Low antispike antibody levels correlate with poor outcomes in COVID‐19 breakthrough hospitalizations
Background While COVID‐19 immunization programs attempted to reach targeted rates, cases rose significantly since the emergence of the delta variant. This retrospective cohort study describes the correlation between antispike antibodies and outcomes of hospitalized, breakthrough cases during the del...
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| Veröffentlicht in: | Journal of internal medicine 2022-07, Vol.292 (1), p.127-135 |
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| creator | Sanghavi, Devang K. Bhakta, Shivang Wadei, Hani M. Bosch, Wendelyn Cowart, Jennifer B. Carter, Rickey E. Shah, Sadia Z. Pollock, Benjamin D. Neville, Matthew R. Oman, Sven P. Speicher, Leigh Siegel, Jason Scindia, Ameya D. Libertin, Claudia R. Kunze, Katie L. Johnson, Patrick W. Matson, Mark W. Franco, Pablo Moreno |
| description | Background
While COVID‐19 immunization programs attempted to reach targeted rates, cases rose significantly since the emergence of the delta variant. This retrospective cohort study describes the correlation between antispike antibodies and outcomes of hospitalized, breakthrough cases during the delta variant surge.
Methods
All patients with positive SARS‐CoV‐2 polymerase chain reaction hospitalized at Mayo Clinic Florida from 19 June 2021 to 11 November 2021 were considered for analysis. Cases were analyzed by vaccination status. Breakthrough cases were then analyzed by low and high antibody titers against SARS‐CoV‐2 spike protein, with a cut‐off value of ≥132 U/ml. Outcomes included hospital length of stay (LOS), need for intensive care unit (ICU), mechanical ventilation, and mortality. We used 1:1 nearest neighbor propensity score matching without replacement to assess for confounders.
Results
Among 627 hospitalized patients with COVID‐19, vaccine breakthrough cases were older with more comorbidities compared to unvaccinated. After propensity score matching, the unvaccinated patients had higher mortality (27 [28.4%] vs. 12 [12.6%], p = 0.002) and LOS (7 [1.0–57.0] vs. 5 [1.0–31.0] days, p = 0.011). In breakthrough cases, low‐titer patients were more likely to be solid organ transplant recipients (16 [34.0%] vs. 9 [12.3%], p = 0.006), with higher need for ICU care (24 [51.1%] vs. 22 [11.0%], p = 0.034), longer hospital LOS (median 6 vs. 5 days, p = 0.013), and higher mortality (10 [21.3%] vs. 5 [6.8%], p = 0.025) than high‐titer patients.
Conclusions
Hospitalized breakthrough cases were more likely to have underlying risk factors than unvaccinated patients. Low‐spike antibody titers may serve as an indicator for poor prognosis in breakthrough cases admitted to the hospital. |
| doi_str_mv | 10.1111/joim.13471 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9115098</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2632149871</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4481-246244260988b3e747e1172f796c67e2a14eb8eec85d8f20414c4b27e99f46483</originalsourceid><addsrcrecordid>eNp9kc9u1DAQhy0EokvhwgMgS1wqpBSP4zjOBQlt-bPVor0AV8vxThpvk3ixk66WE4_AM_IkuN22Ag74Mpbm0zcz-hHyHNgppPd6411_Crko4QGZQS6LjJeVfEhmrCpEJhVnR-RJjBvGIGeSPSZHeQGVUBJmpFn6HTXD6OLWXeLNr_brPe3wCrtIrQ8BOzMi3bmxpVvvA_XTaH2PkbqBzldfF2e_fvyEitYBzeXYBj9dtLT1yTeazn03o_NDfEoeNaaL-Oy2HpMv7999nn_MlqsPi_nbZWaFUJBxIbkQXLJKqTrHUpQIUPImnWNlidyAwFohWlWsVcOZAGFFzUusqkZIofJj8ubg3U51j2uLwxhMp7fB9SbstTdO_90ZXKsv_JWuAIo0NQlObgXBf5swjrp30WLXmQH9FDWXOQdRqRIS-vIfdOOnMKTzElXKomBM8US9OlA2-BgDNvfLANPX8enr-PRNfAl-8ef69-hdXgmAA7BzHe7_o9Lnq8Wng_Q3KpinDQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2676550082</pqid></control><display><type>article</type><title>Low antispike antibody levels correlate with poor outcomes in COVID‐19 breakthrough hospitalizations</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Online Library Free Content</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Sanghavi, Devang K. ; Bhakta, Shivang ; Wadei, Hani M. ; Bosch, Wendelyn ; Cowart, Jennifer B. ; Carter, Rickey E. ; Shah, Sadia Z. ; Pollock, Benjamin D. ; Neville, Matthew R. ; Oman, Sven P. ; Speicher, Leigh ; Siegel, Jason ; Scindia, Ameya D. ; Libertin, Claudia R. ; Kunze, Katie L. ; Johnson, Patrick W. ; Matson, Mark W. ; Franco, Pablo Moreno</creator><creatorcontrib>Sanghavi, Devang K. ; Bhakta, Shivang ; Wadei, Hani M. ; Bosch, Wendelyn ; Cowart, Jennifer B. ; Carter, Rickey E. ; Shah, Sadia Z. ; Pollock, Benjamin D. ; Neville, Matthew R. ; Oman, Sven P. ; Speicher, Leigh ; Siegel, Jason ; Scindia, Ameya D. ; Libertin, Claudia R. ; Kunze, Katie L. ; Johnson, Patrick W. ; Matson, Mark W. ; Franco, Pablo Moreno</creatorcontrib><description>Background
While COVID‐19 immunization programs attempted to reach targeted rates, cases rose significantly since the emergence of the delta variant. This retrospective cohort study describes the correlation between antispike antibodies and outcomes of hospitalized, breakthrough cases during the delta variant surge.
Methods
All patients with positive SARS‐CoV‐2 polymerase chain reaction hospitalized at Mayo Clinic Florida from 19 June 2021 to 11 November 2021 were considered for analysis. Cases were analyzed by vaccination status. Breakthrough cases were then analyzed by low and high antibody titers against SARS‐CoV‐2 spike protein, with a cut‐off value of ≥132 U/ml. Outcomes included hospital length of stay (LOS), need for intensive care unit (ICU), mechanical ventilation, and mortality. We used 1:1 nearest neighbor propensity score matching without replacement to assess for confounders.
Results
Among 627 hospitalized patients with COVID‐19, vaccine breakthrough cases were older with more comorbidities compared to unvaccinated. After propensity score matching, the unvaccinated patients had higher mortality (27 [28.4%] vs. 12 [12.6%], p = 0.002) and LOS (7 [1.0–57.0] vs. 5 [1.0–31.0] days, p = 0.011). In breakthrough cases, low‐titer patients were more likely to be solid organ transplant recipients (16 [34.0%] vs. 9 [12.3%], p = 0.006), with higher need for ICU care (24 [51.1%] vs. 22 [11.0%], p = 0.034), longer hospital LOS (median 6 vs. 5 days, p = 0.013), and higher mortality (10 [21.3%] vs. 5 [6.8%], p = 0.025) than high‐titer patients.
Conclusions
Hospitalized breakthrough cases were more likely to have underlying risk factors than unvaccinated patients. Low‐spike antibody titers may serve as an indicator for poor prognosis in breakthrough cases admitted to the hospital.</description><identifier>ISSN: 0954-6820</identifier><identifier>ISSN: 1365-2796</identifier><identifier>EISSN: 1365-2796</identifier><identifier>DOI: 10.1111/joim.13471</identifier><identifier>PMID: 35194861</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Antibodies ; Antibodies, Viral - blood ; antispike antibodies ; COVID-19 ; COVID-19 - diagnosis ; COVID-19 - immunology ; COVID-19 Vaccines ; delta ; Hospitalization ; Humans ; Immunization ; Matching ; Mechanical ventilation ; Mortality ; Original ; Patients ; Polymerase chain reaction ; Retrospective Studies ; Risk analysis ; Risk factors ; SARS-CoV-2 ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; Spike Glycoprotein, Coronavirus - immunology ; Spike protein ; Vaccination ; vaccine breakthrough ; Vaccines</subject><ispartof>Journal of internal medicine, 2022-07, Vol.292 (1), p.127-135</ispartof><rights>2022 The Association for the Publication of the Journal of Internal Medicine.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4481-246244260988b3e747e1172f796c67e2a14eb8eec85d8f20414c4b27e99f46483</citedby><cites>FETCH-LOGICAL-c4481-246244260988b3e747e1172f796c67e2a14eb8eec85d8f20414c4b27e99f46483</cites><orcidid>0000-0001-5757-7108</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjoim.13471$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjoim.13471$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35194861$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sanghavi, Devang K.</creatorcontrib><creatorcontrib>Bhakta, Shivang</creatorcontrib><creatorcontrib>Wadei, Hani M.</creatorcontrib><creatorcontrib>Bosch, Wendelyn</creatorcontrib><creatorcontrib>Cowart, Jennifer B.</creatorcontrib><creatorcontrib>Carter, Rickey E.</creatorcontrib><creatorcontrib>Shah, Sadia Z.</creatorcontrib><creatorcontrib>Pollock, Benjamin D.</creatorcontrib><creatorcontrib>Neville, Matthew R.</creatorcontrib><creatorcontrib>Oman, Sven P.</creatorcontrib><creatorcontrib>Speicher, Leigh</creatorcontrib><creatorcontrib>Siegel, Jason</creatorcontrib><creatorcontrib>Scindia, Ameya D.</creatorcontrib><creatorcontrib>Libertin, Claudia R.</creatorcontrib><creatorcontrib>Kunze, Katie L.</creatorcontrib><creatorcontrib>Johnson, Patrick W.</creatorcontrib><creatorcontrib>Matson, Mark W.</creatorcontrib><creatorcontrib>Franco, Pablo Moreno</creatorcontrib><title>Low antispike antibody levels correlate with poor outcomes in COVID‐19 breakthrough hospitalizations</title><title>Journal of internal medicine</title><addtitle>J Intern Med</addtitle><description>Background
While COVID‐19 immunization programs attempted to reach targeted rates, cases rose significantly since the emergence of the delta variant. This retrospective cohort study describes the correlation between antispike antibodies and outcomes of hospitalized, breakthrough cases during the delta variant surge.
Methods
All patients with positive SARS‐CoV‐2 polymerase chain reaction hospitalized at Mayo Clinic Florida from 19 June 2021 to 11 November 2021 were considered for analysis. Cases were analyzed by vaccination status. Breakthrough cases were then analyzed by low and high antibody titers against SARS‐CoV‐2 spike protein, with a cut‐off value of ≥132 U/ml. Outcomes included hospital length of stay (LOS), need for intensive care unit (ICU), mechanical ventilation, and mortality. We used 1:1 nearest neighbor propensity score matching without replacement to assess for confounders.
Results
Among 627 hospitalized patients with COVID‐19, vaccine breakthrough cases were older with more comorbidities compared to unvaccinated. After propensity score matching, the unvaccinated patients had higher mortality (27 [28.4%] vs. 12 [12.6%], p = 0.002) and LOS (7 [1.0–57.0] vs. 5 [1.0–31.0] days, p = 0.011). In breakthrough cases, low‐titer patients were more likely to be solid organ transplant recipients (16 [34.0%] vs. 9 [12.3%], p = 0.006), with higher need for ICU care (24 [51.1%] vs. 22 [11.0%], p = 0.034), longer hospital LOS (median 6 vs. 5 days, p = 0.013), and higher mortality (10 [21.3%] vs. 5 [6.8%], p = 0.025) than high‐titer patients.
Conclusions
Hospitalized breakthrough cases were more likely to have underlying risk factors than unvaccinated patients. Low‐spike antibody titers may serve as an indicator for poor prognosis in breakthrough cases admitted to the hospital.</description><subject>Antibodies</subject><subject>Antibodies, Viral - blood</subject><subject>antispike antibodies</subject><subject>COVID-19</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - immunology</subject><subject>COVID-19 Vaccines</subject><subject>delta</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Immunization</subject><subject>Matching</subject><subject>Mechanical ventilation</subject><subject>Mortality</subject><subject>Original</subject><subject>Patients</subject><subject>Polymerase chain reaction</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>SARS-CoV-2</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Spike Glycoprotein, Coronavirus - immunology</subject><subject>Spike protein</subject><subject>Vaccination</subject><subject>vaccine breakthrough</subject><subject>Vaccines</subject><issn>0954-6820</issn><issn>1365-2796</issn><issn>1365-2796</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9u1DAQhy0EokvhwgMgS1wqpBSP4zjOBQlt-bPVor0AV8vxThpvk3ixk66WE4_AM_IkuN22Ag74Mpbm0zcz-hHyHNgppPd6411_Crko4QGZQS6LjJeVfEhmrCpEJhVnR-RJjBvGIGeSPSZHeQGVUBJmpFn6HTXD6OLWXeLNr_brPe3wCrtIrQ8BOzMi3bmxpVvvA_XTaH2PkbqBzldfF2e_fvyEitYBzeXYBj9dtLT1yTeazn03o_NDfEoeNaaL-Oy2HpMv7999nn_MlqsPi_nbZWaFUJBxIbkQXLJKqTrHUpQIUPImnWNlidyAwFohWlWsVcOZAGFFzUusqkZIofJj8ubg3U51j2uLwxhMp7fB9SbstTdO_90ZXKsv_JWuAIo0NQlObgXBf5swjrp30WLXmQH9FDWXOQdRqRIS-vIfdOOnMKTzElXKomBM8US9OlA2-BgDNvfLANPX8enr-PRNfAl-8ef69-hdXgmAA7BzHe7_o9Lnq8Wng_Q3KpinDQ</recordid><startdate>202207</startdate><enddate>202207</enddate><creator>Sanghavi, Devang K.</creator><creator>Bhakta, Shivang</creator><creator>Wadei, Hani M.</creator><creator>Bosch, Wendelyn</creator><creator>Cowart, Jennifer B.</creator><creator>Carter, Rickey E.</creator><creator>Shah, Sadia Z.</creator><creator>Pollock, Benjamin D.</creator><creator>Neville, Matthew R.</creator><creator>Oman, Sven P.</creator><creator>Speicher, Leigh</creator><creator>Siegel, Jason</creator><creator>Scindia, Ameya D.</creator><creator>Libertin, Claudia R.</creator><creator>Kunze, Katie L.</creator><creator>Johnson, Patrick W.</creator><creator>Matson, Mark W.</creator><creator>Franco, Pablo Moreno</creator><general>Blackwell Publishing Ltd</general><general>John Wiley and Sons Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-5757-7108</orcidid></search><sort><creationdate>202207</creationdate><title>Low antispike antibody levels correlate with poor outcomes in COVID‐19 breakthrough hospitalizations</title><author>Sanghavi, Devang K. ; Bhakta, Shivang ; Wadei, Hani M. ; Bosch, Wendelyn ; Cowart, Jennifer B. ; Carter, Rickey E. ; Shah, Sadia Z. ; Pollock, Benjamin D. ; Neville, Matthew R. ; Oman, Sven P. ; Speicher, Leigh ; Siegel, Jason ; Scindia, Ameya D. ; Libertin, Claudia R. ; Kunze, Katie L. ; Johnson, Patrick W. ; Matson, Mark W. ; Franco, Pablo Moreno</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4481-246244260988b3e747e1172f796c67e2a14eb8eec85d8f20414c4b27e99f46483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antibodies</topic><topic>Antibodies, Viral - blood</topic><topic>antispike antibodies</topic><topic>COVID-19</topic><topic>COVID-19 - diagnosis</topic><topic>COVID-19 - immunology</topic><topic>COVID-19 Vaccines</topic><topic>delta</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Immunization</topic><topic>Matching</topic><topic>Mechanical ventilation</topic><topic>Mortality</topic><topic>Original</topic><topic>Patients</topic><topic>Polymerase chain reaction</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>SARS-CoV-2</topic><topic>Severe acute respiratory syndrome</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Spike Glycoprotein, Coronavirus - immunology</topic><topic>Spike protein</topic><topic>Vaccination</topic><topic>vaccine breakthrough</topic><topic>Vaccines</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sanghavi, Devang K.</creatorcontrib><creatorcontrib>Bhakta, Shivang</creatorcontrib><creatorcontrib>Wadei, Hani M.</creatorcontrib><creatorcontrib>Bosch, Wendelyn</creatorcontrib><creatorcontrib>Cowart, Jennifer B.</creatorcontrib><creatorcontrib>Carter, Rickey E.</creatorcontrib><creatorcontrib>Shah, Sadia Z.</creatorcontrib><creatorcontrib>Pollock, Benjamin D.</creatorcontrib><creatorcontrib>Neville, Matthew R.</creatorcontrib><creatorcontrib>Oman, Sven P.</creatorcontrib><creatorcontrib>Speicher, Leigh</creatorcontrib><creatorcontrib>Siegel, Jason</creatorcontrib><creatorcontrib>Scindia, Ameya D.</creatorcontrib><creatorcontrib>Libertin, Claudia R.</creatorcontrib><creatorcontrib>Kunze, Katie L.</creatorcontrib><creatorcontrib>Johnson, Patrick W.</creatorcontrib><creatorcontrib>Matson, Mark W.</creatorcontrib><creatorcontrib>Franco, Pablo Moreno</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of internal medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sanghavi, Devang K.</au><au>Bhakta, Shivang</au><au>Wadei, Hani M.</au><au>Bosch, Wendelyn</au><au>Cowart, Jennifer B.</au><au>Carter, Rickey E.</au><au>Shah, Sadia Z.</au><au>Pollock, Benjamin D.</au><au>Neville, Matthew R.</au><au>Oman, Sven P.</au><au>Speicher, Leigh</au><au>Siegel, Jason</au><au>Scindia, Ameya D.</au><au>Libertin, Claudia R.</au><au>Kunze, Katie L.</au><au>Johnson, Patrick W.</au><au>Matson, Mark W.</au><au>Franco, Pablo Moreno</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low antispike antibody levels correlate with poor outcomes in COVID‐19 breakthrough hospitalizations</atitle><jtitle>Journal of internal medicine</jtitle><addtitle>J Intern Med</addtitle><date>2022-07</date><risdate>2022</risdate><volume>292</volume><issue>1</issue><spage>127</spage><epage>135</epage><pages>127-135</pages><issn>0954-6820</issn><issn>1365-2796</issn><eissn>1365-2796</eissn><abstract>Background
While COVID‐19 immunization programs attempted to reach targeted rates, cases rose significantly since the emergence of the delta variant. This retrospective cohort study describes the correlation between antispike antibodies and outcomes of hospitalized, breakthrough cases during the delta variant surge.
Methods
All patients with positive SARS‐CoV‐2 polymerase chain reaction hospitalized at Mayo Clinic Florida from 19 June 2021 to 11 November 2021 were considered for analysis. Cases were analyzed by vaccination status. Breakthrough cases were then analyzed by low and high antibody titers against SARS‐CoV‐2 spike protein, with a cut‐off value of ≥132 U/ml. Outcomes included hospital length of stay (LOS), need for intensive care unit (ICU), mechanical ventilation, and mortality. We used 1:1 nearest neighbor propensity score matching without replacement to assess for confounders.
Results
Among 627 hospitalized patients with COVID‐19, vaccine breakthrough cases were older with more comorbidities compared to unvaccinated. After propensity score matching, the unvaccinated patients had higher mortality (27 [28.4%] vs. 12 [12.6%], p = 0.002) and LOS (7 [1.0–57.0] vs. 5 [1.0–31.0] days, p = 0.011). In breakthrough cases, low‐titer patients were more likely to be solid organ transplant recipients (16 [34.0%] vs. 9 [12.3%], p = 0.006), with higher need for ICU care (24 [51.1%] vs. 22 [11.0%], p = 0.034), longer hospital LOS (median 6 vs. 5 days, p = 0.013), and higher mortality (10 [21.3%] vs. 5 [6.8%], p = 0.025) than high‐titer patients.
Conclusions
Hospitalized breakthrough cases were more likely to have underlying risk factors than unvaccinated patients. Low‐spike antibody titers may serve as an indicator for poor prognosis in breakthrough cases admitted to the hospital.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>35194861</pmid><doi>10.1111/joim.13471</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5757-7108</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Antibodies Antibodies, Viral - blood antispike antibodies COVID-19 COVID-19 - diagnosis COVID-19 - immunology COVID-19 Vaccines delta Hospitalization Humans Immunization Matching Mechanical ventilation Mortality Original Patients Polymerase chain reaction Retrospective Studies Risk analysis Risk factors SARS-CoV-2 Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Spike Glycoprotein, Coronavirus - immunology Spike protein Vaccination vaccine breakthrough Vaccines |
| title | Low antispike antibody levels correlate with poor outcomes in COVID‐19 breakthrough hospitalizations |
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