Humoral and cellular response of COVID‐19 vaccine among solid organ transplant recipients: A systematic review and meta‐analysis

Transplant Infectious Disease, Год журнала: 2022, Номер 24(6)

Опубликована: Авг. 4, 2022

We aimed to analyze the humoral and cellular response standard booster (additional doses) COVID-19 vaccination in solid organ transplantation (SOT) risk factors involved for an impaired response.We did a systematic review meta-analysis of studies published up until January 11, 2022, that reported immunogenicity vaccine among SOT. The study is registered with PROSPERO, number CRD42022300547.Of 1527 studies, 112 which 15391 SOT 2844 healthy controls, were included. showed low (effect size [ES]: 0.44 [0.40-0.48]) overall control (log-Odds-ratio [OR]: -4.46 [-8.10 -2.35]). was highest liver (ES: 0.67 [0.61-0.74]) followed by heart 0.45 [0.32-0.59]), kidney 0.40 [0.36-0.45]), kidney-pancreas 0.33 [0.13-0.53]), lung (0.27 [0.17-0.37]). dose 0.43 [0.39-0.47] vs. 0.51 [0.43-0.54]) marginal increase 18% efficacy. prior infection had higher 0.94 [0.92-0.96] ES: [0.39-0.41]; p-value < .01). seroresponse mRNA-12723 mRNA 0.52 (0.40-0.64). Mycophenolic acid (OR: 1.42 [1.21-1.63]) Belatacept 1.89 [1.3-2.49]) nonresponse. parallelly decreased 0.42 [0.32-0.52]) -3.12 [-0.4.12 -2.13]).Overall, develops suboptimal compared general population. Immunosuppression including mycophenolic acid, belatacept, tacrolimus associated response. Booster doses immune response, but further upgradation strategy required.

Язык: Английский

---

Immune Response to COVID-19 mRNA Vaccination in Previous Nonresponder Kidney Transplant Recipients After Short-term Withdrawal of Mycophenolic Acid 1 and 3 Months After an Additional Vaccine Dose

Transplantation, Год журнала: 2023, Номер 107(5), С. 1139 - 1150

Опубликована: Янв. 9, 2023

Background. The impaired immune response to coronavirus disease 2019 (COVID-19) vaccination in kidney transplant recipients (KTRs) leads an urgent need for adapted immunization strategies. Methods. Sixty-nine KTRs without seroconversion after ≥3 COVID-19 vaccinations were enrolled, and humoral was determined additional full-dose mRNA-1273 by measuring severe acute respiratory syndrome 2–specific antibodies neutralizing antibody activity against the Delta Omicron variants 1 3 mo postvaccination. T-cell analyzed postvaccination assessing interferon-γ release. Mycophenolic acid (MPA) withdrawn 41 wk before until 4 evaluate effects on immunogenicity. Graft function, changes donor-specific anti-HLA antibodies, donor-derived cell-free DNA monitored undergoing MPA withdrawal. Results. Humoral significantly stronger withdrawal postvaccination; however, overall waning immunity noted all vaccination. Higher anti-S1 immunoglobulin G levels correlated with better variants, whereas no significant association detected between activity. No rejection occurred during study, graft function remained stable In 22 variant breakthrough infections, 2 wild-type than variant. Conclusions. improve vaccine responsiveness should be critically evaluated because withdrawing may associated enhanced alloimmune response, initial effect of rates disappears

Язык: Английский

---

Efficacy and safety of COVID-19 vaccination in solid organ transplant recipients: A systematic review and network meta-analysis

American Journal of Transplantation, Год журнала: 2024, Номер 24(12), С. 2269 - 2281

Опубликована: Авг. 1, 2024

The impact of COVID-19 vaccination on clinical outcomes in solid organ transplant (SOT) recipients remains unclear. This systematic review and network meta-analysis sought to assess the efficacy safety SOT recipients. We searched 6 databases from inception March 1, 2024 for randomized controlled trials (RCTs) observational studies evaluating different strategies Based patient-important outcomes, we performed frequentist random-effects pairwise meta-analyses meta-analyses, separating RCTs nonrandomized evidence, used Grading Recommendation, Assessment, Development, Evaluation approach our certainty evidence. included (N = 814) 43 125 199). Overall, there is a paucity evidence vaccines including infection, mortality, hospitalization, ICU admission, rejection, demonstrated low very due studies' risk bias. Throughout pandemic, clinicians worked with minimal, low-quality relation this population. In instance future public health emergencies, researchers should collaborate closely patient partners ensure sufficient population outcomes.

Язык: Английский

---

Long-term immune response after SARS-CoV2 vaccination in solid organ transplant recipients

BMC Infectious Diseases, Год журнала: 2025, Номер 25(1)

Опубликована: Апрель 25, 2025

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccination in solid organ transplant (SOT) recipients is associated with suboptimal antibody response (AbR) favouring breakthrough infection (BI). The role of cell-mediated immunity (CMI) remains uncertain. Single-center prospective longitudinal cohort study adult SOT monitored for both AbR and CMI at 6 ± months after booster dosage SARS-CoV-2 vaccine. Primary end-point was BI diagnosis the main risk factor. Relationship between investigated by bivariate tests multivariable logistic regression. performed 139 patients. In 66 patients documented before CMI, thus 73 (33 kidney, 24 liver, 14 lung, heart) were analysed. first vaccine doses consisted BNT162b2 mRNA-1273 69.1% 30.9% cases, respectively. Whereas used as third dose 91.2% At a median 215 (IQR 181-252) days dose, 40 (54.8%) displayed 21 (28.8%) only 12 (16.4%) neither or CMI; there no showing negative positive CMI. Overall, 22 (30.1%) reported significant differences those vs. (59.1% 40.9%, p = 0.798), confirmed multiple regression adjusting age, type organs, high time from transplant. Our data suggest that population our cohort, does not appear to be strong predictor BI.

Язык: Английский

---

Nirmatrelvir/ritonavir for the treatment of immunocompromised adult patients with early‐stage symptomatic COVID‐19: A real‐life experience

Journal of Medical Virology, Год журнала: 2023, Номер 95(9)

Опубликована: Сен. 1, 2023

Regardless of vaccination status, progression to severe coronavirus disease 2019 (COVID-19) is still a relevant cause morbidity among immunocompromised patients. Despite the proven efficacy nirmatrelvir/ritonavir (NMV/r), concerns remain regarding potential for drug-to-drug interactions (DDIs) and safety in this at-risk population. We aimed evaluate clinical outcomes patients treated with NMV/r, as well occurrence DDIs treatment-emergent adverse events (TEAEs). This retrospective observational study included all some form immunosuppression laboratory-confirmed COVID-19 that received NMV/r at our center from April August 2022. The main outcome was worsening status (increase ≥1 point baseline validated scale) by Days +7 +28 after initiation therapy. Safety rates any TEAE potentially DDIs. 110 Main causes were hematological malignancy (58.2%) (mainly multiple myeloma [22.7%] non-Hodgkin lymphoma [13.6%]), active chemotherapy (30.0%) hematopoietic stem cell transplantation (14.5%). Clinical observed four (3.6%) five (4.5%), respectively. Only one patient had positive SARS-CoV-2 polymerase chain reaction test Day +28. At least DDI 56.4% rate attributable TEAEs 10.9%, although only two (1.8%) required premature discontinuation NMV/r. Early therapy should be considered COVID-19, particular attention interacting medications.

Язык: Английский

---

Humoral and cellular immune responses after COVID-19 vaccination of lung transplant recipients and patients on the waiting list: a 6-month follow-up

Frontiers in Immunology, Год журнала: 2024, Номер 14

Опубликована: Янв. 4, 2024

Background Data on cellular response and the decay of antibodies T cells in time are scarce lung transplant recipients (LTRs). Additionally, development durability humoral immune responses have not been investigated patients waitlist for transplantation (WLs). Here, we report our 6-month follow-up LTRs WLs, compared with controls. Methods Humoral to two doses mRNA-1273 vaccination were assessed by determining spike (S)-specific IgG neutralizing antibodies. Cellular interferon gamma (IFN-γ) release assay (IGRA) IFN-γ ELISpot at 28 days 6 months after second vaccination. Results In LTRs, level T-cell was significantly lower Also, WLs had antibody titers Six vaccination, all groups showed a decrease responses. rate decline higher than Conclusion Our results show that if they develop, rates comparable contrast, inferior rapid both WL imply may be protected adequately vaccinations repeat boostering necessary induce protection lasts beyond immediately post-transplantation.

Язык: Английский

---

Effectiveness of vaccination against SARS-CoV-2 and the need for alternative preventative approaches in immunocompromised individuals: a narrative review of systematic reviews

Expert Review of Vaccines, Год журнала: 2023, Номер 22(1), С. 341 - 365

Опубликована: Март 15, 2023

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including administration of booster doses, continues to be the most effective method for controlling COVID-19-related complications progression illness and death. However, there is mounting evidence that more needs done protect individuals with compromised immune function.Here, we review effectiveness COVID-19 vaccination in immunocompromised patients, those primary immunodeficiencies, HIV, cancer (including hematological malignancies), solid organ transplant recipients, chronic kidney disease, as reported systematic reviews/meta-analyses published over a 12-month period PubMed. Given varied responses patients function, major goal this analysis was try identify specific risk-factors related vaccine failure.COVID-19 remains global problem, new variants concern emerging at regular intervals. There an ongoing need optimal strategies combat pandemic. In addition, alternative treatment approaches are needed who may not mount adequate response current vaccines. Identification high-risk introduction newer antiviral such monoclonal antibodies will offer physicians therapeutic options vulnerable individuals.

Язык: Английский

---

COVID‑19 vaccination in liver transplant recipients (Review)

Experimental and Therapeutic Medicine, Год журнала: 2023, Номер 25(6)

Опубликована: Май 3, 2023

Severe acute respiratory syndrome coronavirus 2 (Sars‑CoV‑2) infection has significantly affected immunocompromised individuals and subsequently, liver transplant recipients (LTRs). Early in the course of pandemic, this vulnerable population was prioritized for vaccination, after obtaining encouraging data about vaccination benefits on disease severity mortality. As published knowledge mainly supported from studies which were limited to healthy population, present review summarizes literature 2019 (COVID‑19) LTRs available guidelines international societies. The COVID‑19 is strongly recommended as a safe effective measure order prevent severe

Язык: Английский

---

Humoral immune response following a third SARS-CoV-2 mRNA vaccine dose in solid organ transplant recipients compared with matched controls

Frontiers in Immunology, Год журнала: 2022, Номер 13

Опубликована: Дек. 9, 2022

Background Solid organ transplant (SOT) recipients have shown suboptimal antibody response following COVID-19 vaccination. Several risk factors for the diminished been identified including immunosuppression and older age, but influence of different comorbidities is not fully elucidated. Method This case-control study consisted 420 Danish adult SOT 840 sex- age-matched controls, all vaccinated with a third homologous dose either BNT162b2 (Pfizer–BioNTech) or mRNA-1273 (Moderna) vaccine. The primary outcome was differences in humoral immune response. secondary breakthrough infections. Additionally, we looked that could predict possible between two groups. Results Response rate increased from 186/382 (49%) to 275/358 (77%) remained on 781/790 (99%) 601/609 controls vaccine dose. had significantly lower median concentrations after compared (332.6 BAU/ml vs 46,470.0 BAU/ml, p &lt;0.001). Lowest were seen liver disease (10.3 IQR 7.1-319) diabetes (275.3 7.3-957.4). Breakthrough infections occurred similarly frequent, 150 (40%) among cases 301 (39%) (p = 0.80). Conclusion A resulted significant increase immunogenicity maintained high controls. Furthermore, less likely produce antibodies overall immunity highly influenced by presence diabetes. prevalence similar

Язык: Английский

---

Cell-mediated and Neutralizing Antibody Responses to the SARS-CoV-2 Omicron BA.4/BA.5–adapted Bivalent Vaccine Booster in Kidney and Liver Transplant Recipients

Transplantation Direct, Год журнала: 2023, Номер 9(10), С. e1536 - e1536

Опубликована: Сен. 20, 2023

The immunogenicity elicited by the Omicron BA.4/BA.5-adapted bivalent booster vaccine after solid organ transplantation (SOT) has not been characterized.

Язык: Английский

---