Perbedaan Delta Kadar Antibodi Spike Receptor Binding Domain SARS COV-2 Pascavaksinasi Dibandingkan Pascainfeksi COVID 19

Desi Widiyanti, Dr.dr. Andaru Dahesih Dewi, M.Kes., Sp.PK(K);Dr.dr.Umi S. Intansari,M.Kes.,Sp.PK(K)

2023 | Tesis | S2 Kedokteran Klinik

Latar belakang: Coronavirus diseases (COVID 19) menjadi pandemi global dengan angka kematian dan kesakitan yang tinggi. Vaksin SARS CoV-2 inactivated diharapkan dapat membentuk antibodi SARS CoV-2 seperti setelah infeksi COVID 19. Antibodi diharapkan akan melindungi dari infeksi ulang berikutnya. Evaluasi delta kadar antibodi S-RBD SARS CoV-2 di antara pascavaksinasi SARS CoV-2 inactivated dan pascainfeksi COVID 19 diharapkan dapat memberi gambaran mengenai respon imun yang muncul dari dua proses ini.

Tujuan: Penelitian ini bertujuan mengevaluasi perbandingan delta kadar antibodi S-RBD SARS CoV-2 bulan 1 dan 3 pada pascavaksinasi dibandingkan pasca infeksi COVID 19. 

Metode: Desain penelitian ini kohort prospektif. Kriteria inklusi adalah subjek dengan usia ?18 tahun, tidak memiliki gangguan sistem imunokompeten, tidak hamil. Kriteria eksklusi pada pascavaksinasi, tidak ada riwayat terinfeksi COVID 19 sebelumnya, sedangkan pada pascainfeksi, tidak ada riwayat vaksinasi SARS CoV-2 sebelum terinfeksi COVID 19. Kedua kelompok subjek akan diambil sampel darah pada 1 bulan dan 3 bulan setelah vaksinasi ke dua pada penerima vaksin dan setelah selesai terapi dan atau selesai isolasi mandiri pada pascainfeksi. Analisis univariat terkait demografik pasien, analisis bivariat diuji menggunakan chi-square dengan tingkat kemaknaan p<0> bulan ke 1 dan ke 3 di antara pascavaksinasi dan pascainfeksi dilakukan uji beda antara kedua kelompok. Data dianalisis dengan menggunakan software SPSS versi 25 .

Hasil: Subjek penelitian secara keseluruhan adalah 132 subjek yang terdiri dari 73 subjek pascavaksin dan 59 subjek pascainfeksi.  Subjek pascavaksin didominasi penurunan kadar antibodi S-RBD SARS CoV-2 bulan 1 dan 3 dengan median penurunan kadar antibodi sebesar 16,34 U/mL (-203,87-18,51 U/mL). Subjek pascainfeksi didominasi peningkatan kadar antibodi dengan median kadar antibodi sebesar 41,8 U/mL (-429-6798 U/mL). Subjek pascavaksin memiliki kemungkinan lebih kecil mengalami peningkatan kadar antibodi dibandingkan subjek pascainfeksi dengan nilai odds ratio (OR) 0,12 (CI 95% 0,06-0,26).

Simpulan: Delta antibodi S-RBD SARS CoV-2 bulan 1 dan 3 antara pascavaksinasi dibanding pascainfeksi COVID 19 berbeda signifikan dengan nilai p=0,001. Delta antibodi pascavaksin cenderung menurun, sedangkan pacainfeksi cenderung meningkat.

Background: Coronavirus disease (COVID-19) has become a global pandemic with high mortality and morbidity value. The inactivated SARS CoV-2 vaccine is expected to produce SARS CoV-2 antibodies look alike it happened on someone who has recovered from a COVID-19 infection. The antibodies are expected to protect against subsequent reinfection. The evaluation of the delta levels S-RBD SARS CoV-2 antibodies between inactivated SARS CoV-2 post-vaccination and post COVID-19 infection can provide an overview of the immune response that appears.

Purpose: To evaluate the delta comparison of the S-RBD SARS-CoV-2 antibody levels in the first months and third month, in post-vaccination compare to post-infection COVID-19 subject.

Methods: This is a prospective cohort study. Inclusion criteria were subjects ?18 years old, don’t have impaired immunocompetent systems and not pregnant. Exclusion criteria for post-vaccination subject, there is no history of previous infection with COVID-19, whereas for post-infection subject, there is no history of vaccination SARS-CoV-2 before being infected COVID-19. Both subject groups will taken of blood samples at 1 month and 3 months after the second vaccination for post-vaccination subject and after take a complete of therapy and/or a complete of independent isolation in post-infection subject. Univariate analysis used to analyzed subject demographics, bivariate analysis was tested using chi-square with a significance level of p<0>

Result: The whole subjects were 132 subjects consisting of 73 post-vaccination subjects and 59 post-infection subjects. Post-vaccination subjects were dominated by a decrease in S-RBD SARS CoV-2 antibody levels in first month to third month with a median decrease in antibody levels of 16.34 U/mL (-203.87-18.51 U/mL). Post-infection subjects were dominated by increased antibody levels with a median antibody level of 41.8 U/mL (-429-6798 U/mL). Post-vaccine subjects were less likely to have elevated antibody levels than post-infected subjects with an odds ratio (OR) of 0.12 (95% CI 0.06-0.26).

Conclusion: The delta of S-RBD SARS CoV-2 antibody first month to third month between post-vaccination and post COVID 19 infection was significantly different with a p=0.001. Post-vaccination antibody delta tends to decrease, while post-infection tends to increase.

 

Kata Kunci : COVID 19, pascavaksinasi SARS CoV-2 inactivated, pascainfeksi COVID 19, delta antibodi S-RBD SARS CoV-2