CME INDIA Presentation by Admin.

Original Indian Study (Peer reviewed – Published online on 5th February 2022)

It gives a very illuminating learning that despite a higher antibody titre with Covishield, decline was significant at 6-months vs. no decline with Covaxin. It is worth to note that T2DM cohorts had lowest seropositivity, while hypertensive had significant antibody decline at 6-months.

The Study Title

“Humoral Antibody Kinetics with ChAdOx1-nCOV (CovishieldTM) and BBV-152 (CovaxinTM) Vaccine among Indian Healthcare workers: A 6-month Longitudinal Cross-sectional Coronavirus Vaccine-induced Antibody Titre (COVAT) Study.”

COVAT Study Unique Findings: Covishield vs Covaxin - Both Doing Great to Protect Mankind

What is this Study?

  • The 6-month longitudinal study of humoral Ab kinetics following 2 doses of Covishield and Covaxin

Principal Investigators

COVAT Study Unique Findings: Covishield vs Covaxin - Both Doing Great to Protect Mankind
  • Dr. Awadhesh Kumar Singh, MD, DM (Kolkata);
  • Dr. Sanjeev Ratnakar Phatak, MD (Ahmedabad);
  • Dr. Nagendra Kumar Singh (N. K. Singh), Dhanbad;
  • Dr. Arvind Gupta, MD, (Jaipur);
  • Dr. Arvind Sharma, MD (Jaipur);
  • Dr. Kingshuk Bhattacharjee, PhD (Kolkata);
  • Dr. Ritu Singh, MD (Kolkata);
COVAT Study Unique Findings: Covishield vs Covaxin - Both Doing Great to Protect Mankind

PAN INDIA Study (22 cities)

COVAT Study Unique Findings: Covishield vs Covaxin - Both Doing Great to Protect Mankind

Drs. – Akash Kumar Singh (Vadodara), Amit Gupta (Noida), Anuj Maheshwari (Lucknow), Arvind Kumar Ojha (Kolkata), Bhavtharini (Erode), B. Harish Kumar (Mysore), J K Sharma (New Delhi), Jayant Panda (Cuttack), Kavya Chand Yalamudi (Guntur), Kiran Shah (Vadodara), M Gowri Sankar (Coimbatore), Manohar KN (Bangalore), Meena Chhabra (New Delhi), Pratap Jethwani (Rajkot), M Shunmugavelu (Trichy), Rajiv Kovil (Mumbai), Sunil Gupta (Nagpur), Subhash Kumar (Patna), Somnath (Hyderabad) and Urman Dhruv (Ahmedabad) are involved in this study as regional co-ordinators.

Authors are thankful to:  Ms. Roma Dave (Dietician) and Dr. Priya Phatak (Ahmedabad), Dr. Bhavini Shah, Dr. Sandip Shah, and Dr. Krutarth Shah from Neuberg Supratech Laboratory, Ahmedabad.

What was done in the study?

  • The first part (short-term) of this study has been published in Vaccine journal.
  • Pan Indian researchers conducted a 6-month longitudinal study in vaccinated healthcare workers by serially measuring quantitative anti-spike antibody at 3-weeks, 3-months and 6- months after the completion of second dose.
  • Geometric mean titre (GMT) and linear mixed models were used to assess the dynamics of antibody levels at 6 months.
  • Authors now report the results from our 6-month longitudinal study that assessed the humoral antibody response after two doses of two vaccines administered in India.
  • This cross-sectional Pan-India study has analysed humoral antibody dynamics in three groups of participants simultaneously which include:
  • People who had past history of Covid-19 before the first dose of vaccine,
  • People who developed breakthrough infection ≥2-weeks after the second dose and,
  • People who remained infection naïve for entire 6-month after the completion of second dose.
  • The study has also analysed the humoral response between Covishield and Covaxin over 6-month.
  • The study was done on 481 health care workers.
  • These HCWs showed a significant decrease in the anti-spike antibody at 6-months.
  • Reduction in antibody was regardless of demographics, comorbidities and the vaccine type.
  • T2DM cohorts had lowest seropositivity, while hypertensive had significant antibody decline at 6-month.

Quick Take-away

Of the 481 participants, all 360 infection-naive people showed a significant decrease in anti-spike antibody at 6-months.
Reduction in antibody was regardless of demographics, comorbidities and the vaccine type, in a 6-month linear mixed model.
Despite a higher antibody titre with Covishield, decline was significant at 6-month vs. no decline with Covaxin.
T2DM cohorts had lowest seropositivity, while hypertensive had significant antibody decline at 6-months.
Recipients of Covishield had higher anti-spike antibody titers than recipients of Covaxin, however significant decline in antibody titers was seen with Covishield and not Covaxin.
Individuals with past or breakthrough COVID infection had the highest antibody titers which showed minimum decline at 6 months.

Few notable findings:

  • Waning of antibody titre over time regardless of age, sex, BMI, comorbidities and type of vaccine but it was significantly low in hypertensives.
  • Past h/o COVID-19 had significantly higher titre at all time points compared to naive individuals after 2 doses.

COVAT Study Unique Findings: Covishield vs Covaxin - Both Doing Great to Protect Mankind
  • Second dose of Vaccine did only a little increase in titre vs. 1st.
  • Covishield arm had significant higher Ab titre at all time points vs. Covaxin after 2-doses.
  • 44% decline in titre at 6-mth compared to peak with Covishield vs. minimal/no reduction (8%) in Covaxin.
COVAT Study Unique Findings: Covishield vs Covaxin - Both Doing Great to Protect Mankind
  • 5.6-fold reduction in sero+ to anti-spike Ab at 6-month in naive cohorts regardless of the vaccine received.
  • Sero+ was significant higher with Covaxin vs. Covishield at 6-mth in SARS-CoV-2 naive, though no significant difference noted in propensity-matched cohorts.
  • No difference in breakthrough infection rate was noted between Covishield and Covaxin recipients at 6-month.

CME INDIA Learning Points

(By Dr. Awadhesh Kumar Singh)

  • Waning of anti-spike antibody titre over time occurs regardless of age, sex, BMI, comorbidities and type of vaccine
  • Antibody titre wanes significantly low in hypertensive cohort vs. normotensive at 6-month,
  • People with past history of COVID-19 have significantly higher anti-spike antibody titer at all time points compared to SARS-CoV-2 naive individuals after two doses of either vaccine,
  • Notably second dose of vaccine brings only a little augmentation of spike antibody titre compared to the first dose.
  • Covishield recipients had significantly higher anti-spike antibody titer at all time points until 6- month after two doses.
  • In this study, there was a 56% decline in anti-spike antibody GMT at 6-months compared to the peak period (21-days after second dose) in SARS-CoV-2 naive individuals.
  • There was a 44% decline in anti-spike antibody GMT at 6-months compared to peak period (at 21-days) after the second dose of Covishield.
  • There was minimal-to-no reduction (8% decline) in anti-spike antibody GMT at 6-months compared to peak period (at 21-days) after the second dose of Covaxin and similar findings were noted in propensity-matched cohorts.
  • There was 5.6- fold reduction in seropositivity to anti-spike antibody at 6-month in SARS-CoV-2 naive cohorts regardless of the vaccine received.
  • Despite a significant decline in seropositivity with both vaccines, seropositivity was significantly higher with Covaxin compared to Covishield at 6-month in SARS-CoV-2 naive cohorts, although no significant difference was noted in propensity-matched cohorts.
  • No significant difference in breakthrough infection rate was noted between Covishield and Covaxin recipients at 6-month.

CME INDIA Tail Piece

COVAT Study Unique Findings: Covishield vs Covaxin - Both Doing Great to Protect Mankind

COVAT Study Unique Findings: Covishield vs Covaxin - Both Doing Great to Protect Mankind

COVAT Study Unique Findings: Covishield vs Covaxin - Both Doing Great to Protect Mankind

References:

  1. Awadhesh Kumar Singh, Sanjeev Ratnakar Phatak, Ritu Singh, Kingshuk Bhattacharjee, Nagendra Kumar Singh, Arvind Gupta, Arvind Sharma,Humoral antibody kinetics with ChAdOx1-nCOV (Covishield™) and BBV-152 (Covaxin™) vaccine among Indian Healthcare workers: A 6-month longitudinal cross-sectional Coronavirus Vaccine-induced antibody titre (COVAT) study,Diabetes & Metabolic Syndrome: Clinical Research & Reviews,2022,102424,ISSN 1871-4021,https://doi.org/10.1016/j.dsx.2022.102424.(https://www.sciencedirect.com/science/article/pii/S18714 02122000388)
  2. Awadhesh Kumar Singh, Sanjeev Ratnakar Phatak, Ritu Singh, Kingshuk Bhattacharjee, Nagendra Kumar Singh, Arvind Gupta, Arvind Sharma, Title: Antibody Response after First and Second-dose of ChAdOx1-nCOV (Covishield) and BBV-152 (Covaxin) among Health Care Workers in India: The Final Results of Cross-sectional Coronavirus Vaccine-induced Antibody Titre (COVAT) study, Vaccine, 2021, , ISSN 0264-410X, https://doi.org/10.1016/j.vaccine.2021.09.055
  3. Humoral Antibody Kinetics with ChAdOx1-nCOV (CovishieldTM) and BBV-152 (CovaxinTM) Vaccine among Indian Healthcare workers: A 6-month Longitudinal Cross-sectional Coronavirus Vaccine-induced Antibody Titre (COVAT) Study AWADHESH KUMAR SINGH, Sanjeev Ratnakar Phatak, Ritu Singh, Kingshuk Bhattacharjee, Nagendra Kumar Singh, Arvind Gupta, Arvind Sharma medRxiv 2022.02.03.22270182; doi: https://doi.org/10.1101/2022.02.03.22270182



Discover CME INDIA

Discover CME INDIA