众所周知，皮质类固醇会降低免疫反应能力，通常用于化疗的常规术前用药。皮质类固醇的作用持续时间与 COVID-19 疫苗峰值功效之间的时间范围相交可能会损害疫苗的免疫原性。因此，需要询问皮质类固醇对疫苗功效的影响，以促进该人群的有效免疫力。这是一项前瞻性纵向观察队列研究，纳入了实体癌患者，分为地塞米松治疗组和非地塞米松治疗组。所有参与者均接种了两剂 ChAdOx1 nCoV-19 或 CoronaVac 疫苗。本研究的目的是比较地塞米松组和非地塞米松组的癌症患者在接种两剂 COVID-19 疫苗后，皮质类固醇对 SARS-CoV-2 S 蛋白免疫原性反应的影响。次要结局包括免疫后抗尖峰 (S) 免疫球蛋白 G (IgG) 血清转换率、皮质类固醇剂量、持续时间和免疫原性水平的关联。 在 161 名入组的实体癌患者中，71 名和 90 名接受地塞米松和非地塞米松治疗分别为组。地塞米松组接种 COVID-19 疫苗后的中位抗 S IgG 滴度低于非地塞米松组，差异有统计学意义（47.22 vs 141.09 U/mL，P = .035）。地塞米松组的抗 S IgG 血清转化率也显着低于非地塞米松组 (93.83% vs 80.95%, P = .023)。在最高剂量类固醇组（整个化疗过程中地塞米松累积剂量[每个疗程]≥37 mg）的患者和在接受地塞米松的同一天注射了 COVID-19 疫苗，浓度为 25.41 AU/mL。在接受地塞米松的同时接种了针对 COVID-19 疾病疫苗的实体癌患者，其免疫原性反应低于未接种地塞米松疫苗的患者。观察到免疫原性水平与类固醇剂量以及从接种地塞米松的持续时间长度之间的直接关系。

Corticosteroids are known to diminish immune response ability, which is generally used in routine premedication for chemotherapy. The intersecting of timeframe between the corticosteroid's duration of action and peak COVID-19 vaccine efficacy could impair vaccine immunogenicity. Thus, inquiring about corticosteroids affecting the efficacy of vaccines to promote effective immunity in this population is needed.This was a prospective longitudinal observational cohort study that enrolled patients with solid cancer classified into dexamethasone- and nondexamethasone-receiving groups. All participants were immunized with two doses of ChAdOx1 nCoV-19 or CoronaVac vaccines. This study's purpose was to compare corticosteroid's effect on immunogenicity responses to the SARS-CoV-2 S protein in patients with cancer after two doses of COVID-19 vaccine in the dexamethasone and nondexamethasone group. Secondary outcomes included the postimmunization anti-spike (S) immunoglobin G (IgG) seroconversion rate, the association of corticosteroid dosage, time duration, and immunogenicity level.Among the 161 enrolled patients with solid cancer, 71 and 90 were in the dexamethasone and nondexamethasone groups, respectively. The median anti-S IgG titer after COVID-19 vaccination in the dexamethasone group was lower than that in the nondexamethasone group with a statistically significant difference (47.22 v 141.09 U/mL, P = .035). The anti-S IgG seroconversion rate was also significantly lower in the dexamethasone group than in the nondexamethasone group (93.83% v 80.95%, P = .023). The lowest median anti-SARS-CoV-2 IgG titer level at 7.89 AU/mL was observed in patients with the highest dose of steroid group (≥37 mg of dexamethasone cumulative dose throughout the course of chemotherapy [per course]) and patients who were injected with COVID-19 vaccines on the same day of receiving dexamethasone, 25.41 AU/mL.Patients with solid cancer vaccinated against COVID-19 disease while receiving dexamethasone had lower immunogenicity responses than those who got vaccines without dexamethasone. The direct association between the immunogenicity level and steroid dosage, as well as length of duration from vaccination to dexamethasone, was observed.