Clinical Characteristics and Outcomes of Immunocompromised Patients With Coronavirus Disease 2019 Caused by the Omicron Variant: A Prospective, Observational Study

Malahe, S. Reshwan K.; Hoek, Rogier A.S.; Dalm, Virgil A. S. H.; Broers, Annoek E.C.; Hoed, Caroline M. den; Manintveld, Olivier C.; Baan, Carla C.; Deuzen, Charlotte M. van; Papageorgiou, Grigorios; Bax, Hannelore I.; Kampen, Jeroen J Van; Hellemons, Merel E.; Kho, Marcia M. L.; Vries, Rory D de; Molenkamp, Richard; Reinders, Marlies E.J.; Rijnders, Bart

doi:10.1093/cid/ciac571

Cited by 72 publications

(76 citation statements)

References 23 publications

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“…We described 20% mortality in a single-center cohort of hospitalized transplant patients in Saudi Arabia infected with Omicron variants while a recent study in USA showed that the mortality of hospitalized transplant recipients during the Omicron surge was only 4%. The main reason for the high mortality in our study is the lower three doses vaccination status compared to the other study; 36% versus 89% [6]. In addition, COVID-19 monoclonal antibodies were used in 74% of patients in the second study while none of our patients received sotrovimab.…”

Section: Discussionmentioning

confidence: 66%

Outcome of Transplant Recipients Infected with Omicron BA.1 and BA.2: A Single-Center Retrospective Study in Saudi Arabia

Alshukairi

Aldabbagh

Adroub

et al. 2023

J Epidemiol Glob Health

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The outcome of transplant recipients is variable depending on the study population, vaccination status and COVID-19 variants. Our aim was to study the impact of Omicron subvariants on the mortality of transplant recipients. We reviewed the results of SARS-CoV-2 whole genome sequence of random isolates collected from 29 December 2021 until 17 May 2022 in King Faisal Specialist Hospital and Research center, Jeddah (KFSHRC-J), Saudi Arabia performed as hospital genomic surveillance program for COVID-19 variants. We included 25 transplant patients infected with confirmed Omicron variants.17 (68%) and 8 (32%) patients had Omicron BA.1 and BA.2, respectively. 12 (68%) patients had renal transplants. Only 36% of patients received three doses of COVID-19 vaccines. 23 (92%) patients required hospitalization. 20 (80%) patients survived and 6 (25%) required intensive care unit (ICU) admission. Among ICU patients, 66.7% were more than 50 years, 50% had two to three comorbidities and 5 out of 6 (83%) died. The mortality of transplant patients infected with Omicron variants in our cohort was higher than other centers as a limited number of patients received booster vaccines. Optimizing booster vaccination is the most efficient method to improve the mortality of COVID-19 in transplant recipients recognizing the inefficacy of monoclonal antibodies in the presence of SARS-CoV-2 emerging variants. We did not show a difference in mortality in transplant patients infected with Omicron BA.1 and BA.2 knowing the limitation of our sample size.

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Section: Discussionmentioning

confidence: 66%

Outcome of Transplant Recipients Infected with Omicron BA.1 and BA.2: A Single-Center Retrospective Study in Saudi Arabia

Alshukairi

Aldabbagh

Adroub

et al. 2023

J Epidemiol Glob Health

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“…With an overall 20% mortality rate, solid organ transplant recipients have worse outcomes after SARS-CoV-2 infection [ 1 ]. Even when infected by the less lethal SARS-CoV-2 Omicron variant, hospital admission rate is higher and the duration of symptoms is more prolonged in HTx patients, compared to non-immunocompromised individuals [ 9 ]. Although a lot of effort and hope has been put on vaccines, as a strategy to protect this group of patients, the large randomized clinical trials excluded immunocompromised patients in their design.…”

Section: Discussionmentioning

confidence: 99%

T Cell and Antibody Response Following Double Dose of BNT162b2 mRNA Vaccine in SARS-CoV-2 Naïve Heart Transplant Recipients

et al. 2022

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Introduction: Preliminary studies have suggested a low post-vaccination antibody response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in heart transplant(HTx)recipients. Although many studies have focused on the role of antibodies in vaccine-induced protection against SARS-CoV-2, the role of T cell immunity is less well characterized. To date, data regarding seroconversion and T cell response after mRNA SARS-CoV-2 vaccination in patients undergoing HTx are scarce. Therefore, the present study aimed to assess the specific memory humoral and cellular responses after two doses of the BNT162b2 vaccine in HTx recipients. Methods: Blood was drawn from heart transplant (HTx) recipients at two pre-specified time points after the first and second vaccine doses to measure both the anti-SARS-CoV-2 antibody response against the spike protein and the SARS-CoV-2-reactive T cell response. Results: Our study included 34 SARS-CoV-2 naïve HTx recipients (mean age, 61 ± 11 years). The mean time from transplantation to the first vaccine dose is 10 ± 10 years. Subgroup analysis (n = 21) demonstrated that after the first vaccine dose, only 14% had antibodies and 19% had a SARS-CoV-2-reactive T-cell response, which increased to 41% and 53%, respectively, after the second dose. Interestingly, 20% of patients with no antibodies after the second dose still had a positive SARS-CoV-2-reactive T cell response. The percentage of patients with positive S-IgG antibody titers was significantly higher 5 years after transplantation (18% 0–5 years post-TX vs. 65% 5 years post-TX, p = 0.013). Similarly, 5 years after heart transplantation, the percentage of patients with a T cell response was significantly higher (35% 0–5 years post-TX vs. 71% 5 years post-TX, p = 0.030). Conclusions: In SARS-CoV-2 naïve HTx recipients, post-vaccination antibody titers but also SARS-CoV-2 specific T cell response are low. Therefore, the protection from SARS-CoV-2 that is generally attributed to vaccination should be regarded with caution in HTx recipients.

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“…Although the severity of the COVID-19 illness caused by the Omicron variant appears to have been reduced compared to that in the pre-Omicron era, probably owing to the attenuated virulence of the strain and the pre-existing immunity derived from previous infection and vaccination, its rapid spread has resulted in a cumulative increase in acute care visits, hospitalizations, and mortality events [ 6 , 7 ]. Additionally, there are still concerns regarding the impact of COVID-19 on vulnerable populations, such as immunocompromised patients and those with multimorbidity, who have increased risks of hospitalization and prolonged illness durations, even in the Omicron era [ 8 , 9 , 10 , 11 ]. As one of the populations susceptible to this contagious disease, hemodialysis (HD) patients have a remarkably high risk of COVID-19 infection and disease progression owing to the need for regular dialysis visits, multiple comorbidities, and impaired immune responses to pathogens and vaccinations [ 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Real-World Effectiveness of SARS-CoV-2 Vaccine Booster in Hemodialysis Patients with COVID-19 Receiving Molnupiravir

Chen

Huang

et al. 2023

Viruses

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine booster is one of the most essential strategies against coronavirus disease 2019 (COVID-19) in the era of emerging variants. However, the effectiveness of SARS-CoV-2 vaccine boosters has not much been investigated in hemodialysis (HD) patients receiving oral antiviral agents. In this retrospective study involving 258 HD patients with COVID-19 receiving molnupiravir, we stratified the study cohort according to vaccination status and compared the baseline characteristics and risks of 30-day composite events (COVID-19-related acute care visits, hospitalization, or mortality) among groups. Our analysis demonstrated that the SARS-CoV-2 vaccine boosters markedly decreased the risk of composite events in HD patients (hazard ratio (95% confidence interval), 0.163 (0.063–0.423) for three vs. ≤ two doses of vaccination, p < 0.001; 0.309 (0.115–0.830) for four vs. ≤ two doses of vaccination, p = 0.020). The benefits of vaccine boosters were similar between patients receiving mRNA-based and protein-based boosters and between those with post-booster intervals of ≤ 120 and > 120 days. In conclusion, for HD patients with initially mild or asymptomatic COVID-19 receiving molnupiravir, the benefits of SARS-CoV-2 vaccine boosters are prominent, irrespective of booster vaccine types.

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Clinical Characteristics and Outcomes of Immunocompromised Patients With Coronavirus Disease 2019 Caused by the Omicron Variant: A Prospective, Observational Study

Cited by 72 publications

References 23 publications

Outcome of Transplant Recipients Infected with Omicron BA.1 and BA.2: A Single-Center Retrospective Study in Saudi Arabia

Outcome of Transplant Recipients Infected with Omicron BA.1 and BA.2: A Single-Center Retrospective Study in Saudi Arabia

T Cell and Antibody Response Following Double Dose of BNT162b2 mRNA Vaccine in SARS-CoV-2 Naïve Heart Transplant Recipients

Real-World Effectiveness of SARS-CoV-2 Vaccine Booster in Hemodialysis Patients with COVID-19 Receiving Molnupiravir

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