Previous BCG vaccination is associated with less severe clinical progression of COVID-19

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Data
2023
Autores
Pereira, Susan Martins
Barreto, Florisneide Rodrigues
Souza, Ramon Andrade de
Santos, Carlos Antonio de Souza Teles
Pereira, Marcos
Paixão, Enny Santos da
Lima, Carla Cristina Oliveira de Jesus
Natividade, Marcio Santos da
Lindoso, Ana Angélica Bulcão Portela
Fernandes, Eder Gatti
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Medicine
Resumo
Background BCG vaccination, originally used to prevent tuberculosis, is known to “train” the immune system to improve defence against viral respiratory infections. We investigated whether a previous BCG vaccination is associated with less severe clinical progression of COVID-19 Methods A case-control study comparing the proportion with a BCG vaccine scar (indicating previous vaccination) in cases and controls presenting with COVID-19 to health units in Brazil. Cases were subjects with severe COVID-19 (O2 saturation < 90%, severe respiratory efort, severe pneumonia, severe acute respiratory syndrome, sepsis, and sep‐ tic shock). Controls had COVID-19 not meeting the defnition of “severe” above. Unconditional regression was used to estimate vaccine protection against clinical progression to severe disease, with strict control for age, comorbidity, sex, educational level, race/colour, and municipality. Internal matching and conditional regression were used for sensitivity analysis. Results BCG was associated with high protection against COVID-19 clinical progression, over 87% (95% CI 74–93%) in subjects aged 60 or less and 35% (95% CI −44–71%) in older subjects. Conclusions This protection may be relevant for public health in settings where COVID-19 vaccine coverage is still low and may have implications for research to identify vaccine candidates for COVID-19 that are broadly protec‐ tive against mortality from future variants. Further research into the immunomodulatory efects of BCG may inform COVID-19 therapeutic research.
Description
Palavras-chave
BCG, Bacillus Calmette-Guérin, COVID-19, SARS-CoV-2, Coronavirus disease 2019, Severity, Vaccination.
Citação
Pereira SM, Barreto FR, de Souza RA, de Souza Teles Santos CA, Pereira M, da Paixão ES, de Jesus Lima CCO, da Natividade MS, Lindoso AABP, Fernandes EG, Junior EBC, Pescarini JM, de Andrade KVF, de Souza FM, de Britto EA, Nunes C, Ichihara MY, Dalcolmo M, Trajman A, Barral-Netto M, Abubakar I, Barreto ML, de Alencar Ximenes RA, Rodrigues LC. Previous BCG vaccination is associated with less severe clinical progression of COVID-19. BMC Med. 2023 Apr 13;21(1):145. doi: 10.1186/s12916-023-02859-x.