Serologic Status According Severe Acute Respiratory Syndrome Coronavirus 2 in Patients After Orthotopic Heart Transplantation

Kuczaj, Agnieszka; Przybyłowski, Piotr

doi:10.1016/j.transproceed.2022.02.044

Cited by 1 publication

(2 citation statements)

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“…In the current study, seronegative status before infection has been proven to be a significant predictor of severe infection. Kuczaj et al reported similar results: in their HTX population, none of the vaccinated and then infected patients ( n = 6) had detectable antibodies after the vaccination and, on the other hand, none of the patients with detectable antibodies against SARS‐CoV‐2 spike protein contracted COVID‐19 disease (infection severity was not evaluated in this study) 33 . An analysis of thoracic and abdominal organ recipients showed a significantly lower rate of positive antibody response after vaccination in those patients who required hospitalization due to SARS‐CoV‐2 infection compared with nonhospitalized individuals 29 .…”

Section: Discussionsupporting

confidence: 68%

“…similar results: in their HTX population, none of the vaccinated and then infected patients (n = 6) had detectable antibodies after the vaccination and, on the other hand, none of the patients with detectable antibodies against SARS-CoV-2 spike protein contracted COVID-19 disease (infection severity was not evaluated in this study). 33 An analysis of thoracic and abdominal organ recipients showed a significantly lower rate of positive antibody response after vaccination in those patients who required hospitalization due to SARS-CoV-2 infection compared with nonhospitalized individuals. 29 The ESOT also recommends to use the titer of anti-spike IgG in specific cases to estimate the level of protection of transplant recipients against severe COVID-19.…”

Section: Discussionmentioning

confidence: 98%

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Seroconversion after SARS‐CoV‐2 vaccination is protective against severe COVID‐19 disease in heart transplant recipients

Kugler,

Vári,

Veres

et al. 2023

Immunity Inflam & Disease

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BackgroundHeart transplant (HTX) recipients are prone to develop complications after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Vaccination is often ineffective due to weaker immunogenicity. In this high‐volume single‐center study, we aimed to determine factors influencing seroconversion after vaccination and predictors of severe SARS‐CoV‐2 infection.MethodsTwo hundred twenty‐nine HTX recipients were enrolled. Type of the first two vaccine doses included messenger RNA (mRNA), vector, and inactivated vaccines. We carried out analyses on seroconversion after the second and third doses of vaccination and on severity of infection. Antispike protein SARS‐CoV‐2 immunoglobulin G (IgG) was measured after the second and third vaccines and serostatus was defined. Effect of the first two vaccine doses was studied on patients who did not suffer SARS‐CoV‐2 infection before antibody measurement (n = 175). The effectivity of the third vaccine was evaluated among seronegative recipients after the second vaccine (n = 53). Predictors for severe infection defined as pneumonia, hospitalization or death were assessed in all patients who contracted SARS‐CoV‐2 infection (n = 92).Results62% of the recipients became seropositive after the second vaccination. Longer time between HTX and vaccination (odds ratio [OR]: 2.35) and mRNA vaccine (OR: 4.83) were predictors of seroconversion. 58% of the nonresponsive patients became seropositive after receiving the third vaccine. Male sex increased the chance of IgG production after the third dose (OR: 5.65). Clinical course of SARS‐CoV‐2 infection was severe in 32%. Of all parameters assessed, only seropositivity before infection was proven to have a protective effect against severe infection (OR: 0.11).ConclusionsWe found that longer time since HTX, mRNA vaccine type, and male sex promoted seroconversion after SARS‐CoV‐2 vaccination in HTX recipients. Seropositivity—but not the number of vaccine doses—seemed to be protective against severe SARS‐CoV‐2 infection. Screening of HTX patients for anti‐SARS‐COV‐2 antibodies may help to identify patients at risk for severe infection.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 98%