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BRIEF RESEARCH REPORT article

Front. Immunol.
Sec. Viral Immunology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1506203
This article is part of the Research Topic Infectious Diseases in Maternal-Fetal Interface: Role of Immune System to Combat this Pathology and Avoid or Minimize a Possible Vertical Transmission View all articles

Maternal-fetal cytokine profiles in acute SARS-CoV-2 "breakthrough" infection after COVID-19 vaccination

Provisionally accepted
Claire H Packer Claire H Packer Olyvia J Jasset Olyvia J Jasset Nikolina Hanniford Nikolina Hanniford Sara Brigida Sara Brigida Stepan Demidkin Stepan Demidkin Roy H Perlis Roy H Perlis Andrea G Edlow Andrea G Edlow *Lydia L Shook Lydia L Shook *
  • Massachusetts General Hospital, Harvard Medical School, Boston, United States

The final, formatted version of the article will be published soon.

    OBJECTIVE: Vaccination is protective against severe COVID-19 disease, yet whether vaccination reduces COVID-19-associated inflammation in pregnancy has not been established. The objective of this study is to characterize maternal and cord cytokine profiles of acute SARS-CoV-2 "breakthrough" infection (BTI) after vaccination, compared with unvaccinated infection and uninfected controls. STUDY DESIGN: 66 pregnant individuals enrolled in the MGH COVID-19 biorepository (March 2020-April 2022) were included. Maternal sera were collected from 26 unvaccinated and 21 vaccinated individuals with acute SARS-CoV-2 infection. Cord sera were collected at delivery. Maternal and cord sera from 19 term dyads without current or prior SARS-CoV-2 infection were analyzed as controls. Cytokines were quantified using the Human Inflammation 20-Plex ProcartaPlex assay.RESULTS: There was a significantly higher incidence of severe/critical maternal illness in unvaccinated pregnant individuals with SARS-CoV-2 compared to vaccinated (10/26 (38%) vs. 0/21 (0%), p<0.01). Significantly higher maternal levels of TNFα and CD62P were observed in vaccinated individuals with SARS-CoV-2 BTI compared with unvaccinated individuals with infection (p<0.05). Network correlation analyses revealed a distinct maternal cytokine response to SARS-CoV-2 in vaccinated vs unvaccinated individuals. Neither unvaccinated nor vaccinated SARS-CoV-2 infection resulted in elevated cord cytokines compared to controls. Multivariate analyses demonstrate distinct maternal and cord cytokine profiles in the setting of maternal SARS-CoV-2 at delivery. CONCLUSION: Vaccination was associated with higher maternal cytokine levels during acute SARS-CoV-2 infection compared to unvaccinated infection, which may reflect vaccine-mediated priming of the immune system. A fetal inflammatory response specific to maternal SARS-CoV-2 infection was not observed.

    Keywords: COVID-19, Pregnancy, Cytokines, COVID-19 vaccines, SARS-CoV-2, Breakthrough infection

    Received: 07 Oct 2024; Accepted: 16 Dec 2024.

    Copyright: © 2024 Packer, Jasset, Hanniford, Brigida, Demidkin, Perlis, Edlow and Shook. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Andrea G Edlow, Massachusetts General Hospital, Harvard Medical School, Boston, United States
    Lydia L Shook, Massachusetts General Hospital, Harvard Medical School, Boston, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.