I am a big fan of this COVID immunity paper from @Anto_Berto . This was the first paper to longitudinally track viral loads AND virus-specific T cells in COVID patients quantitatively in the same study, from early time points. 🧵

@bertoletti_lab

doi.org/10.1016/j.celr…
The key observations are:

* Early T cell responses were associated with rapid control of virus and mild disease.

* Early antibody responses did not distinguish control of virus or disease severity.

* Peak viral loads were correlated with disease severity.
I talk about the importance of longitudinal studies from early timepoints post-infection in this review.

doi.org/10.1016/j.cell…
Since immune responses (and viral replication) are exponential processes, it is hard to determine meaningful correlations between immune responses and viral control without time courses, starting from very early.
Because this study tracked T cell responses and viral loads together, from early times after infection, the interpretations are more likely to be correct than more commonly available studies with a single time point or much later timepoints.
The study also observed a relationship between peak viral load and duration of infection. That connects this study with the larger literature of studies that tracked viral loads and disease severity but not T cell responses.
This study only had 12 patients, so it will be important to have similar immunological studies from other labs, and other geographical locations and cohort characteristics (as acknowledged by the authors), but it is the first study of its kind and a valuable contribution.

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More from @profshanecrotty

8 Feb
Well, that's a nice surprise!
What happens if you have had COVID infection before and you get a COVID vaccine?
Some observations last week are summarized here:
In a new pre-print by the excellent @McGuire_Lab , they report a big jump in neutralizing antibodies after a single COVID RNA vaccine immunization (Pfizer or Moderna).

That is the same thing observed by @florian_krammer and the Sajadi labs.
medrxiv.org/content/10.110…
Read 5 tweets
8 Feb
The AstraZeneca/Oxford (AZ) COVID vaccine (ChAdOx) results in South Africa are concerning. 🧵

* The AZ vaccine had 75% efficacy against mild COVID through October 2020.

* But only 22% efficacy more recently, with the SA variant  (aka B1351 or 501Y.V2)

facebook.com/HealthZA/video…
Penny Moore and Alex Sigal and colleagues now report on antibodies from AZ ChAdOx vaccinated people, and there was a dramatic loss of function against the B1351 variant. It appears to be more than a 20x reduction. A complete loss of neutralization in most individuals (~80%). Image
First, what to think of the antibody neutralization loss?

It is much steeper than reported by multiple groups elsewhere for COVID19 cases or other COVID vaccines. Multiple labs reported ~2x drop in neutralization of B1351 or related virus, with antibodies from vaccinated people
Read 16 tweets
8 Feb
This is a very nice study of the AstraZeneca/Oxford (AZ) ChAdOx vaccine in the UK (with a  challenging title!).
ssrn.com/abstract=37791…

There are several novel findings in this study, including:
* 75% protection against ASYMPTOMATIC infections, (w/new definition).

* Protection against symptomatic infections was similar for B117 (the UK variant).

* Even though ChAdOx antibodies were 9x weaker against B117.

* Protection against asymptomatic B117 appears mostly lost.
On the topic of vaccine protection from asymptomatic infections:

There have been limited data on vaccine protection from asymptomatic infections, which has important implications for transmission of virus.
Read 20 tweets
5 Feb
Hooray, the shiny colorful final version of our paper is out in Science! 😁🧵
science.sciencemag.org/content/371/65…
Explainer thread when it was first published in Science:
Read 4 tweets
4 Feb
Getting lots of questions about COVID vaccine safety, which is good! Here's a quick compilation of some resources on COVID vaccine safety.🧵
This covers the basics about the RNA vaccines and safety:

I did a Youtube video on RNA vaccines and COVID vaccine safety with the excellent @MedCramVideos . It has been very popular
(over 1 million views!)
Read 8 tweets
2 Feb
SIX successful COVID-19 vaccines! SIX! Three just in the past week! Extraordinary. The newest one is the Russian (Rus) adenoviral (Ad) vector COVID vaccine. The clinical trial data look really good at face value. 🧵

doi.org/10.1016/S0140-…
92% efficacy overall, and 92% efficacy in people over 60 years old.
I will let clinical trial design experts weigh in on trial design features. I will comment on the basic outcomes and the immune responses.
Read 12 tweets

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