Detection of SARS-CoV-2 Antibodies in Kidney Transplant Recipients

Prendecki, Maria; Clarke, Candice; Gleeson, Sarah; Greathead, Louise; Santos, Eva Teixeira dos; McLean, A.G.; Randell, Paul; Moore, Luke; Mughal, Nabeela; Guckian, Mary; Kelleher, Peter; McAdoo, Stephen P.; Willicombe, Michelle

doi:10.1681/asn.2020081152

Cited by 35 publications

(35 citation statements)

References 6 publications

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“…Pendecki et al . [50] performed an extensive evaluation of SARS‐CoV‐2 IgG antibodies in 38 immunocompromised kidney transplant recipients, all of whom had tested positive for SARS‐CoV‐2 by PCR. In this cohort, only three of 38 (7·9%) failed to generate antibodies after infection.…”

Section: Immune Responses To Sars‐cov‐2 In Immunocompromised Patientsmentioning

confidence: 99%

Innate and adaptive immune responses to SARS-CoV-2 in humans: relevance to acquired immunity and vaccine responses

Jordan

2021

Clinical and Experimental Immunology

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Summary The factors responsible for the spectrum of coronavirus 19 (COVID‐19) disease severity and the genesis and nature of protective immunity against COVID‐19 remain elusive. Multiple studies have investigated the immune responses to COVID‐19 in various populations, including those without evidence of COVID‐19 infection. Information regarding innate and adaptive immune responses to the novel severe respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has evolved rapidly. Data are accumulating defining disease phenotypes that aid in rational and informed development of new therapeutic approaches for the treatment of patients infected with SARS‐CoV‐2 and the development of novel vaccines. In this paper, data on important innate immune responses are summarized, including cytokines, specifically interleukin (IL)‐6 and complement, and potential treatments are explored. Adaptive immune responses and derivative therapeutics such as monoclonal antibodies directed at spike proteins are also examined. Finally, data on real‐time assessments of adaptive immune responses are explored, which include CD4 + /CD8 + T cells, natural killer (NK) T cells, memory B cells and T follicular cells with specificities for COVID‐19 peptides in infected and normal individuals. Data of two novel vaccines have been released, both showing > 95% efficacy in preventing SARS‐CoV‐2 infection. Analysis of humoral and cellular responses to the vaccines will determine the robustness and durability of protection. In addition, long‐term assessment of SARS‐CoV‐2 memory B and T cell‐mediated immune responses in patients recovering from an infection or those with cross‐reactive immunological memory will help to define risk for future SARS‐CoV infections. Finally, patients recovering from SARS‐CoV‐2 infection may experience prolonged immune activation probably due to T cell exhaustion. This will be an important new frontier for study.

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Section: Immune Responses To Sars‐cov‐2 In Immunocompromised Patientsmentioning

confidence: 99%

Innate and adaptive immune responses to SARS-CoV-2 in humans: relevance to acquired immunity and vaccine responses

Jordan

2021

Clinical and Experimental Immunology

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“…Only a few studies, predominantly conducted with commercial serologic assays, have investigated SARS-CoV-2 prevalence in patients on maintenance dialysis, [33][34][35][36][37] with some of them having failure of seroconversion after documented COVID-19 infection 33,38 which could be related to the lower sensitivity of the assays used. 39,40 Although S1 and receptor-binding domain antibodies can provide information on functional immunity given reported correlations with neutralizing activity, 16,26,41,42 this has not yet been found for patients on dialysis.…”

Section: Discussionmentioning

confidence: 99%

Neutralizing Antibody Responses After SARS-CoV-2 Infection in End-Stage Kidney Disease and Protection Against Reinfection

Muir

Jaffer

Rees-Spear

et al. 2021

Kidney International Reports

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Patients with end-stage kidney disease (ESKD) represent a vulnerable group with multiple risk factors that are associated with poor outcomes after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Despite established susceptibility to infectious complications and the importance of humoral immunity in protection against SARS-CoV-2, few studies have investigated the humoral immune response to SARS-CoV-2 within this population. Here, we evaluate the seroprevalence of SARS-CoV-2 in patients awaiting renal transplantation and determine whether seroconverted patients with ESKD have durable and functional neutralizing activity against SARS-CoV-2. Serum samples were obtained from 164 patients with ESKD by August 2020. Humoral immune responses were evaluated by SARS-CoV-2 spike S1 subunit and nucleoprotein semiquantitative enzyme-linked immunosorbent assay (ELISA) and SARS-CoV-2 spike pseudotype neutralization assay. All patients with ESKD with reverse-transcriptase polymerase chain reaction (RT-PCR)–confirmed infection (n = 17) except for 1 individual seroconverted against SARS-CoV-2. Overall seroprevalence (anti-S1 and/or anti-N IgG) was 36% and was higher in patients on hemodialysis (44.2%). A total of 35.6% of individuals who seroconverted were asymptomatic. Seroconversion in the absence of a neutralizing antibody (nAb) titer was observed in 12 patients, all of whom were asymptomatic. Repeat measurements at a median of 93 days from baseline sampling revealed that most individuals retained detectable responses although a significant drop in S1, N and nAb titers was observed. Patients with ESKD, including those who develop asymptomatic disease, routinely seroconvert and produce detectable nAb titers against SARS-CoV-2. Although IgG levels wane over time, the neutralizing antibodies remain detectable in most patients, suggesting some level of protection is likely maintained, particularly in those who originally develop stronger responses.

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“…Interestingly, one patient who was less than 6 months from transplantation was able to seroconvert. In a different study, 855 consecutive kidney transplant recipients had their sera tested for the presence of nucleocapsid protein (NP) antibodies [61]; Of those 855, 33 had been previously diagnosed with COVID-19 as confirmed by RT-PCR. 66.6% of those who had proven infection had evidence of IgG at a median time of testing of 36 days following their diagnosis [61].…”

Section: Covid-19 Vaccination In Transplanted Patientsmentioning

confidence: 99%

“…In a different study, 855 consecutive kidney transplant recipients had their sera tested for the presence of nucleocapsid protein (NP) antibodies [61]; Of those 855, 33 had been previously diagnosed with COVID-19 as confirmed by RT-PCR. 66.6% of those who had proven infection had evidence of IgG at a median time of testing of 36 days following their diagnosis [61]. Therefore, despite paucity of data, there is evidence supporting satisfactory seroconversion rates in kidney transplant recipients.…”

Section: Covid-19 Vaccination In Transplanted Patientsmentioning

confidence: 99%

The impact of COVID‐19 on kidney transplantation and the kidney transplant recipient – One year into the pandemic

et al. 2021

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Summary The COVID‐19 pandemic has significantly changed the landscape of kidney transplantation in the United States and worldwide. In addition to adversely impacting allograft and patient survival in postkidney transplant recipients, the current pandemic has affected all aspects of transplant care, including transplant referrals and listing, organ donation rates, organ procurement and shipping, and waitlist mortality. Critical decisions were made during this period by transplant centers and individual transplant physicians taking into consideration patient safety and resource utilization. As countries have begun administering the COVID vaccines, new and important considerations pertinent to our transplant population have arisen. This comprehensive review focuses on the impact of COVID‐19 on kidney transplantation rates, mortality, policy decisions, and the clinical management of transplanted patients infected with COVID‐19.

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Detection of SARS-CoV-2 Antibodies in Kidney Transplant Recipients

Cited by 35 publications

References 6 publications

Innate and adaptive immune responses to SARS-CoV-2 in humans: relevance to acquired immunity and vaccine responses

Innate and adaptive immune responses to SARS-CoV-2 in humans: relevance to acquired immunity and vaccine responses

Neutralizing Antibody Responses After SARS-CoV-2 Infection in End-Stage Kidney Disease and Protection Against Reinfection

The impact of COVID‐19 on kidney transplantation and the kidney transplant recipient – One year into the pandemic

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