A preprint by Michael Simon et al @ArcadiaHealthIT shows that COVID vaccines given before or AFTER infection can reduce incidence of #longCOVID, based on a retrospective analysis of the health record of 240,648 COVID-19-infected people. 🧵(1/)

medrxiv.org/content/10.110…
People who received at least one dose of any of the 3 COVID vaccines in the US prior to COVID diagnosis were 8.8x less likely to report >1 long COVID symptoms between 12-20 weeks after diagnosis. (2/)
This reduction in LC risk appears high, given other studies that found 50% reduction or no reduction by prior vaccination in LC among breakthrough infection. Perhaps this depends on how one measures and defines long covid. (3/)

nature.com/articles/d4158…
More strikingly, people who received at least one dose of any COVID vaccine AFTER COVID diagnosis also benefited. Likelihood of reporting >1 long COVID symptoms was reduced in those who received vax 0-4 wks (5.3x), 4-8 wks (3.2x) or 8-12 wks (2.2x) after COVID diagnosis. (4/)
While more studies are needed to validate these findings, the implication is that people should get the COVID vaccine even after SARS-CoV-2 infections in order to reduce the risk of developing long COVID. Data support earlier the better. (5/)
Mechanistically, post infection vaccination may encourage robust and rapid development of immune responses to the virus to 1) prevent establishment of viral reservoir or 2) reduce inflammatory damage leading to autoimmunity that may drive #longCOVID. (6/)
elemental.medium.com/how-vaccines-m…
Current CDC guideline says "People with known current SARS-CoV-2 infection should defer vaccination at least until recovery from the acute illness (if symptoms were present) has been achieved and criteria to discontinue isolation have been met.” (7/)
cdc.gov/vaccines/covid…
However, CDC does not say how long people should wait before getting the vaccine after isolation is over. This study supports the vaccination of people who acquired SARS-CoV-2 within the first 4 weeks to reduce the risk for long COVID. (8/)
I’d love to know the answers re: What is the impact of the vaccine type? How do age, sex, existing conditions impact the findings? What is the impact of vax at 0-2 vs. 3-4 wks post infection on long COVID risk reduction? Do the findings hold for the Delta variant? (End)

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More from @VirusesImmunity

10 Nov
Our latest study is about an immunocompromised patient with persistent COVID ➡️ treated with remdesivir but developed resistant mutation ➡️ was then cured by monoclonal Ab cocktail. Study by @gandhisk @sneakyvirus1 @epidememeology @marioph13 et al. (1/)

medrxiv.org/content/10.110…
This patient received a course of rituximab (B cell depleting Ab) and bendamustine (chemo agent) for the treatment of Stage IV Non-Hodgkin's lymphoma. As a result, patient had extremely low number of T cells and low lymphocyte counts overall. Analysis by @peowenlu (2/)
So when she was infected with SARS-CoV-2, she was unable to clear the virus for over 150 days. She developed persistent fever, anosmia and ground glass opacities in her lungs. Her viral load stayed high until the remdesivir treatment. (3/)
Read 15 tweets
31 Oct
Our study on immune profiling of a solid organ transplant recipient with SARS-CoV-2 reinfection is now published.

Congrats to lead authors @sneakyvirus1 @AndersonBrito_ Paul Trubin @peowenlu and senior authors Marwan Azar & @BenIsraelow 👏🏼 👏🏼 (1/)

academic.oup.com/jid/advance-ar…
For description of this study, please see my thread from when we first posted the paper in @medrxivpreprint in March 👇🏽 One of the deepest immune profiling that captures reinfection in a longitudinal manner. (2/)

In a nutshell, this transplant patient had, prior to reinfection;

• Huge levels of circulating innate and adaptive cytokines (chronic inflammation)
• Very few naive lymphocytes & dominant exhausted T cells
• Elicited poor and transient neutralizing Ab responses
(3/)
Read 4 tweets
11 Oct
In our study published today, we show;

1) mRNA vaccines (2 shots) induce robust antibodies & T cells to SARS-CoV-2
2) certain mutations in VOC ⬆️ Ab escape
3) prior infection + 2 mRNA shots produce very high neutralizing Ab against most VOC 🦠(1/)

nature.com/articles/s4158…
If the link above does not work, here is a full text access of our paper. (2/)

rdcu.be/czi6G
For an explanatory thread on this study please see👇🏽
(3/)

Read 6 tweets
2 Oct
An important new study looks at how COVID vaccines impacts symptoms in #LongCovid patients. @thitran3’s team used data from ComPaRe long COVID cohort to emulate a target trial (1:1 matched vax:unvax) measuring outcome at 120 days after baseline. (1/)

papers.ssrn.com/sol3/papers.cf…
The study found that the rate of complete remission from long COVID symptoms doubled in vaccinated patients compared to unvaccinated long COVID patients. Wow, vaccines appear to be helping long haulers with recovery 👏🏼 (2/)
In addition, disease impact of long covid on patients’ lives were significantly reduced (symptoms improved) in vax group (long COVID IT score of 24.3) compared to unvax group (IT score of 27.6). (3/)
Read 8 tweets
6 Sep
I am very proud of @marioph13, @peowenlu and @ValterVSM for participating in #scicomm. They explained viral plaque assay, flow cytometry and ELISA to news reporter from WAPA TV 🇵🇷 via @dacolon

Me: Cloro no, vacuna sí! (1/)

wapa.tv/programas/cuar…
Here is @Marioph13 explaining viral plaque assay en español 🤩 (too bad his excellent explanation did not make it into the video clip) (2/)
Here, @ValterVSM explains ELISA, how it can detect levels of antibodies in a person, and what antibody levels mean for protection against SARS-CoV-2 VOCs 💪🏼 (3/)
Read 6 tweets
2 Sep
Excited to share our work by @BenIsraelow et al published today. We asked what are the roles of antibodies vs. T cells in controlling primary infection, reinfection, and vaccine-mediated protection? (1/n)

science.org/doi/10.1126/sc…
First, we asked if B cells are needed to control primary infection. We used muMT mice (devoid of B cells) transduced with AAV-hACE2. These mice had only a slight delay in viral clearance. Thus B cells are not necessary for controlling primary SARS-CoV-2 infection. (2/n)
However, in mice that have neither T cells nor B cells (RAG-/-), SARS-CoV-2 persisted with no sign of clearance. Thus, innate immunity is insufficient, and adaptive immunity is required to control primary infection. (3/n)
Read 15 tweets

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