Seroconversion Rate After SARS-CoV-2 Infection and Two Doses of Either ChAdOx1-nCOV COVISHIELD™ or BBV-152 COVAXIN™ Vaccination in Renal Allograft Recipients: An Experience of Two Public and Private Tertiary Care Center

Abstract

IntroductionVaccination is an effective strategy for preventing SARS-CoV-2 infection and associated mortality. Renal Transplant Recipients (RTRs) are vulnerable to acquiring infection and high mortality due to their immunocompromised state. Varying responses to the different vaccines, depending on types of vaccines and population, have been reported. Vaccines supply is also limited. The current study evaluated the seroconversion rate after SARS-CoV-2 infection and 2 doses of either COVAXIN™ or COVISHIELD™ vaccination in RTR.MethodsThe serum anti-SARS-CoV-2 spike protein neutralizing antibody titer was measured in 370 RTRs who acquired SARS-CoV-2 infection (n=172), yet not vaccinated; and those vaccinated with COVAXIN™ (n=78), and COVISHIELD™ (n=120) by chemiluminescence microparticle immunoassay methods from serum.ResultOverall, the seroconversion rate either after vaccination or infection was 85.13% (315/370). The vaccine-associated seroconversion was 80.30% (159/198). SARS-CoV-2 infection-associated seroconversion was 90.69% (156/172), COVISHIELD™ associated seroconversion was 79.2% (95/120), and COVAXIN™ associated seroconversion was 82.05% (64/78). The median IgG titer in the SARS-CoV-2 infection group was 646.50 AU/ml (IQR: 232.52-1717.42), in the COVAXIN™ group was 1449.75 AU/ml (IQR: 400.0-3068.55), and the COVISHIELD™ vaccination group was 1500.51 AU/ml (IQR: 379.47-4938.50). The seroconversion rate and antibody titers were similar irrespective of the place of sampling. Patient’s age-associated seroconversion in <45 years was 88.01% (213/242), 45.1-60 years was 83.18% (94/113), and > 60 years was 58.3% (7/12).ConclusionsBoth infection and vaccination induce robust antibody formation in RTRs. The seroconversion rate after SARS-CoV-2 infection was higher but with a lower antibody titer than vaccines. The vaccines, COVAXIN™ and COVISHIELD™, induce more elevated antibody titers than natural infection. The seroconversion rate and antibody titer in Indian RTRs appears to be better than in the western population, irrespective of their vaccination status.

Higher pro‐inflammatory cytokines IL‐6 and IFN‐γ are associated with anti‐SARS‐CoV‐2 spike protein‐specific seroconversion in renal allograft recipients

“…Patients with hyper‐inflammatory responses often developed complications like tissue damage, acute respiratory distress syndrome, pulmonary fibrosis, multi‐organ failure, and ultimately higher mortality 10,11 . Moreover, patients with severe COVID‐19 had higher seroconversion rates, as observed in previous studies 6,7 . Our previous study and other studies in RTRs revealed several factors like HLA polymorphism, patient's age, and metabolic conditions influences the seroconversion rate 6–8,12 …”

“…10,11 Moreover, patients with severe COVID-19 had higher seroconversion rates, as observed in previous studies. 6,7 Our previous study and other studies in RTRs revealed several factors like HLA polymorphism, patient's age, and metabolic conditions influences the seroconversion rate. [6][7][8]12 Cytokines are small proteins of pleiotropic function produced by the activated immune cell-like macrophages, dendritic cells, T-cells, and resident cell-like endothelium.…”

“…6,7 Our previous study and other studies in RTRs revealed several factors like HLA polymorphism, patient's age, and metabolic conditions influences the seroconversion rate. [6][7][8]12 Cytokines are small proteins of pleiotropic function produced by the activated immune cell-like macrophages, dendritic cells, T-cells, and resident cell-like endothelium. Cytokine responses are the hallmark of immune activity and disease severity.…”

“…Immune responses of RTRs remain blunted due to the immunosuppression; therefore, optimal humoral response to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection remains suboptimal. [1][2][3][4] It was well observed that solid organ transplant recipients at a younger age, without antimetabolites immunosuppression, are more likely to develop an antibody against SARS-CoV-2, 5,6 which points out that a lower degree of immunosuppression may be associated with higher seroconversion rate.…”

Analysis of Robust Immune Response among Diabetic and Non-Diabetic Individuals against SARS-CoV-2 Vaccination

“…17 nine times more than the seropositivity threshold (9.5 AU/ml,), were recorded following vaccination as same as Klinger J et al, which showed nearly 8 times of the threshold raise. 18 Robust levels of SARS-CoV-2-total antibodies in the present cohort study after BBV-152 (CovaxinTM) and ChAdOx1-nCOV (CovishieldTM) in two doses show that all people have effective processing and presentation of antigens, suggested like different BBV-152 (CovaxinTM) and ChAdOx1-nCOV (CovishieldTM) vaccination studies in diverse cohorts. 15,16 Inhibition of the ACE2 receptor interaction and the spike (S1) protein of SARS-CoV-2 has been observed to be strongly positively correlated with viral neutralization experiments.…”