The type of SARS‐CoV‐2 vaccine influences serological response in kidney transplant recipients

Background Kidney transplant recipients and patients receiving hemodialysis are immunocompromised populations that are prioritized for COVID-19 vaccination but were excluded from clinical trials of SARS-CoV-2 mRNA vaccines. Antibody titers and rates of seroconversion following vaccination are lower among patients with chronic kidney disease and those taking immunosuppressants compared with controls. Data are lacking regarding their humoral response to vaccination to prevent COVID-19. Methods This investigation of early serological response after COVID-19 vaccination with the Pfizer/BioNTech (BNT162b2) mRNA vaccine included 78 patients undergoing hemodialysis, 74 kidney transplant recipients, and 7 healthy controls. We recorded data from the medical file for various clinical parameters, including response to hepatitis B vaccination, and measured antibody titers against SARS-CoV-2 at 0, 14, 28, 36 and 58 days after the first injection. Results In controls, we detected antibodies at a positive level (>13 arbitrary units per milliliter [AU/ml]) at day 14 postinjection, which increased progressively to peak at day 36 (1082 AU/ml; interquartile range [IQR], 735.0-1662.0]). Patients undergoing hemodialysis had lower titers that peaked at day 58 (276 AU/ml [IQR, 83.4-526.0]. We detected a positive antibody level in only three transplant recipients at day 36. In hemodialysis patients, those younger than 75 years had a higher antibody response versus those older than 75 years and serum albumin and Kt/V were positively correlated with serological response (P< 0.043 and P<0.019, respectively); nonresponders to HBV vaccine had the lowest anti-SARS-CoV-2 antibody titers. Conclusions Our results suggest that the postvaccination humoral response is strongly inhibited by immunosuppressant therapy in kidney transplant recipients and is reduced by the uremic condition in patients undergoing hemodialysis.

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Weak anti-SARS-CoV-2 antibody response after the first injection of an mRNA COVID-19 vaccine in kidney transplant recipients

10.1101/2021.03.08.21252741 ◽

2021 ◽

Author(s):

Ilies Benotmane ◽

Gabriela Gautier-Vargas ◽

Noelle Cognard ◽

Jerome Olagne ◽

Francoise Heibel ◽

...

Keyword(s):

Antibody Response ◽

Kidney Transplant ◽

Seroconversion Rate ◽

Clinical Population ◽

Serological Response ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Vaccine Injection

AbstractData concerning the anti-SARS-CoV-2 antibody response after mRNA COVID-19 vaccine in kidney transplant recipients (KTRs) are currently lacking. Here, we sought to examine this issue by analyzing the serological response observed in 241 KTRs after a first vaccine injection. Our results indicate that KTRs have a weak anti-SARS-CoV-2 antibody response, ultimately resulting in a low seroconversion rate (26/241, 10.8%). This phenomenon likely stems from a high immunosuppression burden in this clinical population.

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Serological response and disease-specific neutralizing antibodies in kidney transplant recipients with SARS-CoV-2 infection – a case series

10.21203/rs.3.rs-110295/v1 ◽

2020 ◽

Author(s):

Claudius Speer ◽

Paul Schnitzler ◽

Thomas Giese ◽

Anna Plaszczyca ◽

Ralf Bartenschlager ◽

...

Keyword(s):

Kidney Transplant ◽

Neutralizing Antibodies ◽

Case Series ◽

Immunological Response ◽

Kidney Graft ◽

Serological Response ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Disease Specific

Abstract Background Since SARS-CoV-2 is a highly contagious virus without an available disease-specific medication, the hope is focused on a sustained immunity after SARS-CoV-2 infection and a near-term successful vaccination therapy. A sufficient anti-SARS-CoV-2 antibody production with neutralizing antibodies is crucial to prevent further viral spreading and for protection against prospective reinfection. Kidney transplant recipients may have a potentially aggravated risk for COVID-19 complications as well as a reduced vaccine response due to the allograft protecting immunosuppressive therapy. However, little is known about the strength and duration of their immunological response upon SARS-CoV-2 infection.Case presentation Here we report on 4 kidney transplant recipients proven to have SARS-CoV-2 infection by positive PCR testing, focusing on their immunological response with the production of disease-specific neutralizing antibodies. All kidney transplant recipients developed a sufficient antibody response including specific neutralizing antibodies against SARS-CoV-2 within 2 to 3 weeks after the first onset of symptoms that sustained during the follow-up of 15 weeks. After 6 weeks, the virus was eliminated in all patients. Most important, the serological response and viral shedding were achieved and sustained in the presence of immunosuppression. Acute kidney graft deterioration was common but reconstituted in all transplant recipients during follow-up. Conclusions Immunocompromised kidney transplant recipients showed a functional serological response with disease-specific neutralizing antibodies upon SARS-CoV-2 infection, a basic prerequisite for a prospective successful vaccination response.

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In-depth virological assessment of kidney transplant recipients with COVID-19

10.1101/2020.06.17.20132076 ◽

2020 ◽

Author(s):

Ilies Benotmane ◽

Gabriela Gautier Vargas ◽

Marie-Josée Wendling ◽

Peggy Perrin ◽

Aurélie Velay ◽

...

Keyword(s):

Viral Load ◽

Kidney Transplant ◽

Symptom Onset ◽

Plasma Viral Load ◽

Humoral Response ◽

Serological Response ◽

Upper Respiratory Tract ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Viral Loads

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread widely, causing coronavirus disease 2019 (COVID-19) and significant mortality. However, data on viral loads and antibody kinetics in immunocompromised populations are lacking. We aimed to determine nasopharyngeal and plasma viral loads via RT-PCR and SARS-CoV-2 serology via ELISA and study their association with severe forms of COVID-19 and death in kidney transplant recipients. In this study we examined hospitalized kidney transplant recipients with non-severe (n = 21) and severe (n =19) COVID-19. SARS-CoV-2 nasopharyngeal and plasma viral load and serological response were evaluated based on outcomes and disease severity. Ten recipients (25%) displayed persistent viral shedding 30 days after symptom onset. The SARS-CoV-2 viral load of the upper respiratory tract was not associated with severe COVID-19, whereas the plasma viral load was associated with COVID-19 severity (p=0.0087) and mortality (p=0.024). All patients harbored antibodies the second week after symptom onset that persisted for two months. We conclude that plasma viral load is associated with COVID-19 morbidity and mortality, whereas nasopharyngeal viral load is not. SARS-CoV-2 shedding is prolonged in kidney transplant recipients and the humoral response to SARS-CoV-2 does not show significant impairment in this series of transplant recipients.

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