Hybrid immunity to SARS-CoV-2 in kidney transplant recipients and hemodialysis patients

Kemlin, Delphine; Lemy, Anne; Pannus, Pieter; Desombere, Isabelle; Gemander, Nicolas; Goossens, Maria E.; Marchant, Arnaud; Moine, Alaín Le

doi:10.1111/ajt.16853

Cited by 12 publications

(6 citation statements)

References 6 publications

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“…Interestingly, T cell response was identified in 7 out of 40 (18%) infection-naive patients vaccinated with the BNT162b2 and in 2 of 39 patients (5%) given the ChAdOx1 nCov-19 vaccine. As observed also by other groups of investigators (128), seroconversion rates, Ab titers and T-cell responses were significantly higher in COVID-19 recovered compared to naive patients.…”

Section: Solid Organ Transplant Recipientssupporting

confidence: 84%

Insights From Early Clinical Trials Assessing Response to mRNA SARS-CoV-2 Vaccination in Immunocompromised Patients

et al. 2022

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It is critical to protect immunocompromised patients against COVID-19 with effective SARS-CoV-2 vaccination as they have an increased risk of developing severe disease. This is challenging, however, since effective mRNA vaccination requires the successful cooperation of several components of the innate and adaptive immune systems, both of which can be severely affected/deficient in immunocompromised people. In this article, we first review current knowledge on the immunobiology of SARS-COV-2 mRNA vaccination in animal models and in healthy humans. Next, we summarize data from early trials of SARS-COV-2 mRNA vaccination in patients with secondary or primary immunodeficiency. These early clinical trials identified common predictors of lower response to the vaccine such as anti-CD19, anti-CD20 or anti-CD38 therapies, low (naive) CD4+ T-cell counts, genetic or therapeutic Bruton tyrosine kinase deficiency, treatment with antimetabolites, CTLA4 agonists or JAK inhibitors, and vaccination with BNT162b2 versus mRNA1273 vaccine. Finally, we review the first data on third dose mRNA vaccine administration in immunocompromised patients and discuss recent strategies of temporarily holding/pausing immunosuppressive medication during vaccination.

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Section: Solid Organ Transplant Recipientssupporting

confidence: 84%

Insights From Early Clinical Trials Assessing Response to mRNA SARS-CoV-2 Vaccination in Immunocompromised Patients

et al. 2022

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“…There is preliminary evidence that immunologic benefits of hybrid immunity may extend to patients with immune suppression, such as kidney and other solid organ transplant recipients. These patients have very attenuated humoral responses to vaccines but still exhibit a more robust post‐vaccination antibody response if they had PI 39,40 . How antibody and cellular responses to COVID‐19 vaccines in MS patients on different DMTs compare in patients with and without prior COVID‐19 infection has not, to our knowledge, been investigated.…”

Section: Introductionmentioning

confidence: 99%

“…These patients have very attenuated humoral responses to vaccines but still exhibit a more robust post‐vaccination antibody response if they had PI. 39 , 40 How antibody and cellular responses to COVID‐19 vaccines in MS patients on different DMTs compare in patients with and without prior COVID‐19 infection has not, to our knowledge, been investigated. To address this question is the primary objective of our study.…”

Section: Introductionmentioning

confidence: 99%

Hybrid and vaccine‐induced immunity against SAR‐CoV‐2 in MS patients on different disease‐modifying therapies

Kister

Curtin

Pei³

et al. 2022

Ann Clin Transl Neurol

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Objective: To compare "hybrid immunity" (prior COVID-19 infection plus vaccination) and post-vaccination immunity to SARS CoV-2 in MS patients on different disease-modifying therapies (DMTs) and to assess the impact of vaccine product and race/ethnicity on post-vaccination immune responses. Methods: Consecutive MS patients from NYU MS Care Center (New York, NY), aged 18-60, who completed primary COVID-19 vaccination series ≥6 weeks previously were evaluated for SARS CoV-2-specific antibody responses with electro-chemiluminescence and multiepitope bead-based immunoassays and, in a subset, live virus immunofluorescence-based microneutralization assay. SARS CoV-2-specific cellular responses were assessed with cellular stimulation TruCulture IFNc and IL-2 assay and, in a subset, with IFNc and IL-2 ELISpot assays. Multivariate analyses examined associations between immunologic responses and prior COVID-19 infection while controlling for age, sex, DMT at vaccination, time-to-vaccine, and vaccine product. Results: Between 6/01/2021 and 11/11/2021, 370 MS patients were recruited (mean age 40.6 years; 76% female; 53% non-White; 22% with prior infection; common DMT classes: ocrelizumab 40%; natalizumab 15%, sphingosine-1-phosphate receptor modulators 13%; and no DMT 8%). Vaccine-to-collection time was 18.7 (AE7.7) weeks and 95% of patients received mRNA vaccines. In multivariate analyses, patients with laboratory-confirmed prior COVID-19 infection had significantly increased antibody and cellular post-vaccination responses compared to those without prior infection. Vaccine product and DMT class were independent predictors of antibody and cellular responses, while race/ethnicity was not. Interpretation: Prior COVID-19 infection is associated with enhanced antibody and cellular postvaccine responses independent of DMT class and vaccine type. There were no differences in immune responses across race/ethnic groups.

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“…Impferfolge mit den aktuell zur Verfügung stehenden COVID-19-Impfstoffen sind bei Patient:innen mit chronischen Nierenerkrankungen, insbesondere an Dialyse und nach Nierentransplantation deutlich seltener zu verzeichnen als bei der allgemeinen Bevölkerung gleichen Alters. Impfstrategien müssen daher gerade bei diesem Patient:innenkollektiv weiter verbessert werden [ 83 – 86 ].…”

Section: Covid-19-pandemie Und Niereninsuffizienzunclassified

Langfristige körperliche und psychische Folgen chronischer Nierenerkrankungen

Thaiss

2022

Bundesgesundheitsbl

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ZusammenfassungAufgrund der verbesserten Behandlungsoptionen können Patient:innen mit chronischen Nierenerkrankungen heute deutlich länger überleben als noch vor 10 Jahren. Das Überleben ist für die Betroffenen jedoch immer mit einem Verlust an Lebensqualität verbunden. In diesem Beitrag wird eine kurze Übersicht über die körperlichen und psychischen Erkrankungsfolgen, Begleiterkrankungen und Therapienebenwirkungen bei chronischen Nierenerkrankungen gegeben. Auf bisher bekannte Auswirkungen der COVID-19-Pandemie wird hingewiesen. Abschließend wird aufgezeigt, wie die Langzeitbehandlung weiterentwickelt werden sollte, um die Lebensqualität der Patient:innen zu erhöhen.Funktionseinschränkungen der Niere haben aufgrund der Kontamination des Blutes mit harnpflichtigen Substanzen (Urämie) schwere Auswirkungen auf den Gesamtorganismus. Zusätzlich sind die Patient:innen von Nebenwirkungen betroffen, die im Zusammenhang mit der medikamentösen Therapie, Dialyse oder Nierentransplantation auftreten können. Patient:innen und Angehörige sind einer großen psychischen Belastung ausgesetzt. Infektionen mit SARS-CoV‑2 können die Nierenfunktion beeinträchtigen und auch die Prognose einer bereits bestehenden Erkrankung verschlechtern.Die ganzheitliche Versorgung der Patient:innen mit chronischen Nierenerkrankungen muss neben der medizinischen Versorgung auch die psychologischen und psychosozialen Aspekte berücksichtigen. Nephrologie und Psychonephrologie müssen Hand in Hand weiterentwickelt werden, um die medizinische Versorgung und Lebensqualität der betroffenen Patient:innen zu verbessern.

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Hybrid immunity to SARS-CoV-2 in kidney transplant recipients and hemodialysis patients

Cited by 12 publications

References 6 publications

Insights From Early Clinical Trials Assessing Response to mRNA SARS-CoV-2 Vaccination in Immunocompromised Patients

Insights From Early Clinical Trials Assessing Response to mRNA SARS-CoV-2 Vaccination in Immunocompromised Patients

Hybrid and vaccine‐induced immunity against SAR‐CoV‐2 in MS patients on different disease‐modifying therapies

Langfristige körperliche und psychische Folgen chronischer Nierenerkrankungen

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