Dados do Trabalho

Título

SARS-CoV-2 infection pos vaccine: clinical outcome and genomic features and intra host variants post vaccination

Introdução

Coronavirus disease (COVID-19) has affected more than six hundred million people causing more than six million deaths. In January 2021, the Brazilian immunization program started vaccination against SARS-CoV-2 with the aim to control COVID-19 severe cases. It began at a moment when the country was facing the emergence and spread of the VOC Gamma (P.1/P.1. *). As expected, SARS-CoV-2 cases were reported following vaccination in Brazil.

Objetivo (s)

The objective of this study was to evaluate a series of cases who reported a previous complete vaccine course and to observe the clinical outcome, to describe viral genomic features of these cases, including intra-host minor variants.

Material e Métodos

Samples from SARS-CoV-2 infection cases post-vaccine were collected throughout the country. We considered a vaccinated patient, someone who had taken two doses of vaccine with at least 15 days interval between the last dose and the date of the onset of symptoms or collection date. All viruses had the whole genome sequenced and using the ViralFlow we assembled the genomes and observed the presence of intra-host minor variants.

Resultados e Conclusão

539 post vaccination SARS-CoV-2 cases were recovered from 8 different Brazilian states. The median age of the post-vaccination infected population was 51 (ranging 15 to 98) years-old (y.o). The vaccines administered were AstraZeneca (n = 239), CoronaVac (n = 223), Janssen (n = 9), Pfizer (n = 68), with 83 individuals having received a booster dose of Pfizer. The interval between the last dose and the onset of symptoms was 141 days (ranging 16 to 331 days). In most cases, 77,6% (n = 418) patients recovered well, 15,6% (n = 86) were hospitalized and 6,4% (n = 35) died. It is important to consider that hospitalized cases and death may be associated with other factors such as comorbidities and complications. The lineages that affected these individuals were Delta (n = 167), Gamma (n = 9) and Omicron (n = 363). Up to 127 (79%, 127/163 analyzed) genomes presented minor variants. The selective pressure of immune system may contribute to the emergence of the intra-host diversity found in this study. In summary, vaccination is a great strategy to reduce severe cases. Monitoring infections post vaccination is interesting to observe strains that can escape from host immune system. Additionally, phenotypic assays and viral neutralization using sera from convalescent and vaccinated are important to monitor new variant.

Palavras-chave

Vaccine; Vaccination; Infecction SARS-CoV-2; Vaccination SARS-CoV-2