Abstract
Vaccination against SARS-CoV2 represents a key weapon to prevent COVID-19, but lower response rates to vaccination have frequently been reported in solid organ transplant recipients. The aim of our study was to evaluate the rate of seroconversion to SARS-CoV-2 mRNA vaccines in a cohort of kidney transplant recipients and the potential role of the different immunosuppressive regimens. We conducted an observational retrospective cohort study in kidney transplant patients vaccinated for COVID-19. For each patient, we evaluated IgG anti-S-RBD SARS-CoV-2 titers immediately before the administration of first COVID-19 vaccination dose, 20 days after the first dose and 40 days after the second dose. Moreover, we evaluated the type of immunosuppressive treatment and the incidence of vaccine breakthrough SARS-CoV-2 infection. We enrolled 121 kidney transplant patients vaccinated for COVID-19. At the time of administration of the first vaccine dose, all patients had a negative antibody titer; only 4.1% had positive antibody titers 20 days after the first dose. More than half patients 62 (51%) had protective antibody titers 40 days after the second dose. A total of 18 Solid Organ Transplant Recipients (SOTRs) (14.9%) got a SARS-CoV-2 breakthrough infection during the study period. With regard to immunosuppressive regimen, patients on mycophenolate-based regimen (48.7%) showed the lowest antibody response rates (27.5%) compared to other regimens. Our study confirms that kidney transplant patients show a poor response to two doses of COVID-19 vaccination. Moreover, in our study the use of mycophenolate is significantly associated with a non-response to COVID-19 m-RNA vaccines.
Keywords: COVID-19; SARS-CoV-2; immunosuppression; serological response; transplant; vaccination.
【저자키워드】 COVID-19, SARS-CoV-2, Immunosuppression, vaccination., Transplant, serological response, 【초록키워드】 IgG, Vaccine, SARS-CoV2, vaccination, Vaccines, antibody, mRNA vaccine, SARS-COV-2 infection, vaccine dose, Cohort, COVID-19 vaccination, Patient, Antibody titer, Breakthrough infection, incidence, serological, kidney transplant, solid organ transplant, Protective, kidney transplant recipient, administration, dose, immunosuppressive, Immunosuppressive treatment, regimen, retrospective cohort study, recipients, second dose, first dose, study period, regimens, antibody response rate, positive, recipient, Prevent, lowest, enrolled, evaluate, significantly, reported, evaluated, conducted, rate of seroconversion, Solid, 【제목키워드】 protection, drug, clinical, response, role,