Keywords
P.1 variant
Immunogenicity
Vaccine
Immune escape
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Abstract
Objective: To analyze the immunogenicity of the P.1 variant and the immune escape against the critical evolution of a patient with complete vaccination against COVID-19. Case detail: Case study that aims to evaluate, through the analysis of medical records, the clinical-epidemiological profile of a single participant, over 18 years old, male and health professional, who was hospitalized at the General Hospital of Roraima (HGR) for the treatment of COVID-19 in its severe form. Individuals who have risk factors, such as diabetes mellitus, coronary disease and obesity, have an imbalance in the immune response and in the endocrine system, high cardiovascular risk and compromised lung function. The negative outcome of the clinical picture occurred due to infection by the SARS-Cov-2 variant, P1. The participant had been immunized with both doses of the CoronaVac vaccine, thus resulting in an immune escape and vaccine ineffectiveness. Final considerations: The potential for virulence and mutations worsened the patient's condition, reflecting on the configuration of high transmission and lethality triggered by the infection. The vaccinal scheme carried out showed a decline in efficacy due to immunological escape, a result of the high selectivity pressure promoted by different mutations, such as P1, sequencing in cross-neutralization of antibodies to combat it and the reduction of immunogenicity.
References
BANHO CA, et al. Impact of SARS-CoV-2 Gamma lineage introduction and COVID-19 vaccination on the epidemiological landscape of a Brazilian city. Commun Med 2, 2022; 41.
BRASIL. MINISTÉRIO DA SAÚDE. Guia de Vigilância Epidemiológica – Emergência de Saúde Pública de Importância Nacional Pela Doença pelo CoronaVírus 2019. Brasília: Ministério da Saúde; 2020; 1: 37.
BRASIL. MINISTÉRIO DA SAÚDE. Plano nacional de operacionalização da vacinação contra a COVID-19. Brasília: Ministério da Saúde; 2021.
BRASIL. MINISTÉRIO DA SAÚDE. Sistema de Informação de Vigilância Epidemiológica da Gripe/Secretaria de Vigilância em Saúde. 2022. Disponível em: https ://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/boletins/epidemiologicos/covid-19/2023/boletim-epidemiologico-no-152-boletim-coe-coronavirus. Acessado em: 20 de junho de 2023.
CHALLEN R, et al. Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study. BMJ. 2022; 372: 579.
CHAN JFW, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020; 395: 30154-59.
DAVIES NG, et al. Estimated transmissibility and impact of SARS-CoV-2 lineage B.1.1.7 in England. Science, 2021; 372: 3-9.
DE SOUZA WM, et al. Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil. Nat Hum Behav , 2022; 4: 856–65.
DONG E, et al. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2022; 20(5): 533–534.
FREITAS ARR, et al. Emerging variants of SARS-CoV-2 and its public health implications. InterAmerican Journal of Medicine and Health. 2022; 4: 181.
HALLAL PC, et al. SARS-CoV-2 antibody prevalence in Brazil: results from two successive nationwide serological household surveys. The Lancet. 2020; 8(11): 1390-8.
HUANG C, et al. The genome of COVID-19 shares sequence identity with both SARS-CoV and MERS-COV. Lancet. 2021; 20: 30183-30185.
KANNAN S, et al. COVID-19 (Novel Coronavirus 2019) - recent trends. Eur Rev Med Pharmacol Sci. 2021; 24: 2006-11.
NAVECA FG, et al. COVID-19 in Amazonas, Brazil, was driven by the persistence of endemic lineages and P.1 emergence. Nat Med. 2022; 27: 1230-1238.
OMS. Secuenciación genómica del SARS-CoV-2 para objetivos de salud pública. Guia provisório: Organização Mundial da Saúde. 2023; 1: 1-20.
PREMKUMAR L, et al.The receptor binding domain of the viral spike protein is an immunodominant and highly specific target of antibodies in SARS-CoV-2 patients. Sci Immunol. 2020; 5eabc8413.
RIBAS ARF, et al. Variantes emergentes do SARS-CoV-2 e suas implicações na saúde coletiva. InterAmerican Journal of Medicine and Health 2022; 4: 181.
SABINO EC, et al. Resurgence of COVID-19 in Manaus, Brazil, despite high seroprevalence. Lancet. 2022; 397: 452–5.
STARLING, et al. COVID-19 Normality Rate: Criteria for Optimal Time to Return to In-person Learning. Open Forum Infectious Diseases, 2021; 8: S303–S304.
TEGALLY H, et al. Emergence of a SARS-CoV-2 variant of concern with mutations in spike glycoprotein. Nature. 2023; 592: 1–8.
ZHANG Y, et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18-59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. Lancet Infect Dis. 2023; 21: 181–92.