Longitudinal outcomes of COVID-19 in solid organ transplant recipients from 2020 to 2023

Solera, Javier T.; Árbol, Berta G.; Mittal, Ankit; Hall, Victoria; Marinelli, Tina; Bahinskaya, Ilona; Selzner, Nazia; McDonald, Michael; Schiff, Jeffrey; Sidhu, Aman; Humar, Atul; Kumar, Deepali

doi:10.1016/j.ajt.2024.03.011

Cited by 5 publications

(2 citation statements)

References 28 publications

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“…Recent studies have reported that the COVID-19 severity of the Omicron variants is less than that of the previous lineages in both the general population and KTXRs 24 – 28 . However, Solera et al reported that the rate of hospitalization for COVID-19 in solid organ transplant recipients (SORTs) was 9.8% during the XBB.1.5 phase, which was higher than that in general population, suggesting that KTXRs might remain susceptible to current Omicron lineages and develop more severe disease 29 , 30 . Therefore, the development of an effective prophylaxis strategy for COVID-19 infection is essential in KTXRs.…”

Section: Discussionmentioning

confidence: 99%

Neutralizing antibody responses and cellular responses against SARS-CoV-2 Omicron subvariants after mRNA SARS-CoV-2 vaccination in kidney transplant recipients

Kawashiro,

Suzuki,

Nogimori

et al. 2024

Sci Rep

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Although the mRNA SARS-CoV-2 vaccine has improved the mortality rate in the general population, its efficacy against rapidly mutating virus strains, especially in kidney transplant recipients, remains unclear. We examined the anti-SARS-CoV-2 spike protein IgG antibody and neutralizing antibody titers and cellular immunity against B.1.1, BA.1, and BA.5 antigens in 73 uninfected kidney recipients and 16 uninfected healthy controls who received three doses of an mRNA SARS-CoV-2 vaccine. The IgG antibody titers were significantly lower in recipients than in healthy controls. Similarly, neutralizing antibody titers against three viral variants were significantly lower in recipients. When the virus was mutated, the neutralizing antibody titers decreased significantly in both groups. In cellular immunity analysis, the number of spike-specific CD8 + non-naïve T cells against three variants significantly decreased in recipients. Conversely, the frequency of spike-specific Th2 CD4 + T-cells in recipients was higher than that in healthy controls. Nineteen recipients and six healthy controls also received a bivalent omicron-containing booster vaccine, leading to increase IgG and neutralizing antibody titers in both groups. After that, eleven recipients and five healthy controls received XBB.1.5 monovalent vaccines, increasing the neutralizing antibody titers against not only XBB.1.5, but also EG.5.1 and BA.2.86 antigens in kidney recipients. Although kidney recipients did not gain sufficient immunity against Omicron BA.5 with the third dose of vaccine, humoral response against mutant SARS-CoV-2 lineages significantly increased after bivalent Omicron-containing booster vaccine and the XBB.1.5 monovalent vaccine. Therefore, it is important for kidney recipients to continue to administer updated vaccines.

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Section: Discussionmentioning

confidence: 99%

Neutralizing antibody responses and cellular responses against SARS-CoV-2 Omicron subvariants after mRNA SARS-CoV-2 vaccination in kidney transplant recipients

Kawashiro,

Suzuki,

Nogimori

et al. 2024

Sci Rep

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“…After infection with SARS-CoV-2 solid organ transplant (SOT), recipients remain at risk of severe outcomes due to COVID-19 [ 1 , 2 , 3 ]. Although SOT recipients elicit inferior responses to COVID-19 mRNA vaccines compared to healthy populations [ 4 , 5 , 6 , 7 ], vaccination is an important preventive measure to lower the risk of severe disease in SOT recipients [ 2 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Time between Booster Doses on Humoral Immune Response in Solid Organ Transplant Recipients Vaccinated with BNT162b2 Vaccines

Hamm,

Loft,

Pérez-Alós

et al. 2024

Viruses

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As solid organ transplant (SOT) recipients remain at risk of severe outcomes after SARS-CoV-2 infections, vaccination continues to be an important preventive measure. In SOT recipients previously vaccinated with at least three doses of BNT162b2, we investigated humoral responses to BNT162b2 booster doses. Anti-SARS-CoV-2 receptor binding domain (RBD) immunoglobulin G (IgG) was measured using an in-house ELISA. Linear mixed models were fitted to investigate the change in the geometric mean concentration (GMC) of anti-SARS-CoV-2 RBD IgG after vaccination in participants with intervals of more or less than six months between the last two doses of vaccine. We included 107 SOT recipients vaccinated with a BNT162b2 vaccine. In participants with an interval of more than six months between the last two vaccine doses, we found a 1.34-fold change in GMC per month (95% CI 1.25–1.44), while we found a 1.09-fold change in GMC per month (95% CI 0.89–1.34) in participants with an interval of less than six months between the last two vaccine doses, resulting in a rate ratio of 0.82 (95% CI 0.66 to 1.01, p = 0.063). In conclusion, the administration of identical COVID-19 mRNA vaccine boosters within six months to SOT recipients may result in limited humoral immunogenicity of the last dose.

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Safety and effectiveness of remdesivir in hospitalized patients with COVID-19 and severe renal impairment: experience at a large medical center

Chang,

Hsu,

et al. 2024

Annals of Medicine

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Background Literature on the safety of remdesivir in hospitalized COVID-19 patients with severe renal impairment is limited. We aimed to investigate the safety and effectiveness of remdesivir in this population. Methods We conducted a retrospective cohort study of adult hospitalized COVID-19 patients who received remdesivir between April 2022 and October 2022. Outcomes were compared between estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m 2 and ≥30 mL/min/1.73 m 2 groups. The primary safety outcomes were acute kidney injury (AKI) and bradycardia, while the primary effectiveness outcomes included mortality in COVID-19-dedicated wards and hospital mortality. Secondary outcomes included laboratory changes, disease progression, and recovery time. Results A total of 1,343 patients were recruited, with 307 (22.9%) in the eGFR <30 group and 1,036 (77.1%) in the eGFR ≥30 group. Patients with an eGFR <30 had higher risks of AKI (adjusted hazard ratio [aHR] 2.92, 95% CI 1.93–4.44) and hospital mortality (aHR 1.47, 95% CI 1.06–2.05) but had comparable risks of bradycardia (aHR 1.15, 95% CI 0.85–1.56) and mortality in dedicated wards (aHR 1.43, 95% CI 0.90–2.28) than patients with an eGFR ≥30. Risk of disease progression was higher in the eGFR <30 group (adjusted odds ratio 1.62, 95% CI 1.16–2.26). No difference between the two groups in laboratory changes and recovery time. Conclusions Hospitalized COVID-19 patients receiving remdesivir with severe renal impairment had an increased risk of AKI, hospital mortality, and COVID-19 disease progression compared to patients without severe renal impairment.

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Longitudinal outcomes of COVID-19 in solid organ transplant recipients from 2020 to 2023

Cited by 5 publications

References 28 publications

Neutralizing antibody responses and cellular responses against SARS-CoV-2 Omicron subvariants after mRNA SARS-CoV-2 vaccination in kidney transplant recipients

Neutralizing antibody responses and cellular responses against SARS-CoV-2 Omicron subvariants after mRNA SARS-CoV-2 vaccination in kidney transplant recipients

The Impact of Time between Booster Doses on Humoral Immune Response in Solid Organ Transplant Recipients Vaccinated with BNT162b2 Vaccines

Safety and effectiveness of remdesivir in hospitalized patients with COVID-19 and severe renal impairment: experience at a large medical center

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