{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:41:09Z","timestamp":1760146869916,"version":"build-2065373602"},"reference-count":53,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>This longitudinal study examined how active gastrointestinal (GI) cancer types affect immune responses to SARS-CoV-2, focusing on the ability to neutralize the Omicron variants. Patients with GI cancer (n = 168) were categorized into those with hepatocellular carcinoma, hepatic metastatic GI cancer, non-hepatic metastatic GI cancer, and two control groups of patients with and without underlying liver diseases. Humoral and cellular immune responses were evaluated before and after Omicron antigen exposures. In the pre-Omicron era, humoral SARS-CoV-2 immunity decreased after three antigen contacts without further antigen exposure. While Omicron neutralization was significantly lower than wildtype neutralization (p &lt; 0.01), Omicron infections were yet mild to moderate. Additional Omicron exposures improved IgG levels (p &lt; 0.01) and Omicron neutralization (p &lt; 0.01). However, this effect was significantly less intense in patients with active GI cancer, particularly in patients with pancreaticobiliary neoplasms (PBN; p = 0.04), with underlying immunodeficiency (p = 0.05), and\/or under conventional chemotherapy (p = 0.05). Pre-Omicron SARS-CoV-2 immunity prevented severe clinical courses of infections with Omicron variants in patients with GI cancer. However, in patients with PBN, with underlying immunodeficiency, and\/or under conventional chemotherapy initial contacts with Omicron antigens triggered only reduced immune responses. Thus, subgroups could be identified for whom booster vaccinations are of special clinical significance.<\/jats:p>","DOI":"10.3390\/ijms252413613","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T10:54:20Z","timestamp":1734605660000},"page":"13613","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Study of SARS-CoV-2 Vaccinations and Infections in Patients with Gastrointestinal Cancer: Stabilizing Immune Responses and Neutralizing Emerging Variants with Variant-Adapted Antigen Exposures"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3956-1457","authenticated-orcid":false,"given":"Maria A.","family":"Gonzalez-Carmona","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"},{"name":"Centre for Integrated Oncology (CIO), Aachen, Bonn, Cologne, D\u00fcsseldorf (ABCD), Partner-Site Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1682-4084","authenticated-orcid":false,"given":"Alina M.","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moritz","family":"Berger","sequence":"additional","affiliation":[{"name":"Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leona I.","family":"Baier","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens G.","family":"Gorny","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farsaneh","family":"Sadeghlar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"},{"name":"Centre for Integrated Oncology (CIO), Aachen, Bonn, Cologne, D\u00fcsseldorf (ABCD), Partner-Site Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Anhalt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"},{"name":"Centre for Integrated Oncology (CIO), Aachen, Bonn, Cologne, D\u00fcsseldorf (ABCD), Partner-Site Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"},{"name":"Centre for Integrated Oncology (CIO), Aachen, Bonn, Cologne, D\u00fcsseldorf (ABCD), Partner-Site Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taotao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"},{"name":"Centre for Integrated Oncology (CIO), Aachen, Bonn, Cologne, D\u00fcsseldorf (ABCD), Partner-Site Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Mahn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"},{"name":"Centre for Integrated Oncology (CIO), Aachen, Bonn, Cologne, D\u00fcsseldorf (ABCD), Partner-Site Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"M\u00f6hring","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"},{"name":"Centre for Integrated Oncology (CIO), Aachen, Bonn, Cologne, D\u00fcsseldorf (ABCD), Partner-Site Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Linnemann","sequence":"additional","affiliation":[{"name":"Institute of Experimental Haematology and Transfusion Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Schmid","sequence":"additional","affiliation":[{"name":"Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian P.","family":"Strassburg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"},{"name":"Centre for Integrated Oncology (CIO), Aachen, Bonn, Cologne, D\u00fcsseldorf (ABCD), Partner-Site Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Boesecke","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"},{"name":"German Centre for Infection Research (DZIF), Partner-Site Cologne-Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2858-3888","authenticated-orcid":false,"given":"J\u00fcrgen K.","family":"Rockstroh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"},{"name":"German Centre for Infection Research (DZIF), Partner-Site Cologne-Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna-Maria","family":"Eis-H\u00fcbinger","sequence":"additional","affiliation":[{"name":"Institute of Virology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8794-3612","authenticated-orcid":false,"given":"Malte B.","family":"Monin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 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of the SARS-CoV-2 Omicron variant in southern Africa","volume":"603","author":"Viana","year":"2022","journal-title":"Nature"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1056\/NEJMoa2119658","article-title":"Population Immunity and COVID-19 Severity with Omicron Variant in South Africa","volume":"386","author":"Madhi","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/S0140-6736(22)00017-4","article-title":"Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa: A data linkage study","volume":"399","author":"Wolter","year":"2022","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/S1473-3099(22)00154-2","article-title":"Risk of hospitalisation associated with infection with SARS-CoV-2 omicron variant versus delta variant in Denmark: An observational cohort study","volume":"22","author":"Bager","year":"2022","journal-title":"Lancet Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2693","DOI":"10.1093\/jac\/dkac256","article-title":"Real-world effectiveness of early remdesivir and sotrovimab in the highest-risk COVID-19 outpatients during the Omicron surge","volume":"77","author":"Piccicacco","year":"2022","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1007\/s15010-023-01994-0","article-title":"Use and effectiveness of remdesivir for the treatment of patients with COVID-19 using data from the Lean European Open Survey on SARS-CoV-2 infected patients (LEOSS): A multicentre cohort study","volume":"51","author":"Pilgram","year":"2023","journal-title":"Infection"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/cid\/ciac673","article-title":"Oral Nirmatrelvir and Ritonavir in Nonhospitalized Vaccinated Patients With Coronavirus Disease 2019","volume":"76","author":"Ganatra","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1007\/s15010-023-02125-5","article-title":"Early combination therapy of COVID-19 in high-risk patients","volume":"52","author":"Orth","year":"2023","journal-title":"Infection"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.cell.2021.12.032","article-title":"The Omicron variant is highly resistant against antibody-mediated neutralization: Implications for control of the COVID-19 pandemic","volume":"185","author":"Hoffmann","year":"2022","journal-title":"Cell"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1016\/j.cell.2022.06.005","article-title":"Antibody escape of SARS-CoV-2 Omicron BA.4 and BA.5 from vaccine and BA.1 serum","volume":"185","author":"Tuekprakhon","year":"2022","journal-title":"Cell"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"112911","DOI":"10.1016\/j.envres.2022.112911","article-title":"SARS-CoV-2 reinfections: Overview of efficacy and duration of natural and hybrid immunity","volume":"209","author":"Pilz","year":"2022","journal-title":"Environ. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1111\/bjh.18690","article-title":"Outcome of early treatment of SARS-CoV-2 infection in patients with haematological disorders","volume":"201","author":"Mikulska","year":"2023","journal-title":"Br. J. Haematol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Nachtigall, I., Kwast, S., Hohenstein, S., K\u00f6nig, S., Dang, P.L., Leiner, J., Giesen, N., Schleenvoigt, B.T., Bonsignore, M., and Bollmann, A. (2024). Retrospective, Observational Analysis on the Impact of SARS-CoV-2 Variant Omicron in Hospitalized Immunocompromised Patients in a German Hospital Network\u2014The VISAGE Study. Vaccines, 12.","DOI":"10.3390\/vaccines12060634"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.ejca.2022.11.030","article-title":"AGIHO guideline on evidence-based management of COVID-19 in cancer patients: 2022 update on vaccination, pharmacological prophylaxis and therapy in light of the omicron variants","volume":"181","author":"Giesen","year":"2023","journal-title":"Eur. J. Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"JCO2400032","DOI":"10.1200\/JCO.24.00032","article-title":"Vaccination of Adults With Cancer: ASCO Guideline","volume":"42","author":"Kamboj","year":"2024","journal-title":"J. Clin. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/j.jhep.2021.01.032","article-title":"EASL position paper on the use of COVID-19 vaccines in patients with chronic liver diseases, hepatobiliary cancer and liver transplant recipients","volume":"74","author":"Cornberg","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1016\/j.jhep.2022.07.008","article-title":"Impact of COVID-19 on the liver and on the care of patients with chronic liver disease, hepatobiliary cancer, and liver transplantation: An updated EASL position paper","volume":"77","author":"Marjot","year":"2022","journal-title":"J. Hepatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1038\/s43018-021-00274-w","article-title":"Adaptive immunity and neutralizing antibodies against SARS-CoV-2 variants of concern following vaccination in patients with cancer: The CAPTURE study","volume":"2","author":"Fendler","year":"2021","journal-title":"Nat. Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.21037\/jgo-22-1065","article-title":"Impaired immunogenicity after vaccination for SARS-CoV-2 in patients with gastrointestinal cancer: Does tumor entity matter?","volume":"14","author":"Monin","year":"2023","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1136\/gutjnl-2022-328169","article-title":"SARS-CoV-2 vaccination in patients with GI and hepatobiliary carcinoma: A call for booster vaccination","volume":"72","author":"Monin","year":"2023","journal-title":"Gut"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1159\/000529608","article-title":"Deficient Immune Response following SARS-CoV-2 Vaccination in Patients with Hepatobiliary Carcinoma: A Forgotten, Vulnerable Group of Patients","volume":"12","author":"Monin","year":"2023","journal-title":"Liver Cancer"},{"key":"ref_23","first-page":"e1","article-title":"SARS-CoV-2 Vaccine Immunogenicity in Patients with Gastrointestinal Cancer Receiving Systemic Anti-Cancer Therapy","volume":"28","author":"Lau","year":"2023","journal-title":"Oncology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1016\/j.cell.2022.01.015","article-title":"SARS-CoV-2 vaccination induces immunological T cell memory able to cross-recognize variants from Alpha to Omicron","volume":"185","author":"Tarke","year":"2022","journal-title":"Cell"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e388","DOI":"10.1016\/S2666-5247(23)00105-2","article-title":"Bivalent mRNA vaccine-elicited SARS-CoV-2 specific T cells recognise the omicron XBB sublineage","volume":"4","author":"Traut","year":"2023","journal-title":"Lancet Microbe"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1038\/s41586-022-04460-3","article-title":"T cell responses to SARS-CoV-2 spike cross-recognize Omicron","volume":"603","author":"Keeton","year":"2022","journal-title":"Nature"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1038\/s41564-022-01106-y","article-title":"SARS-CoV-2-specific T-cell epitope repertoire in convalescent and mRNA-vaccinated individuals","volume":"7","author":"Luxenburger","year":"2022","journal-title":"Nat. Microbiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1038\/s41586-022-04465-y","article-title":"Vaccines elicit highly conserved cellular immunity to SARS-CoV-2 Omicron","volume":"603","author":"Liu","year":"2022","journal-title":"Nature"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/S0140-6736(22)00147-7","article-title":"Omicron neutralising antibodies after third COVID-19 vaccine dose in patients with cancer","volume":"399","author":"Fendler","year":"2022","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e28582","DOI":"10.1002\/jmv.28582","article-title":"Live-virus neutralization of the omicron variant in children and adults 14 months after d-2 wild-type infection","volume":"95","author":"Stich","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1056\/NEJMoa2119451","article-title":"COVID-19 Vaccine Effectiveness against the Omicron (B.1.1.529) Variant","volume":"386","author":"Andrews","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1056\/NEJMc2200133","article-title":"Protection against the Omicron Variant from Previous SARS-CoV-2 Infection","volume":"386","author":"Altarawneh","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"eabn8590","DOI":"10.1126\/sciimmunol.abn8590","article-title":"SARS-CoV-2 Omicron-neutralizing memory B cells are elicited by two doses of BNT162b2 mRNA vaccine","volume":"7","author":"Kotaki","year":"2022","journal-title":"Sci. Immunol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"10633","DOI":"10.1007\/s00432-023-04961-2","article-title":"Longitudinal data on humoral response and neutralizing antibodies against SARS-CoV-2 Omicron BA.1 and subvariants BA.4\/5 and BQ.1.1 after COVID-19 vaccination in cancer patients","volume":"149","author":"Overheu","year":"2023","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1038\/s41571-022-00610-8","article-title":"COVID-19 vaccines in patients with cancer: Immunogenicity, efficacy and safety","volume":"19","author":"Fendler","year":"2022","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1086\/315245","article-title":"Pneumococcal Vaccine Response in Cirrhosis and Liver Transplantation","volume":"181","author":"McCashland","year":"2000","journal-title":"J. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Bakasis, A.-D., Bitzogli, K., Mouziouras, D., Pouliakis, A., Roumpoutsou, M., Goules, A.V., and Androutsakos, T. (2022). Antibody Responses after SARS-CoV-2 Vaccination in Patients with Liver Diseases. Viruses, 14.","DOI":"10.3390\/v14020207"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Willuweit, K., Frey, A., Passenberg, M., Korth, J., Saka, N., Anastasiou, O.E., M\u00f6hlendick, B., Sch\u00fctte, A., Schmidt, H., and Rashidi-Alavijeh, J. (2022). Patients with Liver Cirrhosis Show High Immunogenicity upon COVID-19 Vaccination but Develop Premature Deterioration of Antibody Titers. Vaccines, 10.","DOI":"10.3390\/vaccines10030377"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2842","DOI":"10.1182\/blood.2022016087","article-title":"Neutralization of SARS-CoV-2 Omicron after vaccination of patients with myelodysplastic syndromes or acute myeloid leukemia","volume":"139","author":"Bellusci","year":"2022","journal-title":"Blood"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"4144","DOI":"10.1080\/21645515.2021.1953346","article-title":"Adjuvanted recombinant zoster vaccine in adult autologous stem cell transplant recipients: Polyfunctional immune responses and lessons for clinical practice","volume":"17","author":"Stadtmauer","year":"2021","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ejca.2022.01.011","article-title":"Rapid decline of humoral response to two doses of BNT162b2 vaccine in patients with solid cancer after six months: The urgent need of the additional dose!","volume":"165","author":"Pimpinelli","year":"2022","journal-title":"Eur. J. Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/S1470-2045(22)00202-9","article-title":"Vaccine effectiveness against COVID-19 breakthrough infections in patients with cancer (UKCCEP): A population-based test-negative case-control study","volume":"23","author":"Lee","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_43","first-page":"481","article-title":"Measles and rubella antibody status in children after treatment for acute lymphoblastic leukemia","volume":"82","author":"Volc","year":"2006","journal-title":"J. Pediatr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1086\/514661","article-title":"Decline in Rates of Seropositivity for Measles, Mumps, and Rubella Antibodies Among Previously Immunized Children Treated for Acute Leukemia","volume":"27","author":"Feldman","year":"1998","journal-title":"Clin. Infect. Dis."},{"key":"ref_45","unstructured":"(2024, November 15). Robert Koch-Institut. Available online: https:\/\/www.rki.de\/DE\/Content\/InfAZ\/N\/Neuartiges_Coronavirus\/Situationsberichte\/Wochenbericht\/Wochenbericht_2022-01-13.pdf?__blob=publicationFile."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1080\/14760584.2023.2274484","article-title":"Immunogenicity assessment of elder hepatocellular carcinoma patients after inactivated whole-virion SARS-CoV-2 vaccination","volume":"22","author":"Gao","year":"2023","journal-title":"Expert Rev. Vaccines"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1980","DOI":"10.1007\/s11606-022-07511-7","article-title":"WHO Ordinal Scale and Inflammation Risk Categories in COVID-19. Comparative Study of the Severity Scales","volume":"37","author":"Formiga","year":"2022","journal-title":"J. Gen. Intern. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e192","DOI":"10.1016\/S1473-3099(20)30483-7","article-title":"A minimal common outcome measure set for COVID-19 clinical research","volume":"20","author":"Marshall","year":"2020","journal-title":"Lancet Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1007\/s15010-023-02081-0","article-title":"Antiviral treatment of COVID-19: Which role can clinical parameters play in therapy evaluation?","volume":"51","author":"Spuck","year":"2023","journal-title":"Infection"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1038\/s41587-020-0631-z","article-title":"A SARS-CoV-2 surrogate virus neutralization test based on antibody-mediated blockage of ACE2\u2013spike protein\u2013protein interaction","volume":"38","author":"Tan","year":"2020","journal-title":"Nat. Biotechnol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1128\/MMBR.00024-15","article-title":"Deconstructing the Antiviral Neutralizing-Antibody Response: Implications for Vaccine Development and Immunity","volume":"80","author":"VanBlargan","year":"2016","journal-title":"Microbiol. Mol. Biol. Rev."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2835","DOI":"10.1038\/s41467-023-38127-y","article-title":"Impaired humoral immunity to BQ.1.1 in convalescent and vaccinated patients","volume":"14","author":"Dewald","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"100646","DOI":"10.1016\/j.lanepe.2023.100646","article-title":"Vaccine-induced correlate of protection against fatal COVID-19 in older and frail adults during waves of neutralization-resistant variants of concern: An observational study","volume":"30","author":"Gwon","year":"2023","journal-title":"Lancet Reg. 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