By Rajan Verma
As the world is witnessing one of the largest vaccination drives, there are concerns about how the Covid-19 vaccine work for patients with other critical issues.
University of Pittsburgh Medical Center, USA rolled out a study, it said: negative or positive test result does not change the suggestion for immunocompromised people. As part of this study, they drew out the blood of 489 immunocompromised patients, patients with autoimmune disorders, organ transplants, blood cancer, solid tumour cancer and HIV.
To compare, they took the blood of perfectly healthy workers from the health care sector, specifically those who got their vaccine in April or June.
- 37% people of the organ transplant patients produced antibodies.
- 98% of people from the healthy group were found to have developed antibodies after vaccination.
- 55% of blood cancer patients had antibodies.
- 82% of solid tumor cancer patients were found to have antibodies.
- 84% of those with autoimmune disorders had antibodies.
People who underwent organ transplants are put on immunosuppressants which is why they are less likely to develop antibodies.
In the initial rounds of vaccine trials, the immunocompromised people were not tested, which means there is very little information on vaccine effectiveness in such patients.
Vaccines work well when it comes to guarding people against dangerous diseases. But there is some demoralizing evidence that shows that people with weakened immune systems may not react to the vaccine similarly. In other words, they might not develop potent antibodies – in some unfortunate cases, any antibodies at all.
But some recently conducted studies show that patients with cancer develop enough antibodies against the virus, but patients with organ transplants did not show a desirable response to the vaccine. Patients with blood cancer had the same response to vaccines as organ transplant patients.
Patients who have been receiving therapies for their disease were found to have developed muted antibody responses. It is difficult to understand a layman, but even the doctors are not sure what this means for their protection against the infection.
The doctors stress washing hands, wearing masks, and maintaining social distance, especially for the immunocompromised people.
How effective are Covid-19 vaccines for people with organ transplants?
France started a study in March. It involves 30 hospitals. They are aiming to include 8650 immunocompromised patients and 1,850 people with uncompromised immune systems. The doctors will draw blood from these participants to measure the ratio of antibodies present in their bodies. The test will be performed in regular intervals, one month, six months, one year, and then two years.
This data will allow them to adapt their vaccine recommendations to the precise patient population.
For example, the health authorities could lessen the waiting period between two doses. If the period is smaller between the three doses for immunocompromised patients, they can be safer against the infection.
They are also preparing for alternate methods to protect the patients. If the vaccines do not work, they will vaccinate the patient’s family and their caregivers.
A number of French hospitals recently launched a 2-year study. Ten thousand people helped in understanding how cancer patients react to immunization for Covid-19. Based on which United States Centers for Disease Control and Prevention said that even the patients in an immunocompromised state could be given the vaccine. At the same, they also stressed how little data is available on safety aspects of it.
The organ transplant patients who are on medication have a weak immune system, which means even if they are vaccinated, they will not be 100% safe.
The organ transplant patients who are on medication have a weak immune system, which means even if they are vaccinated, they will not be 100% safe.
The immune system of these patients is compromised due to treatments and by the condition itself, which might make it difficult for their bodies to produce the antibodies vaccines are supposed to trigger.
New England Journal of Medicine published a French study – it observed 100 patients who had undergone transplants. The study found that the immune systems of these patients were not stronger even after two doses.
Owing to this study, French scientists recommended that such patients must be given three doses. The government recognized it and made it a rule.
Renin-angiotensin-aldosterone system (RAAS)
The Renin-angiotensin-aldosterone system (RAAS) is known to be a critical element in the remodelling of the tumour microenvironment. Another reason for pressing concern for the cancer patient with Covid-19.
It helps the cancer cells metastasizing and growing throughout the body. SARS-Cov2 unsettles RAAS making the situation even more complicated and dangerous.
Oncologists all over the world are accelerating research to understand the virus and find the right solution. We have already come a long way, but there is still a long road ahead of us.
Impact of Covid-19 infection on immunosuppressed patients
Scientists have found that Covid-19 does not affect all patients alike. Patients with organ transplants experience elevated symptoms of the infection than the general public.
People with cancer suffer the most in all immunosuppressed patients
Given that cancer patients are defenceless against severe symptoms of the Covid-19, they paused the cancer treatments. It is because the anti-cancer therapies make them more vulnerable. A study shows9% of lung cancer patients willingly delayed their therapy. 80% of which did not suggest their doctors and made their decision themselves.
Delaying the cancer treatment by a month has increased the mortality rate in the patient in the past. If the intervals last longer than 5-6 weeks, the results turn out to be more damaging.
Despite being around for two years, there is still uncertainty due to new strains incoming.
It is understandable that patients are anxious. But they must continue their treatment to keep their condition from getting worse.
Defenceless against the Covid-19
The immune system of patients is in a compromised state, which makes them more prone to SARS-CoV-2 infection. Studies show the intensity of the situation, based on research; scientists estimated that such patients have a death ratio of 3.56 due to the virus.
Age, aside from all the other reasons, also turned out to be a significant factor in higher death numbers. The mortality rate in younger patients is much lower when compared to in older cancer patients.
The threat of heart-related complications
Covid-19 has only grown stronger. It poses challenges researchers and doctors could not have predicted. The cardiovascular complication is one such threat in Covid-19 positive immunosuppressed patients.
Not just cancer but even its treatments have been closely associated with intensifying cardiovascular problems. And when it combines with Covid-19, the results can be mortifying. Cardiac injuries, arrhythmias, stroke, embolism are just a few afflictions that have been noticed in the Covid-19 patients.
Covid-19 has been a reason to amplify specific conditions in the patients.
Covid-19 has been a reason to amplify specific conditions in the patients. The requirements include vascular wall damage, hypercoagulation states, and blood stasis – gravely all of which develop chances of thrombosis.
All the available data suggests that the hyperinflammatory reaction to two of these complications combined inflicts dysfunction in the patient’s cardiovascular systems. However, it is not 100% yet clear why the virus worsens heart conditions in the patient.
Conclusion
The biggest takeaway remains that transplant patients must not assume that they are immune even after they get vaccinated. But despite that, we encourage them to get vaccinated. Their family members, and close friends, should prioritize vaccination to confer a certain level of protection for the patients against the virus.
Also Read: Availability of true generic drugs in India are scarce: Nandita Das, CDMU
(Rajan Verma is Medical Director, Lab operations at Oncquest Laboratories Ltd.)
(Disclaimer: The views expressed in the article above are those of the author’s and do not necessarily represent or reflect the views of Autofintechs.com. Unless otherwise noted, the author is writing in his/her personal capacity. They are not intended and should not be thought to represent official ideas, attitudes, or policies of any agency or institution.)
