Evaluating the antibody response to SARS-COV-2 vaccination amongst kidney transplant recipients at a single nephrology centre

Kidney transplant recipients are highly vulnerable to the serious complications of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infections and thus stand to benefit from vaccination. Therefore, it is necessary to establish the effectiveness of available vaccines as this group of pati...

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Veröffentlicht in:PloS one 2022-03, Vol.17 (3), p.e0265130
Hauptverfasser: Chukwu, Chukwuma A, Mahmood, Kassir, Elmakki, Safa, Gorton, Julie, Kalra, Phillip A, Poulikakos, Dimitrios, Middleton, Rachel
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Mahmood, Kassir
Elmakki, Safa
Gorton, Julie
Kalra, Phillip A
Poulikakos, Dimitrios
Middleton, Rachel
description Kidney transplant recipients are highly vulnerable to the serious complications of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infections and thus stand to benefit from vaccination. Therefore, it is necessary to establish the effectiveness of available vaccines as this group of patients was not represented in the randomized trials. A total of 707 consecutive adult kidney transplant recipients in a single center in the United Kingdom were evaluated. 373 were confirmed to have received two doses of either the BNT162b2 (Pfizer-BioNTech) or AZD1222 (Oxford-AstraZeneca) and subsequently had SARS-COV-2 antibody testing were included in the final analysis. Participants were excluded from the analysis if they had a previous history of SARS-COV-2 infection or were seropositive for SARS-COV-2 antibody pre-vaccination. Multivariate and propensity score analyses were performed to identify the predictors of antibody response to SARS-COV-2 vaccines. The primary outcome was seroconversion rates following two vaccine doses. Antibody responders were 56.8% (212/373) and non-responders 43.2% (161/373). Antibody response was associated with greater estimated glomerular filtration (eGFR) rate [odds ratio (OR), for every 10 ml/min/1.73m2 = 1.40 (1.19-1.66), P
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Therefore, it is necessary to establish the effectiveness of available vaccines as this group of patients was not represented in the randomized trials. A total of 707 consecutive adult kidney transplant recipients in a single center in the United Kingdom were evaluated. 373 were confirmed to have received two doses of either the BNT162b2 (Pfizer-BioNTech) or AZD1222 (Oxford-AstraZeneca) and subsequently had SARS-COV-2 antibody testing were included in the final analysis. Participants were excluded from the analysis if they had a previous history of SARS-COV-2 infection or were seropositive for SARS-COV-2 antibody pre-vaccination. Multivariate and propensity score analyses were performed to identify the predictors of antibody response to SARS-COV-2 vaccines. The primary outcome was seroconversion rates following two vaccine doses. Antibody responders were 56.8% (212/373) and non-responders 43.2% (161/373). Antibody response was associated with greater estimated glomerular filtration (eGFR) rate [odds ratio (OR), for every 10 ml/min/1.73m2 = 1.40 (1.19-1.66), P&lt;0.001] whereas, non-response was associated with mycophenolic acid immunosuppression [OR, 0.02(0.01-0.11), p&lt;0.001] and increasing age [OR per 10year increase, 0.61(0.48-0.78), p&lt;0.001]. In the propensity-score analysis of four treatment variables (vaccine type, mycophenolic acid, corticosteroid, and triple immunosuppression), only mycophenolic acid was significantly associated with vaccine response [adjusted OR by PSA 0.17 (0.07-0.41): p&lt;0.001]. 22 SARS-COV-2 infections were recorded in our cohort following vaccination. 17(77%) infections, with 3 deaths, occurred in the non-responder group. No death occurred in the responder group. Vaccine response in allograft recipients after two doses of SARS-COV-2 vaccine is poor compared to the general population. 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This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Therefore, it is necessary to establish the effectiveness of available vaccines as this group of patients was not represented in the randomized trials. A total of 707 consecutive adult kidney transplant recipients in a single center in the United Kingdom were evaluated. 373 were confirmed to have received two doses of either the BNT162b2 (Pfizer-BioNTech) or AZD1222 (Oxford-AstraZeneca) and subsequently had SARS-COV-2 antibody testing were included in the final analysis. Participants were excluded from the analysis if they had a previous history of SARS-COV-2 infection or were seropositive for SARS-COV-2 antibody pre-vaccination. Multivariate and propensity score analyses were performed to identify the predictors of antibody response to SARS-COV-2 vaccines. The primary outcome was seroconversion rates following two vaccine doses. Antibody responders were 56.8% (212/373) and non-responders 43.2% (161/373). 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Maintenance with mycophenolic acid appears to have the strongest negative impact on vaccine response.</description><subject>Adult</subject><subject>Aged</subject><subject>Antibodies</subject><subject>Antibodies, Viral - immunology</subject><subject>Antibody Formation - immunology</subject><subject>Antibody response</subject><subject>Antigens</subject><subject>Biology</subject><subject>Biology and Life Sciences</subject><subject>Cardiovascular disease</subject><subject>Clinical trials</subject><subject>Cohort Studies</subject><subject>Complications</subject><subject>Coronaviruses</subject><subject>Corticosteroids</subject><subject>COVID-19</subject><subject>COVID-19 - immunology</subject><subject>COVID-19 vaccines</subject><subject>COVID-19 Vaccines - immunology</subject><subject>Data collection</subject><subject>Drug dosages</subject><subject>Evaluation</subject><subject>Female</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunization</subject><subject>Immunoassay</subject><subject>Immunosuppression</subject><subject>Immunosuppression Therapy</subject><subject>Infections</subject><subject>Kidney diseases</subject><subject>Kidney Transplantation</subject><subject>Kidney transplants</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Mycophenolic acid</subject><subject>Nephrology</subject><subject>Organ transplant recipients</subject><subject>Population</subject><subject>SARS-CoV-2 - immunology</subject><subject>SARS-CoV-2 - pathogenicity</subject><subject>Seroconversion</subject><subject>Severe acute respiratory syndrome</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Transplant Recipients - statistics &amp; 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Therefore, it is necessary to establish the effectiveness of available vaccines as this group of patients was not represented in the randomized trials. A total of 707 consecutive adult kidney transplant recipients in a single center in the United Kingdom were evaluated. 373 were confirmed to have received two doses of either the BNT162b2 (Pfizer-BioNTech) or AZD1222 (Oxford-AstraZeneca) and subsequently had SARS-COV-2 antibody testing were included in the final analysis. Participants were excluded from the analysis if they had a previous history of SARS-COV-2 infection or were seropositive for SARS-COV-2 antibody pre-vaccination. Multivariate and propensity score analyses were performed to identify the predictors of antibody response to SARS-COV-2 vaccines. The primary outcome was seroconversion rates following two vaccine doses. Antibody responders were 56.8% (212/373) and non-responders 43.2% (161/373). Antibody response was associated with greater estimated glomerular filtration (eGFR) rate [odds ratio (OR), for every 10 ml/min/1.73m2 = 1.40 (1.19-1.66), P&lt;0.001] whereas, non-response was associated with mycophenolic acid immunosuppression [OR, 0.02(0.01-0.11), p&lt;0.001] and increasing age [OR per 10year increase, 0.61(0.48-0.78), p&lt;0.001]. In the propensity-score analysis of four treatment variables (vaccine type, mycophenolic acid, corticosteroid, and triple immunosuppression), only mycophenolic acid was significantly associated with vaccine response [adjusted OR by PSA 0.17 (0.07-0.41): p&lt;0.001]. 22 SARS-COV-2 infections were recorded in our cohort following vaccination. 17(77%) infections, with 3 deaths, occurred in the non-responder group. No death occurred in the responder group. Vaccine response in allograft recipients after two doses of SARS-COV-2 vaccine is poor compared to the general population. Maintenance with mycophenolic acid appears to have the strongest negative impact on vaccine response.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>35271655</pmid><doi>10.1371/journal.pone.0265130</doi><tpages>e0265130</tpages><orcidid>https://orcid.org/0000-0002-9488-2256</orcidid><oa>free_for_read</oa></addata></record>
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1932-6203
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subjects Adult
Aged
Antibodies
Antibodies, Viral - immunology
Antibody Formation - immunology
Antibody response
Antigens
Biology
Biology and Life Sciences
Cardiovascular disease
Clinical trials
Cohort Studies
Complications
Coronaviruses
Corticosteroids
COVID-19
COVID-19 - immunology
COVID-19 vaccines
COVID-19 Vaccines - immunology
Data collection
Drug dosages
Evaluation
Female
Health aspects
Hospitals
Humans
Immunization
Immunoassay
Immunosuppression
Immunosuppression Therapy
Infections
Kidney diseases
Kidney Transplantation
Kidney transplants
Kidneys
Male
Medicine and Health Sciences
Middle Aged
Mycophenolic acid
Nephrology
Organ transplant recipients
Population
SARS-CoV-2 - immunology
SARS-CoV-2 - pathogenicity
Seroconversion
Severe acute respiratory syndrome
Severe acute respiratory syndrome coronavirus 2
Transplant Recipients - statistics & numerical data
United Kingdom
Vaccination
Vaccines
Variables
Viral diseases
title Evaluating the antibody response to SARS-COV-2 vaccination amongst kidney transplant recipients at a single nephrology centre
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