Randomized clinical trial of BCG vaccine in patients with convalescent COVID-19: Clinical evolution, adverse events, and humoral immune response.

Autor: Jalalizadeh M; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil., Buosi K; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil., Dionato FAV; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil., Dal Col LSB; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil., Giacomelli CF; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil., Ferrari KL; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil., Pagliarone AC; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil., Leme PAF; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil., Maia CL; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil., Yadollahvandmiandoab R; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil., Trinh QD; Brigham and Women's Center for Surgery and Public Health, Harvard Medical School, Boston, Massachusetts, USA., Franchini KG; Brazilian Center for Research in Energy and Materials, CNPEM, Brazilian Biosciences National Laboratory-LNBio, Campinas, Brazil., Bajgelman MC; Brazilian Center for Research in Energy and Materials, CNPEM, Brazilian Biosciences National Laboratory-LNBio, Campinas, Brazil., Reis LO; Department of UroScience, School of Medical Sciences, State University of Campinas-UNICAMP, Campinas, Brazil.; Center for Life Sciences, Pontifical Catholic University of Campinas, Campinas, Brazil.
Jazyk: angličtina
Zdroj: Journal of internal medicine [J Intern Med] 2022 Oct; Vol. 292 (4), pp. 654-666. Date of Electronic Publication: 2022 Jun 03.
DOI: 10.1111/joim.13523
Abstrakt: Background: The Bacillus Calmette-Guérin (BCG) vaccine may confer cross-protection against viral diseases in adults. This study evaluated BCG vaccine cross-protection in adults with convalescent coronavirus disease 2019 (COVID-19).
Method: This was a multicenter, prospective, randomized, placebo-controlled, double-blind phase III study (ClinicalTrials.gov: NCT04369794).
Setting: University Community Health Center and Municipal Outpatient Center in South America.
Patients: a total of 378 adult patients with convalescent COVID-19 were included.
Intervention: single intradermal BCG vaccine (n = 183) and placebo (n = 195).
Measurements: the primary outcome was clinical evolution. Other outcomes included adverse events and humoral immune responses for up to 6 months.
Results: A significantly higher proportion of BCG patients with anosmia and ageusia recovered at the 6-week follow-up visit than placebo (anosmia: 83.1% vs. 68.7% healed, p = 0.043, number needed to treat [NNT] = 6.9; ageusia: 81.2% vs. 63.4% healed, p = 0.032, NNT = 5.6). BCG also prevented the appearance of ageusia in the following weeks: seven in 113 (6.2%) BCG recipients versus 19 in 126 (15.1%) placebos, p = 0.036, NNT = 11.2. BCG did not induce any severe or systemic adverse effects. The most common and expected adverse effects were local vaccine lesions, erythema (n = 152; 86.4%), and papules (n = 111; 63.1%). Anti-severe acute respiratory syndrome coronavirus 2 humoral response measured by N protein immunoglobulin G titer and seroneutralization by interacting with the angiotensin-converting enzyme 2 receptor suggest that the serum of BCG-injected patients may neutralize the virus at lower specificity; however, the results were not statistically significant.
Conclusion: BCG vaccine is safe and offers cross-protection against COVID-19 with potential humoral response modulation.
Limitations: No severely ill patients were included.
(© 2022 The Association for the Publication of the Journal of Internal Medicine.)
Databáze: MEDLINE
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