PB1133 - COVID-19 vaccination in patients with hemophilia: experience from a single center

Tuesday, July 12, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Co-Author(s)

CS

Chiara Suffritti, PhD

PhD
Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
Milano, Lombardia, Italy

Presenting Author(s)

Roberta Gualtierotti, MD, PhD

Assistant Professor
Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Centro Emofilia e Trombosi Angelo Bianchi Bonomi
Milan, Lombardia, Italy

Co-Author(s)

ES

Erica Scalambrino

BSc
Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
Milano, Lombardia, Italy
MC

Marigrazia Clerici

Collaboratore Professionale di Ricerca
Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia e Trhombosis Center, Milan, Italy
Milano, Lombardia, Italy
AL

Anna Lecchi

Biologist
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
Milan, Lombardia, Italy
Cristina Novembrino, PhD

BSc
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
Milan, Lombardia, Italy
Eugenia Biguzzi, MD

Hematologist
Hematology clinic, Oncology Institute of Southern Switzerland, EOC
Bellinzona, Ticino, Switzerland
SS

Simona Maria Siboni

Hematologist
Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center
Milan, Lombardia, Italy
SA

Sara Arcudi, MD

Academic researcher, MD, PhD
Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Centro Emofilia e Trombosi Angelo Bianchi Bonomi
Milan, Lombardia, Italy
AC

Alessandro Ciavarella

PhD Student
Università degli Studi di Milano, Department of Biomedical Sciences for Health
Milan, Lombardia, Italy
PB

Patrizia Bono

MSc in Biology
Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
Milan, Lombardia, Italy
FC

Ferruccio Ceriotti

MD
Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
Milan, Lombardia, Italy
Flora Peyvandi, MD, PhD

Professor of Internal Medicine; Director of the Angelo Bianchi Bonomi Hemophilia & Thrombosis Center
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
Milan, Lombardia, Italy

Background: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in an ongoing world-wide pandemic. Vaccination is the key countermeasure of the COVID-19 pandemic. Data on the efficacy, safety and immunogenicity of COVID-19 vaccination in patients with hemophilia - and in particular in those with HIV - are still scarce.

Aims: The aim of our study was to characterize the immunogenicity and biomarkers of coagulation and endothelial perturbation after mRNA-COVID-19 vaccination in HIV-positive hemophilic patients.

Methods: We collected blood from 24 adult HIV-positive hemophilic patients followed at our centre (19 with hemophilia A, 5 with hemophilia B) before and two weeks after the administration of the complete vaccination schedule with mRNA-1273 (Moderna Biotech). Most patients had severe hemophilia (n=21). We measured antibodies to SARS-CoV-2 spike protein by Elecsys (Roche) to assess immunogenicity and we evaluated protein C, VWF, D-dimer plasma levels as biomarkers of coagulation and endothelial perturbation. Anti-Platelet Factor 4 (PF4) antibodies were also measured.

Results: Before vaccination, three patients out of 24 showed anti-Spike IgG levels >0.8 U/mL (cut-off value). Two weeks after completing the vaccination schedule, all patients had high values of anti-Spike IgG (min-max 2,387-12,500 U/mL). Mean (standard deviation) basal values of protein C, VWF and D-dimer (106±21%, 171±45%, 593±692 ng/mL respectively) were not significantly different from values measured two weeks after the second dose of vaccine (103±20%, 162±43%, 583±531 ng/mL). Anti-PF4 antibodies were detected in three patients with no associated clinical manifestations. None of the patients reported bleeding in the site of inoculation nor serious adverse events after the vaccination.

Conclusion(s): Since immune abnormalities can occur in HIV-positive patients, it is important to collect data on COVID-19 vaccination immunogenicity. We demonstrated that hemophilic HIV-positive patients have a normal antibody response against SARS-CoV-2 spike protein. In addition, mRNA-1273 had no effect on coagulation and endothelial perturbation.