scispace - formally typeset
Search or ask a question
Author

Teresa Po Yu Chiang

Bio: Teresa Po Yu Chiang is an academic researcher from Johns Hopkins University. The author has contributed to research in topics: Medicine & Vaccination. The author has an hindex of 2, co-authored 2 publications receiving 5 citations.

Papers
More filters
Journal ArticleDOI
TL;DR: In this article, the anti-spike antibody response to SARS-CoV-2 vaccination in patients with rheumatic and musculoskeletal diseases (RMD) was compared to recipients of the mRNA series.
Abstract: In immunocompetent populations, the Janssen/Johnson & Johnson (J&J) SARS-CoV-2 vaccine induces antibody, CD4+ and CD8+ T cell responses and offers protection against severe and symptomatic SARS-CoV-2 infection.1 2 This vaccine is an adenovirus serotype 26 (Ad26) vector expressing a stabilised SARS-CoV-2 spike (S) (Ad26.COV2.S), a platform without prior approval for use in the general population, or for patients with rheumatic and musculoskeletal diseases (RMD).3 Patients on immunosuppressive therapy were excluded from the clinical trials1 2 and early data have suggested that the J&J vaccine results in lower humoral immunity than mRNA vaccination in immunosuppressed transplant patients.4 Given the attenuated immunogenicity to mRNA-based SARS-CoV-2 vaccines in certain patients with RMD,5 we studied the anti-spike antibody response to J&J SARS-CoV-2 vaccination in patients with RMD and compared them to recipients of the mRNA series. We used our prospective cohort of patients with RMD who underwent SARS-CoV-2 vaccination between December 2020 and May 2021.5 We collected information on demographics, rheumatic diagnoses and immunosuppressive medications. One month following completion of vaccine series (J&J or mRNA), serologic testing on the semi-quantitative Roche Elecsys anti-SARS-CoV-2 S enzyme immunoassay, which tests for antibodies against the receptor binding domain (RBD) of the SARS-CoV-2 S protein, was completed. We compared the percentage of participants with detectable anti-RBD antibody in the J&J group (n=45) to the mRNA group (n=994) using Fisher’s exact test (online supplemental table 1). We compared the two …

22 citations

Journal ArticleDOI
TL;DR: In this article, the authors aimed to capture immunosuppression practices globally following the early months of the COVID-19 pandemic, and surveyed 1267 physicians; 40.5% from 71 countries participated.
Abstract: During the COVID-19 pandemic, there has been wide heterogeneity in the medical management of transplant recipients. We aimed to pragmatically capture immunosuppression practices globally following the early months of the pandemic. From June to September 2020, we surveyed 1267 physicians; 40.5% from 71 countries participated. Management decisions were made on a case-by-case basis by the majority (69.6%) of the programs. Overall, 76.8% performed ≥1 transplantation and many commented on avoiding high-risk transplantations. For induction, 26.5% were less likely to give T-cell depletion and 14.8% were more likely to give non-depleting agents. These practices varied by program-level factors more so than the COVID-19 burden. In patients with mild, moderate and severe COVID-19 symptoms 59.7%, 76.0%, and 79.5% decreased/stopped anti-metabolites, 23.2%, 45.4%, and 68.2% decreased/stopped calcineurin inhibitors, and 25.7%, 43.9%, and 57.7% decreased/stopped mTOR inhibitors, respectively. Also, 2.1%, 30.6%, and 46.0% increased steroids in patients with mild, moderate, and severe COVID-19 symptoms. For prevalent transplant recipients, some programs also reported decreasing/stopping steroids (1.8%), anti-metabolites (10.3%), calcineurin inhibitors (4.1%), and mTOR inhibitors (5.5%). Transplant programs changed immunosuppression practices but also avoided high-risk transplants and increased maintenance steroids. The long-term ramifications of these practices remain to be seen as programs face the aftermath of the pandemic.

11 citations

Journal ArticleDOI
TL;DR: In this article , the authors administered third monovalent mRNA vaccines to 81 kidney transplant recipients (KTRs) with negative or low-titer anti-receptor binding domain (RBD) antibody (n = 39 anti-RBDNEG; n = 42 anti RBDLO), compared with healthy controls (HCs, n = 19), measuring antiRBD, Omicron neutralization, spike-specific CD8+%, and SARS-CoV-2-reactive T cell receptor (TCR) repertoires.

2 citations

Journal ArticleDOI
TL;DR: In this article , the authors proposed a method to solve the problem of unstructured data in order to improve the quality of the data collected by the data collection system, including:
Abstract: Supplemental Digital Content is Available in the Text.

1 citations


Cited by
More filters
Journal ArticleDOI
TL;DR: In this paper, the authors conducted a systematic review of literature to assess immunogenicity, efficacy and effectiveness of COVID-19 vaccines in immunocompromised populations, including solid organ transplant recipients and patients with haematological malignancy.

78 citations

Journal ArticleDOI
TL;DR: In this article , the authors conducted a systematic review of literature to assess immunogenicity, efficacy and effectiveness of COVID-19 vaccines in immunocompromised populations, including solid organ transplant recipients and patients with haematological malignancy.

78 citations

Journal ArticleDOI
TL;DR: In this paper, a literature search of PubMed and Google scholar databases was conducted to identify articles with terms “SARS-CoV2,” „COVID-19,“, „donor recovered,’ and “transplantation” published through 08/10/2021.
Abstract: As the prevalence of individuals with recovered coronavirus disease 2019 (COVID-19) increases, determining if and when organs from these donors can be safely used is an important priority. We examined current knowledge of outcomes of transplant using donors with recovered COVID-19. A literature search of PubMed and Google scholar databases was conducted to identify articles with terms “SARS-CoV2,” “COVID-19,” “donor recovered,” and “transplantation” published through 08/10/2021. We identified 25 reports detailing 94 recipients of both abdominal and thoracic transplants from donors with both prior and active COVID-19 infection. Rates of transmission to the recipient and of transplanted organ dysfunction were low among reports of donors with prior COVID-19 infection. End organ dysfunction and transmission were more common with active infection, although few reports are available. Standardized reporting is needed to better assess the impact of donor symptomatology, cycle thresholds, and individual recipient risk factors on postoperative outcomes. Available reports suggest that transplantation from COVID-19 donors may be feasible and safe, at least in short term follow-up. Nevertheless, there is a need for standardized testing and management protocols which should be tailored for available resources. While increased availability of COVID-19 vaccinations will mitigate risks of donor-derived COVID-19 and simplify management, continued vigilance is warranted during the ongoing public health emergency.

32 citations

Journal ArticleDOI
01 Apr 2022-RMD Open
TL;DR: While COVID-19 vaccination prevents severe infections, poor immunogenicity in immunocompromised people threatens vaccine effectiveness and further risk mitigation strategies are likely needed to protect this selected high-risk population.
Abstract: Objective While COVID-19 vaccination prevents severe infections, poor immunogenicity in immunocompromised people threatens vaccine effectiveness. We analysed the clinical characteristics of patients with rheumatic disease who developed breakthrough COVID-19 after vaccination against SARS-CoV-2. Methods We included people partially or fully vaccinated against SARS-CoV-2 who developed COVID-19 between 5 January and 30 September 2021 and were reported to the Global Rheumatology Alliance registry. Breakthrough infections were defined as occurring ≥14 days after completion of the vaccination series, specifically 14 days after the second dose in a two-dose series or 14 days after a single-dose vaccine. We analysed patients’ demographic and clinical characteristics and COVID-19 symptoms and outcomes. Results SARS-CoV-2 infection was reported in 197 partially or fully vaccinated people with rheumatic disease (mean age 54 years, 77% female, 56% white). The majority (n=140/197, 71%) received messenger RNA vaccines. Among the fully vaccinated (n=87), infection occurred a mean of 112 (±60) days after the second vaccine dose. Among those fully vaccinated and hospitalised (n=22, age range 36–83 years), nine had used B cell-depleting therapy (BCDT), with six as monotherapy, at the time of vaccination. Three were on mycophenolate. The majority (n=14/22, 64%) were not taking systemic glucocorticoids. Eight patients had pre-existing lung disease and five patients died. Conclusion More than half of fully vaccinated individuals with breakthrough infections requiring hospitalisation were on BCDT or mycophenolate. Further risk mitigation strategies are likely needed to protect this selected high-risk population.

29 citations

Journal ArticleDOI
TL;DR: In this article, the authors assessed the humoral response to mRNA vaccines after the first and the second dose of the vaccine in terms of seroconversion rate and titre in patients with rheumatoid arthritis and seronegative spondyloarthritis.
Abstract: Objectives To assess the kinetics of humoral response after the first and second dose of messenger RNA (mRNA) vaccines in patients with inflammatory joint diseases compared with healthy controls (HC). To analyse factors influencing the quantity of the immune response. Methods We enrolled patients with rheumatoid arthritis (RA) and seronegative spondyloarthritis (SpA), excluding those receiving B-cell depleting therapies and assessed the humoral response to mRNA vaccines after the first and the second dose of the vaccine in terms of seroconversion rate and titre. We compared the results to a HC group and analysed the influence of therapies as well as other characteristics on the humoral response. Results Samples from 53 patients with RA, 46 patients with SpA and 169 healthy participants were analysed. Seroconversion rates after the first immunisation were only 54% in patients with inflammatory arthritis compared with 98% in the HC group. However, seroconversion rates were 100% in all groups after second immunisation. Patients developed reduced antibody titres after the first vaccination compared with HC, but there was no difference after the second dose. While disease modifying anti-rheumatic drug (DMARD) monotherapy did not affect antibody levels, seroconversion rates as well as titre levels were reduced in patients receiving a combination of DMARDs compared with HC. Conclusions Patients with inflammatory joint diseases under DMARD therapy show impaired humoral responses to the first vaccine dose but excellent final responses to vaccination with mRNA vaccines. Therefore, the full course of two immunisations is necessary for efficient vaccination responses in patients with inflammatory arthritis under DMARD therapy.

16 citations