Immunogenicity of COVID-19 vaccines in patients with haematological malignancy: A systematic review and meta-analysis

The objectives of this study were to assess the immunogenicity and safety of COVID-19 vaccines in patients with haematological malignancy. A systematic review and meta-analysis of clinical studies of immune responses to COVID-19 vaccination stratified by underlying malignancy and published from 1 January 2021 to 31 August 2021 was conducted using MEDLINE, EMBASE and CENTRAL. Primary outcome was the rate of seropositivity following 2 doses of COVID-19 vaccine with rates of seropositivity following 1 dose, rates of positive neutralising antibody (nAb), cellular responses and adverse events as secondary outcomes. Rates were pooled from single arm studies while rates of seropositivity were compared against the rate in healthy controls for comparator studies using a random effects model and expressed as a pooled odds ratio with 95% confidence intervals. Forty-four studies (16 mixed group, 28 disease specific) with 7064 patients were included in the analysis (2331 following first dose, 4733 following second dose). Overall seropositivity rates were 61-67% following 2 doses and 37-51% following 1 dose of COVID-19 vaccine. The lowest seropositivity rate was 51% in CLL patients and was highest in patients with acute leukaemia (93%). Following 1 dose, nAb and cellular response rates were 18-63% and 33-86% respectively. Active treatment, ongoing or recent treatment with targeted and CD-20 monoclonal antibody therapies within 12 months was associated with poor COVID-19 vaccine immune responses. New approaches to prevention are urgently required to reduce COVID-19 infection morbidity and mortality in high-risk patient groups that respond poorly to COVID-19 vaccination.

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Immunogenicity of COVID-19 vaccines in patients with hematological malignancy: a systematic review and meta-analysis

Blood Advances ◽

10.1182/bloodadvances.2021006333 ◽

2021 ◽

Author(s):

Joanne S.K. Teh ◽

Julien Coussement ◽

Zoe C.F. Neoh ◽

Tim Spelman ◽

Smaro Lazarakis ◽

...

Keyword(s):

Systematic Review ◽

Immune Responses ◽

Cellular Response ◽

Primary Outcome ◽

Meta Analysis ◽

High Risk Patient ◽

Seropositivity Rate ◽

Dose Rates ◽

Underlying Malignancy ◽

Patient Groups

The objectives of this study were to assess the immunogenicity and safety of COVID-19 vaccines in patients with haematological malignancy. A systematic review and meta-analysis of clinical studies of immune responses to COVID-19 vaccination stratified by underlying malignancy and published from 1 January 2021 to 31 August 2021 was conducted using MEDLINE, EMBASE and CENTRAL. Primary outcome was the rate of seropositivity following 2 doses of COVID-19 vaccine with rates of seropositivity following 1 dose, rates of positive neutralising antibody (nAb), cellular responses and adverse events as secondary outcomes. Rates were pooled from single arm studies while rates of seropositivity were compared against the rate in healthy controls for comparator studies using a random effects model and expressed as a pooled odds ratio with 95% confidence intervals. Forty-four studies (16 mixed group, 28 disease specific) with 7064 patients were included in the analysis (2331 following first dose, 4733 following second dose). Overall seropositivity rates were 61-67% following 2 doses and 37-51% following 1 dose of COVID-19 vaccine. The lowest seropositivity rate was 51% in CLL patients and was highest in patients with acute leukaemia (93%). Following 2 doses, nAb and cellular response rates were 57-60% and 40-75% respectively. Active treatment, ongoing or recent treatment with targeted and CD-20 monoclonal antibody therapies within 12 months was associated with poor COVID-19 vaccine immune responses. New approaches to prevention are urgently required to reduce COVID-19 infection morbidity and mortality in high-risk patient groups that respond poorly to COVID-19 vaccination.

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Faculty Opinions recommendation of The burden of Invasive Aspergillosis in patients with haematological malignancy: A meta-analysis and systematic review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.733175739.793562610 ◽

2019 ◽

Author(s):

Corrado Girmenia

Keyword(s):

Systematic Review ◽

Invasive Aspergillosis ◽

Haematological Malignancy ◽

Meta Analysis

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732 Delay to Elective Colorectal Cancer Surgery and its Potential Implications During the Covid-19 Pandemic: A Systematic Review and Metanalysis

British Journal of Surgery ◽

10.1093/bjs/znab259.817 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

T Whittaker ◽

M Abdelrazek ◽

A Fitzpatrick ◽

J Froud ◽

J Kelly ◽

...

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Elective Surgery ◽

Meta Analysis ◽

Disease Free Survival ◽

Colorectal Cancer Surgery ◽

Elective Resection ◽

Hazard Ratios ◽

Patient Groups ◽

Number Needed To Harm

Abstract Aim The ongoing Covid-19 pandemic has interrupted the surgical treatment of colorectal cancer (CRC). This systematic review will assess literature concerning the risk of delay of elective surgery for CRC patients, focusing on overall survival (OS) and disease-free survival (DFS). Method A systematic review was performed as per PRISMA guidelines (PROSPERO ID: CRD42020189158). Medline, EMBASE and Scopus were searched. Delay to elective surgery was defined as the period between CRC diagnosis and the day of surgery. Metanalyses of the outcome’s OS and DFS were conducted. Forest plots, funnel plots, and tests of heterogeneity were produced. An estimated Number Needed to Harm (NNH) was calculated for statistically significant pooled Hazard Ratios (HRs). Results Of 3753 articles identified, seven met the inclusion criteria. Encompassing 314560 patients, three of the seven studies showed that a delay to elective resection is associated with poorer OS or DFS. OS was assessed at a one-month delay, the HR for six datasets was 1.13 (95%CI 1.02-1.26, p = 0.020) and at three months the pooled HR for three datasets was 1.57 (95%CI 1.16-2.12, p = 0.004). Estimated NNHs for a delay at one month and three months were 35 and 10 respectively. Delay was non-significantly negatively associated with DFS on meta-analysis. Conclusions This review recommends that elective surgery for CRC patients is not postponed, as evidence suggests delays from diagnosis are associated with poorer outcomes. Focused research is essential so that patient groups can be prioritized based on risk factors for future pandemics.

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Medical end-of-life decisions: Does its use differ in vulnerable patient groups? A systematic review and meta-analysis

Social Science & Medicine ◽

10.1016/j.socscimed.2011.12.046 ◽

2012 ◽

Vol 74 (8) ◽

pp. 1282-1287 ◽

Cited By ~ 39

Author(s):

Judith A.C. Rietjens ◽

Reginald Deschepper ◽

Roeline Pasman ◽

Luc Deliens

Keyword(s):

Systematic Review ◽

End Of Life ◽

Meta Analysis ◽

End Of Life Decisions ◽

Vulnerable Patient ◽

Patient Groups ◽

Life Decisions

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Assessment of humoral and cell-mediated immune responses to pertussis vaccination: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2018-028109 ◽

2019 ◽

Vol 9 (6) ◽

pp. e028109 ◽

Cited By ~ 1

Author(s):

Funbi Akinola ◽

Rudzani Muloiwa ◽

Gregory, D Hussey ◽

Violette Dirix ◽

Benjamin Kagina ◽

...

Keyword(s):

Systematic Review ◽

Immune Response ◽

Immune Responses ◽

Public Space ◽

Systematic Reviews ◽

Data Extraction ◽

Meta Analysis ◽

Grey Literature ◽

Assessment Tools ◽

Population Type

IntroductionGlobally, some studies show a resurgence of pertussis. The risks and benefits of using whole-cell pertussis (wP) or acellular pertussis (aP) vaccines in the control of the disease have been widely debated. Better control of pertussis will require improved understanding of the immune response to pertussis vaccines. Improved understanding and assessment of the immunity induced by pertussis vaccines is thus imperative. Several studies have documented different immunological outcomes to pertussis vaccination from an array of assays. We propose to conduct a systematic review of the different immunological assays and outcomes used in the assessment of the humoraland cell-mediated immune response following pertussis vaccination.Methods and analysisThe primary outcomes for consideration are quality and quantity of immune responses (humoral and cell-mediated) post-pertussis vaccination. Of interest as secondary outcomes are types of immunoassays used in assessing immune responses post-pertussis vaccination, types of biological samples used in assessing immune responses post-pertussis vaccination, as well as the types of antigens used to stimulate these samples during post-pertussis vaccination immune response assessments. Different electronic databases (including PubMed, Cochrane, EBSCO Host, Scopus and Web of Science) will be accessed for peer-reviewed published and grey literature evaluating immune responses to pertussis vaccines between 1990 and 2019. The quality of included articles will be assessed using standardised risk and quality assessment tools specific to the study design used in each article. Data extraction will be done using a data extraction form. The extracted data will be analysed using STATA V.14.0 and RevMan V.5.3 software. A subgroup analysis will be conducted based on the study population, type of vaccine (wP or aP) and type of immune response (cell-mediated or humoral). Guidelines for reporting systematic reviews in the revised 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement will be used in this study.Ethics and disseminationEthics approval is not required for this study as it is a systematic review. We will only make use of data already available in the public space. Findings will be reported via publication in a peer-reviewed journal and presented at scientific meetings and workshops.Trial registration numberCRD42018102455.

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