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Kinetics of humoral immune response and severity of infection after three doses of SARS-CoV-2 mRNA vaccine in a large cohort of kidney transplant recipients
BACKGROUND: COVID-19 in kidney transplant recipients is associated with high morbidity and mortality. In this study we aimed to evaluate: (i) the seroconversion rate after BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine, (ii) factors associated with humoral response, (iii) clinical outcome of COVID-19...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer International Publishing
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393874/ https://www.ncbi.nlm.nih.gov/pubmed/37458909 http://dx.doi.org/10.1007/s40620-023-01650-8 |
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author | Simone, Simona Pesce, Francesco Fontò, Giulia Pronzo, Virginia Pontrelli, Paola Conserva, Francesca Schirinzi, Annalisa Casanova, Annalisa Gallo, Pasquale Rossini, Michele Lucarelli, Giuseppe Spilotros, Marco Rendina, Maria Stallone, Giovanni Di Serio, Francesca Di Leo, Alfredo Tafuri, Silvio Ditonno, Pasquale Gesualdo, Loreto |
author_facet | Simone, Simona Pesce, Francesco Fontò, Giulia Pronzo, Virginia Pontrelli, Paola Conserva, Francesca Schirinzi, Annalisa Casanova, Annalisa Gallo, Pasquale Rossini, Michele Lucarelli, Giuseppe Spilotros, Marco Rendina, Maria Stallone, Giovanni Di Serio, Francesca Di Leo, Alfredo Tafuri, Silvio Ditonno, Pasquale Gesualdo, Loreto |
author_sort | Simone, Simona |
collection | PubMed |
description | BACKGROUND: COVID-19 in kidney transplant recipients is associated with high morbidity and mortality. In this study we aimed to evaluate: (i) the seroconversion rate after BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine, (ii) factors associated with humoral response, (iii) clinical outcome of COVID-19 in kidney transplanted patients. METHODS: We enrolled a cohort of 743 kidney transplant recipients followed up from March 2020 until April 2022. A subset of 336 patients, who received three-doses of SARS-CoV-2 vaccine, was analyzed in terms of kinetics of humoral immune response and compared to a control group of 94 healthcare workers. Antibody response was tested before vaccination (T(0)), 15 and 90 days after the second dose (T(1) and T(2)), on the day of the third dose (T(3)) and one month after the third dose (T(4)). RESULTS: We observed that 66 out of 743 subjects had COVID-19 infection pre-vaccination: 65.2% had severe symptoms, 27.3% were hospitalized (9 deaths), none were asymptomatic. After three doses, 51 patients had COVID-19 infection, 60.8% were asymptomatic, 27.5% reported mild symptoms, 3.9% showed severe symptoms, 7.8% were hospitalized (2 deaths). In the subset of 336 vaccinated patients, an antibody level > 0.8 U/ml was detected at T(1), that increased at T(2) and T(3,) peaking at T(4). Independent factors associated with a negative antibody titer at T(4) were decreasing estimated glomerular filtration rate, time from transplantation, and antimetabolites (all p < 0.001) and age (p = 0.007). CONCLUSIONS: The kinetics of humoral response after three doses of vaccine in kidney transplant patients is characterized by a late but effective immune response against SARS-CoV-2, reducing morbidity and mortality. GRAPHICAL ABSTRACT: [Image: see text] |
format | Online Article Text |
id | pubmed-10393874 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-103938742023-08-03 Kinetics of humoral immune response and severity of infection after three doses of SARS-CoV-2 mRNA vaccine in a large cohort of kidney transplant recipients Simone, Simona Pesce, Francesco Fontò, Giulia Pronzo, Virginia Pontrelli, Paola Conserva, Francesca Schirinzi, Annalisa Casanova, Annalisa Gallo, Pasquale Rossini, Michele Lucarelli, Giuseppe Spilotros, Marco Rendina, Maria Stallone, Giovanni Di Serio, Francesca Di Leo, Alfredo Tafuri, Silvio Ditonno, Pasquale Gesualdo, Loreto J Nephrol Original Article BACKGROUND: COVID-19 in kidney transplant recipients is associated with high morbidity and mortality. In this study we aimed to evaluate: (i) the seroconversion rate after BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine, (ii) factors associated with humoral response, (iii) clinical outcome of COVID-19 in kidney transplanted patients. METHODS: We enrolled a cohort of 743 kidney transplant recipients followed up from March 2020 until April 2022. A subset of 336 patients, who received three-doses of SARS-CoV-2 vaccine, was analyzed in terms of kinetics of humoral immune response and compared to a control group of 94 healthcare workers. Antibody response was tested before vaccination (T(0)), 15 and 90 days after the second dose (T(1) and T(2)), on the day of the third dose (T(3)) and one month after the third dose (T(4)). RESULTS: We observed that 66 out of 743 subjects had COVID-19 infection pre-vaccination: 65.2% had severe symptoms, 27.3% were hospitalized (9 deaths), none were asymptomatic. After three doses, 51 patients had COVID-19 infection, 60.8% were asymptomatic, 27.5% reported mild symptoms, 3.9% showed severe symptoms, 7.8% were hospitalized (2 deaths). In the subset of 336 vaccinated patients, an antibody level > 0.8 U/ml was detected at T(1), that increased at T(2) and T(3,) peaking at T(4). Independent factors associated with a negative antibody titer at T(4) were decreasing estimated glomerular filtration rate, time from transplantation, and antimetabolites (all p < 0.001) and age (p = 0.007). CONCLUSIONS: The kinetics of humoral response after three doses of vaccine in kidney transplant patients is characterized by a late but effective immune response against SARS-CoV-2, reducing morbidity and mortality. GRAPHICAL ABSTRACT: [Image: see text] Springer International Publishing 2023-07-17 2023 /pmc/articles/PMC10393874/ /pubmed/37458909 http://dx.doi.org/10.1007/s40620-023-01650-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Simone, Simona Pesce, Francesco Fontò, Giulia Pronzo, Virginia Pontrelli, Paola Conserva, Francesca Schirinzi, Annalisa Casanova, Annalisa Gallo, Pasquale Rossini, Michele Lucarelli, Giuseppe Spilotros, Marco Rendina, Maria Stallone, Giovanni Di Serio, Francesca Di Leo, Alfredo Tafuri, Silvio Ditonno, Pasquale Gesualdo, Loreto Kinetics of humoral immune response and severity of infection after three doses of SARS-CoV-2 mRNA vaccine in a large cohort of kidney transplant recipients |
title | Kinetics of humoral immune response and severity of infection after three doses of SARS-CoV-2 mRNA vaccine in a large cohort of kidney transplant recipients |
title_full | Kinetics of humoral immune response and severity of infection after three doses of SARS-CoV-2 mRNA vaccine in a large cohort of kidney transplant recipients |
title_fullStr | Kinetics of humoral immune response and severity of infection after three doses of SARS-CoV-2 mRNA vaccine in a large cohort of kidney transplant recipients |
title_full_unstemmed | Kinetics of humoral immune response and severity of infection after three doses of SARS-CoV-2 mRNA vaccine in a large cohort of kidney transplant recipients |
title_short | Kinetics of humoral immune response and severity of infection after three doses of SARS-CoV-2 mRNA vaccine in a large cohort of kidney transplant recipients |
title_sort | kinetics of humoral immune response and severity of infection after three doses of sars-cov-2 mrna vaccine in a large cohort of kidney transplant recipients |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10393874/ https://www.ncbi.nlm.nih.gov/pubmed/37458909 http://dx.doi.org/10.1007/s40620-023-01650-8 |
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