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Based on a vaccinated\u2010infected cohort, we analyzed complement immune responses across mild to critical COVID\u201019 cases by a dynamic model. Our results showed that complement activation was earlier (7\u201314 days post symptom onset), more intense and lasted longer in severe and critical vaccination\u2010COVID\u201019, mediated by alternative and lectin pathways instead of classical pathway. Moreover, complement activation in severe vaccination\u2010COVID\u201019 was related to thromboinflammation but not to the virus\u2010specific antibody response. Our study elucidated the kinetics of complement activation in vaccination\u2010COVID\u201019 infection, revealing that Bb in alternative pathway were crucial in severe vaccination\u2010COVID\u201019. These findings indicate the optimal timing for implementing complement activation\u2010targeted interventions in the management of severe vaccination\u2010COVID\u201019 and provide more potential therapeutic targets.<\/jats:p>","DOI":"10.1002\/jmv.70863","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:21:51Z","timestamp":1772965311000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Complement Hyperactivation Is Mediated by Alternative and Lectin Pathways During Early Phase of Severe Vaccination\u2010Omicron BA.5 Infection"],"prefix":"10.1002","volume":"98","author":[{"given":"Jinpeng","family":"Cao","sequence":"first","affiliation":[{"name":"State Key Laboratory of Respiratory Disease &amp; National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University Guangzhou Medical 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