在加泰罗尼亚进行的一项前瞻性人群研究中，接种 COVID-19 疫苗后的精神疾病和抗体反应。

IF 4.5 3区医学 Q2 IMMUNOLOGY

Vaccine Pub Date : 2025-01-25 DOI:10.1016/j.vaccine.2024.126591

Marianna Karachaliou , Ana Espinosa , Xavier Farré , Natalia Blay , Gemma Castaño-Vinyals , Susana Iraola-Guzmán , Rocio Rubio , Marta Vidal , Alfons Jiménez , Marc Bañuls , Ruth Aguilar , Judith Garcia-Aymerich , Carlota Dobaño , Manolis Kogevinas , Gemma Moncunill , Rafael de Cid

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引用次数: 0

摘要

精神疾病作为影响COVID-19疫苗抗体反应的潜在因素一直被忽视。精神障碍和抗体反应之间的关联可能因具体疾病而异，取决于疾病的长期病程，并与精神药物治疗有关。方法：对西班牙加泰罗尼亚地区939名接种过COVID-19疫苗的成人进行10年以上精神疾病诊断（情绪情感障碍、焦虑障碍等）与精神药物处方的相关性分析。我们采用线性回归模型来评估特定精神疾病和精神药物与抗体水平之间的关系，校正人口统计学、合并症和生活方式因素。在基因型亚组（n = 247）中，我们评估了多基因风险评分（PRS）对精神疾病的影响，并进行了双样本孟德尔随机化（MR）分析，以检验精神疾病与抗体反应之间的因果关系。结果：情绪情感性障碍与受体结合域IgG （RBD）降低相关[百分比变化= -26.37 (95% CI, -42.00, -6.54)]。焦虑障碍的诊断与结果无关。其他诊断组（主要包括失眠和尼古丁依赖）与IgG RBD水平降低相关[百分比变化：-21.53 (95% CI, -35.38, -4.71)]，近期发病（≤5年前）患者抗体水平下降更大。在过去6个月内服用第二代抗精神病药物和多种精神药物的参与者显示出较低的抗体水平。在基因型人群中，较高的精神分裂症遗传倾向性（较高的PRS）与较低的IgG RBD水平相关[百分比变化= -35.49 (95% CI, -56.55, -4.23)]。MR分析揭示了重性抑郁症遗传工具变量与较低的IgG RBD和S水平之间的因果关系。结论：这些发现引起了人们对COVID-19疫苗以及其他疫苗在情绪情感障碍、当前/近期失眠和尼古丁依赖以及多种精神药物患者中的有效性的担忧。这些关联是否转化为突破性感染和免疫介导的SARS-CoV-2感染长期后遗症的风险增加，值得进一步调查。

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Mental illness and antibody responses after COVID-19 vaccination in a prospective population-based study in Catalonia

Background

Mental illnesses have been overlooked as a potential factor influencing antibody responses to COVID-19 vaccine. Associations between mental disorders and antibody response might vary by specific disorders, depend on the long-term course of the illness and relate to psychotropic treatment.

Methods

The association between mental illness diagnoses (mood affective disorders, anxiety disorders, other) over ten years and psychotropic drug prescription based on electronic health records with antibody levels (IgG and IgA) post COVID-19 vaccination was assessed in 939 vaccinated adults from Catalonia, Spain. We employed linear regression models to assess associations between specific mental illnesses and psychotropic drugs with antibody levels, correcting for demographics, comorbidities and lifestyle factors. In a genotyped subset (n = 247) we assessed the effect of polygenic risk scores (PRS) for mental illnesses and performed a two-sample mendelian randomization (MR) analysis to examine causality between mental illness and antibody responses.

Results

Mood affective disorders were associated with lower IgG to receptor binding domain (RBD) [percentage change = −26.37 (95 % CI, −42.00, −6.54)]. Diagnosis of anxiety disorders was not associated with the outcome. The group of other diagnoses (mainly including insomnia and nicotine dependence) were associated with lower IgG RBD levels [percentage change: -21.53 (95 % CI, −35.38, −4.71)] and recent onset cases (≤5 years ago) showed greater decline in antibody levels. Participants on second-generation antipsychotics and multiple classes of psychotropic drugs in the last 6 months exhibited lower antibody levels. In the genotyped population, higher genetic liability (higher PRS) to schizophrenia was associated with lower IgG RBD levels [percentage change = −35.49 (95 % CI, −56.55, −4.23)]. MR analysis revealed a causal relationship between major depression genetic instrumental variables and lower IgG RBD and S levels.

Conclusions

These findings raise concerns about the efficacy of COVID-19 vaccines and potentially of other vaccines as well, in individuals with mood affective disorders, current/recent insomnia and nicotine dependence and people on multiple psychotropic drugs. Whether these associations are translated into increased risk for breakthrough infections and immune mediated long-term sequels of the SARS-CoV-2 infection warrants further investigation

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来源期刊

Vaccine 医学-免疫学

CiteScore

8.70

自引率

5.50%

发文量

992

审稿时长

131 days

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