your infusion, in the comfort of your own home.
NBN Infusions will even help you and your doctor complete all necessary documents. Our goal is to make the process as easy as possible so you can focus on getting the treatment that you need.
Insurance companies can be challenging to deal with in the IVIG treatment approval process sometimes. So, NBN Infusions will help you deal with your insurance process so that you can get approved for your IVIG treatments in a timely manner.
What Does IVIG Treat?
IVIG Therapy has been used extensively in the treatment and prevention of a variety of infectious and inflammatory diseases. Patients with compromised Immune systems who have these conditions often benefit from the passive immunity provided by IVIG therapy.
IVIG is used in patients with primary immunodeficiencies and certain conditions associated with B-cell Chronic Lymphocytic Leukemia, Pediatric HIV, and Bone Marrow Transplant. IVIG is also utilized to raise platelet counts in patients with Idiopathic Thrombocytopenic Purpura and to treat the symptoms related to other clinical conditions such as Kawasaki Syndrome.
Various other diseases and immune disorders where IVIG is used include:
Chronic Sinusitis
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
Multiple Sclerosis (MS)
Myasthenia Gravis(MG)
Systenic Lupus Erythematosus (SLE)
Guillain-Barre Syndrome (GBS)
Autoimmune Diabetic Neuropathy
Polymyositis
Multifocal Motor Neuropathy (MMN)
Dermatomyositis
Rheumatoid Arthritis (RA)
Common Variable Immunodeficiency (CVID)
Hypogammaglobulinemia
Severe Combined Immunodeficiency (SCID)
Wiskott-Aldrich Syndrome (WAS)
X-Linked Agammaglobulinemia (XLA)
other connective tissue disorders
Both SARS-CoV-2 infection and vaccination in pregnancy elicited neutralizing ...MHAASAID
To the Editor
To date, few data on SARS-CoV-2 immune response after
infection or vaccination have been reported in pregnant women. So
far, maternal immunization during pregnancy inducing transplacental antibody transfer to the newborn is currently supported
to reduce morbidity and mortality from infectious diseases after
birth.
After having signed written informed consent, two healthcare
workers received complete BNT162b2 mRNA vaccination during
pregnancy. The first vaccinated woman (VW#1) received the first
dose at 31 weeks' gestation and 4 days, the second woman (VW#2)
at 27 weeks' gestation and 6 days.
Serum samples from the mother/newborn pairs collected at
delivery were tested by ELISA (Euroimmun, Luebeck, Germany) for
anti-SARS-CoV-2 Spike IgG and IgA antibodies. Semi-quantitative
results are expressed as optical density (OD) ratio with respect to
an internal calibrator: a ratio 1.1 was considered positive
Covid-19 Brief Review | A holistic review at pandemic Akhtar Hussain
Presentation holistically and briefly covers the technical aspects of global pandemic. To put things in perspective a comparison woth recent pandemics is also included.
I have tried to make the presentation as rational and unbiased. Though with the ever coming developments daily some things might become redundant even in 10 days only. would love to get suggestions for improvement.
Jonathan Corren, MD, and Monica Kraft, MD, prepared useful practice aids pertaining to severe asthma for this CME activity titled "A MasterClass on New Avenues in Asthma Management: Finding the Right Patients for Targeted Therapies." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2yC6zBd. CME credit will be available until November 6, 2019.
Zyvac tcv noida aug 2018 - Completely indigenous Typhoid Vaccine - with a QuizGaurav Gupta
Zyvac tcv noida aug 2018 - Completely indigenous Typhoid Vaccine - with a Quiz, presentation in NOIDA.
Lively discussion about the Clinical studies of various Typhoid vaccines
Know your COVID-19 Vaccine (Philippines)AxcelPerez1
The content aims to contribute spreading right information about COVID-19 Vaccine. The information are from World Health Organization and Philippine Department of Health. This may help my fellow Filipino to build his/her confidence to get vaccinated.
How Nutrition Can Help Fight Against the COVID-19 PandemicUN SPHS
By Dr. Randah Miqbil Alqurashi Assistant Professor, King Faisal University, delivered at the Global Forum 2020 Food Safety and Risk Assessment session.
These slides highlight the approved & widely used therapeutics for treating COVID-19 patients (end Q1 2021). At the time of writing, there are 5 therapeutics that have been granted Emergency Use Authorization by the US FDA, mostly being antivirals and monoclonal antibodies (mAbs). The use of corticosteroids and cytokine inhibitors are also showing promise in their ability to reduce case fatalities, progression as well as hospitalization time.
There are rare graphs and charts showing Covid-19 and Covid-19 Vaccination data together, which might be not political correct now for major medical or health organizations.
So I produced some such charts based on related worldwide open data.
The PPT just shows a set of charts about covid-19 and vaccination for different countries using world wide open data downloaded on 8-28, 2021.
Intravenous Immunoglobulin (IVIG) is a solution of highly purified immunoglobulin G, derived from large pools of human plasma that contains antibodies against a broad spectrum of bacterial and viral agents.
IVIG can be given safely in the convenience of your home. It can be given either intravenously (IV through the veins) or subcutaneously (under the skin).
NBN Infusions will send a nurse with all necessary supplies to complete your infusion, in the comfort of your own home.
NBN Infusions will even help you and your doctor complete all necessary documents. Our goal is to make the process as easy as possible so you can focus on getting the treatment that you need.
Insurance companies can be challenging to deal with in the IVIG treatment approval process sometimes. So, NBN Infusions will help you deal with your insurance process so that you can get approved for your IVIG treatments in a timely manner.
What Does IVIG Treat?
IVIG Therapy has been used extensively in the treatment and prevention of a variety of infectious and inflammatory diseases. Patients with compromised Immune systems who have these conditions often benefit from the passive immunity provided by IVIG therapy.
IVIG is used in patients with primary immunodeficiencies and certain conditions associated with B-cell Chronic Lymphocytic Leukemia, Pediatric HIV, and Bone Marrow Transplant. IVIG is also utilized to raise platelet counts in patients with Idiopathic Thrombocytopenic Purpura and to treat the symptoms related to other clinical conditions such as Kawasaki Syndrome.
Various other diseases and immune disorders where IVIG is used include:
Chronic Sinusitis
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
Multiple Sclerosis (MS)
Myasthenia Gravis(MG)
Systenic Lupus Erythematosus (SLE)
Guillain-Barre Syndrome (GBS)
Autoimmune Diabetic Neuropathy
Polymyositis
Multifocal Motor Neuropathy (MMN)
Dermatomyositis
Rheumatoid Arthritis (RA)
Common Variable Immunodeficiency (CVID)
Hypogammaglobulinemia
Severe Combined Immunodeficiency (SCID)
Wiskott-Aldrich Syndrome (WAS)
X-Linked Agammaglobulinemia (XLA)
other connective tissue disorders
Both SARS-CoV-2 infection and vaccination in pregnancy elicited neutralizing ...MHAASAID
To the Editor
To date, few data on SARS-CoV-2 immune response after
infection or vaccination have been reported in pregnant women. So
far, maternal immunization during pregnancy inducing transplacental antibody transfer to the newborn is currently supported
to reduce morbidity and mortality from infectious diseases after
birth.
After having signed written informed consent, two healthcare
workers received complete BNT162b2 mRNA vaccination during
pregnancy. The first vaccinated woman (VW#1) received the first
dose at 31 weeks' gestation and 4 days, the second woman (VW#2)
at 27 weeks' gestation and 6 days.
Serum samples from the mother/newborn pairs collected at
delivery were tested by ELISA (Euroimmun, Luebeck, Germany) for
anti-SARS-CoV-2 Spike IgG and IgA antibodies. Semi-quantitative
results are expressed as optical density (OD) ratio with respect to
an internal calibrator: a ratio 1.1 was considered positive
These slides talk about the top few candidates in the COVID-19 vaccine race. There are currently around 200 candidates in R&D, a handful of which has entered clinical trials. The top runners are AstraZeneca, Pfizer, & Moderna.
A brief overview of the process of vaccine production, clinical trials, and licensing, along with a summary of the different vaccines platforms and vaccine candidates.
Zyvac tcv the Indian typhoid conjugate vaccination - Yamunanagar aug 2018Gaurav Gupta
Zyvac TCV by Zydus Vaccines is the Indian Typhoid Conjugate vaccination with Indian Carrier TT protein.
Recent data from Lancet regarding TCV efficacy is featured in this presentation
Journal club covid vaccine neurological complications ZIKRULLAH MALLICK
the risks of adverse neurological events following SARS-CoV-2 infection are much greater than those associated with vaccinations, highlighting the benefits of ongoing vaccination programs.
Triglytza: Counter-Regulation of RAAS and COVID-19 TreatmentRavi Kumar, Ph.D.
TriGlytza is a proprietary dual combination product of ARKAY Therapeutics. It is custom-designed for treatment and mitigation of ARDS and MODS associated with COVID-19.
Influenza vaccine is nothing new . However there are lesser known facts about Influenza vaccine. This is just a humble attempt to highlight a few important points about Influenza vaccine, including some updates.
Burden of Influenza disease worldwide.
Importance of Influenza vaccine in Corona virus pandemic.
Influenza vaccine quadrivalent vs trivalent vaccine.
Split virion vs Subunit influenza vaccine
0.5 ml dose of influenza vaccine below 3 yrs age in children
Northern hemisphere or Southern hemisphere influenza vaccine for India, some suggestions
Die britische Regierung räumt ein, dass Impfstoffe das natürliche Immunsystem von Doppelgeimpften geschädigt haben. Die britische Regierung hat zugegeben, dass Sie nach einer Doppelimpfung nie wieder eine vollständige natürliche Immunität gegen Covid-Varianten – oder möglicherweise gegen andere Viren – erlangen können. Sehen wir also zu, wie die „echte“ Pandemie jetzt beginnt! In seinem „COVID-19 Vaccine Surveillance Report“ (Woche 42) räumt das britische Gesundheitsministerium auf Seite 23 ein, dass „die N-Antikörperspiegel bei Menschen, die sich nach zwei Impfdosen infizieren, niedriger zu sein scheinen“. Es heißt weiter, dass dieser Rückgang der Antikörper im Wesentlichen dauerhaft ist. Was bedeutet das? Wir wissen, dass Impfstoffe eine Infektion oder Übertragung des Virus nicht verhindern (tatsächlich zeigt der Bericht an anderer Stelle, dass geimpfte Erwachsene jetzt viel wahrscheinlicher infiziert werden als ungeimpfte). Die Briten stellen nun fest, dass der Impfstoff die Fähigkeit des Körpers beeinträchtigt, nach einer Infektion Antikörper zu bilden, nicht nur gegen das Spike-Protein, sondern auch gegen andere Teile des Virus. Insbesondere scheinen geimpfte Personen keine Antikörper gegen das Nukleokapsid-Protein, die Hülle des Virus, zu bilden, das ein entscheidender Teil der Reaktion bei ungeimpften Personen ist. Langfristig sind die Geimpften deutlich anfälliger für eventuelle Mutationen im Spike-Protein, auch wenn sie bereits einmal oder mehrmals infiziert und geheilt wurden. Die Ungeimpften hingegen werden eine dauerhafte, wenn nicht sogar dauerhafte Immunität gegen alle Stämme des angeblichen Virus erlangen, nachdem sie auch nur einmal auf natürliche Weise damit infiziert wurden. Quelle: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1027511/Vaccine-surveillance-report-week-42.pdf Die
Guillain Barre Syndrome & Covid-19: A Case Reportclinicsoncology
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia, headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection.
Guillain Barre Syndrome & Covid-19: A Case Reportpateldrona
Besides respiratory symptoms, coronavirus disease 2019 (COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs
Guillain Barre Syndrome & Covid-19: A Case Reportkomalicarol
Besides respiratory symptoms, coronavirus disease 2019
(COVID-19), like the severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), has neurological signs. Symptoms like myalgia,
headaches, dizziness, anosmia, ageusia and disorder of consciousness confirms that the nervous system is involved in COVID-19 infection. Guillain barre syndrome (GBS) is a neurological disorder
that usually follows a viral infection, it is possible that COVID-19
infection and GBS are closely related. In this case report, we try to
elucidate the relation between SARS-CoV-2 and GBS.
Similar to Covid, lo studio sugli anticorpi di guariti e obesi (20)
Toxic effects of heavy metals : Lead and Arsenicsanjana502982
Heavy metals are naturally occuring metallic chemical elements that have relatively high density, and are toxic at even low concentrations. All toxic metals are termed as heavy metals irrespective of their atomic mass and density, eg. arsenic, lead, mercury, cadmium, thallium, chromium, etc.
Comparing Evolved Extractive Text Summary Scores of Bidirectional Encoder Rep...University of Maribor
Slides from:
11th International Conference on Electrical, Electronics and Computer Engineering (IcETRAN), Niš, 3-6 June 2024
Track: Artificial Intelligence
https://www.etran.rs/2024/en/home-english/
Earliest Galaxies in the JADES Origins Field: Luminosity Function and Cosmic ...Sérgio Sacani
We characterize the earliest galaxy population in the JADES Origins Field (JOF), the deepest
imaging field observed with JWST. We make use of the ancillary Hubble optical images (5 filters
spanning 0.4−0.9µm) and novel JWST images with 14 filters spanning 0.8−5µm, including 7 mediumband filters, and reaching total exposure times of up to 46 hours per filter. We combine all our data
at > 2.3µm to construct an ultradeep image, reaching as deep as ≈ 31.4 AB mag in the stack and
30.3-31.0 AB mag (5σ, r = 0.1” circular aperture) in individual filters. We measure photometric
redshifts and use robust selection criteria to identify a sample of eight galaxy candidates at redshifts
z = 11.5 − 15. These objects show compact half-light radii of R1/2 ∼ 50 − 200pc, stellar masses of
M⋆ ∼ 107−108M⊙, and star-formation rates of SFR ∼ 0.1−1 M⊙ yr−1
. Our search finds no candidates
at 15 < z < 20, placing upper limits at these redshifts. We develop a forward modeling approach to
infer the properties of the evolving luminosity function without binning in redshift or luminosity that
marginalizes over the photometric redshift uncertainty of our candidate galaxies and incorporates the
impact of non-detections. We find a z = 12 luminosity function in good agreement with prior results,
and that the luminosity function normalization and UV luminosity density decline by a factor of ∼ 2.5
from z = 12 to z = 14. We discuss the possible implications of our results in the context of theoretical
models for evolution of the dark matter halo mass function.
The ability to recreate computational results with minimal effort and actionable metrics provides a solid foundation for scientific research and software development. When people can replicate an analysis at the touch of a button using open-source software, open data, and methods to assess and compare proposals, it significantly eases verification of results, engagement with a diverse range of contributors, and progress. However, we have yet to fully achieve this; there are still many sociotechnical frictions.
Inspired by David Donoho's vision, this talk aims to revisit the three crucial pillars of frictionless reproducibility (data sharing, code sharing, and competitive challenges) with the perspective of deep software variability.
Our observation is that multiple layers — hardware, operating systems, third-party libraries, software versions, input data, compile-time options, and parameters — are subject to variability that exacerbates frictions but is also essential for achieving robust, generalizable results and fostering innovation. I will first review the literature, providing evidence of how the complex variability interactions across these layers affect qualitative and quantitative software properties, thereby complicating the reproduction and replication of scientific studies in various fields.
I will then present some software engineering and AI techniques that can support the strategic exploration of variability spaces. These include the use of abstractions and models (e.g., feature models), sampling strategies (e.g., uniform, random), cost-effective measurements (e.g., incremental build of software configurations), and dimensionality reduction methods (e.g., transfer learning, feature selection, software debloating).
I will finally argue that deep variability is both the problem and solution of frictionless reproducibility, calling the software science community to develop new methods and tools to manage variability and foster reproducibility in software systems.
Exposé invité Journées Nationales du GDR GPL 2024
DERIVATION OF MODIFIED BERNOULLI EQUATION WITH VISCOUS EFFECTS AND TERMINAL V...Wasswaderrick3
In this book, we use conservation of energy techniques on a fluid element to derive the Modified Bernoulli equation of flow with viscous or friction effects. We derive the general equation of flow/ velocity and then from this we derive the Pouiselle flow equation, the transition flow equation and the turbulent flow equation. In the situations where there are no viscous effects , the equation reduces to the Bernoulli equation. From experimental results, we are able to include other terms in the Bernoulli equation. We also look at cases where pressure gradients exist. We use the Modified Bernoulli equation to derive equations of flow rate for pipes of different cross sectional areas connected together. We also extend our techniques of energy conservation to a sphere falling in a viscous medium under the effect of gravity. We demonstrate Stokes equation of terminal velocity and turbulent flow equation. We look at a way of calculating the time taken for a body to fall in a viscous medium. We also look at the general equation of terminal velocity.
Professional air quality monitoring systems provide immediate, on-site data for analysis, compliance, and decision-making.
Monitor common gases, weather parameters, particulates.
Nutraceutical market, scope and growth: Herbal drug technologyLokesh Patil
As consumer awareness of health and wellness rises, the nutraceutical market—which includes goods like functional meals, drinks, and dietary supplements that provide health advantages beyond basic nutrition—is growing significantly. As healthcare expenses rise, the population ages, and people want natural and preventative health solutions more and more, this industry is increasing quickly. Further driving market expansion are product formulation innovations and the use of cutting-edge technology for customized nutrition. With its worldwide reach, the nutraceutical industry is expected to keep growing and provide significant chances for research and investment in a number of categories, including vitamins, minerals, probiotics, and herbal supplements.
THE IMPORTANCE OF MARTIAN ATMOSPHERE SAMPLE RETURN.Sérgio Sacani
The return of a sample of near-surface atmosphere from Mars would facilitate answers to several first-order science questions surrounding the formation and evolution of the planet. One of the important aspects of terrestrial planet formation in general is the role that primary atmospheres played in influencing the chemistry and structure of the planets and their antecedents. Studies of the martian atmosphere can be used to investigate the role of a primary atmosphere in its history. Atmosphere samples would also inform our understanding of the near-surface chemistry of the planet, and ultimately the prospects for life. High-precision isotopic analyses of constituent gases are needed to address these questions, requiring that the analyses are made on returned samples rather than in situ.
Body fluids_tonicity_dehydration_hypovolemia_hypervolemia.pptx
Covid, lo studio sugli anticorpi di guariti e obesi
1. Abstract 03188 – European Congress of Clinical Microbiology & Infectious
Diseases (ECCMID 2022)
Long-term humoral immunity of COVID-19 recovered and BNT162b2
vaccinated individuals: a prospective comparative study
Embargo: 2301H UK time Thursday 10 February, 2022
C. Cohen 1
, Y. Lustig 2, 3
, E. Levin 1, 3
, V. Indenbaum 1
, K. Asraf 1
, C.
Rubin 4
, Y. Kreiss 1
, Gili Regev-Yochay 1, 3
1
Sheba Medical Center - Ramat Gan (Israel), 2
Central Virology Laboratory, Public Health
Authority, Ministry of Health - Ramat Gan (Israel), 3
Sackler School of Medicine - Tel Aviv
(Israel), 4
Gertner institute for epidemiology and health policy research - Ramat Gan
(Israel)
Background
While protection against re-infection lasts for a long time in SARS-CoV-2 recovered patients,
breakthrough infections are significantly induced six months following BNT162b2 vaccination.
We aimed to longitudinally characterize the humoral immune kinetics in COVID-19 recovered
individuals compared to two dose BNT162b2 vaccinated individuals along eight months of
survey.
Methods
We conducted a 12-month follow-up of 130 patients diagnosed with SARS-COV-2 by qRT-
PCR. Data on acute as well as long term (6 weeks) symptoms were collected. We compared
anti-spike IgG and neutralizing antibodies of these patients to an eight months follow-up of
402 age and body mass index (BMI), matched SARS-CoV-2 naïve, vaccinated individuals.
Avidity index for sub-cohorts composed of 16 and 22 recovered and vaccinated individuals,
respectively, was compered at one- and six-month following SARS-CoV-2 diagnosis or
BNT162b2 vaccination. For recovered patients, questionnaires concerning symptoms
including long-covid were collected.
Results
We found higher IgG and neutralizing antibodies at peak titers in the vaccinated cohort than
in the recovered cohort, but also a steeper decline (Fig 1.). Avidity index was higher in
vaccinated individuals than in recovered patients, yet, avidity did not significantly change with
time in vaccinated individuals while avidity gradually increased in recovered patients (Fig 2.).
Interestingly, IgG and Neutralizing Ab of recovered patients with BMI>30 vs. those with BMI
≤30, were higher at all time points (Fig 3.). Of all recovered patients, 42 (36%) individuals
experienced long-covid symptoms including mental (5%), neurologic (9%), cardiovascular
(5%) and respiratory (31%) manifestations.
Conclusions
While the quantity of antibodies decrease with time in both COVID-19 recovered patients and
vaccinated individuals, the quality of antibodies increases following infection but not after
vaccination. Obese individuals have a significantly higher and sustained humoral response
following infection. These results provide specific characteristics of the immune response that
may explain the differential protection against COVID-19 in previously infected and vaccinated
individuals.
2. Figure 1. a. RBD- binding IgG and b. neutralizing antibodies (NAB) distribution and geometric
mean (GMT) along eight and twelve month in BNT162b2 vaccinated and COVID-19 recovered
individuals, respectively. The dashed line indicates the cutoff for diagnostic positivity
Figure 2. Avidity index, indicated as percentage at for recovered individuals compared to
BNT162b2 vaccinated individuals, one and six month after receiving the second dose and,
one, six and 12 month post SARS-COV-2 diagnosis
Figure 3. Antibody distribution, along 12 month of SARS-COV-2 recovered patients with
BMI>30 compared to recovered patients with BMI≤30; a. Distribution and observed
geometric mean of RBD-binding IgG, b. distribution and observed geometric mean of
neutralizing antibodies (NAB). The dashed line indicates the cutoff for diagnostic positivity