Early humoral immune response to two doses of severe acute respiratory syndrome coronavirus 2 vaccine in a diverse group of solid organ transplant candidates and recipients

Abstract

Response to two doses of a nucleoside‐modified messenger ribonucleic acid (mRNA) vaccine was evaluated in a large solid‐organ transplant program. mRNA COVID‐19 vaccine was administered to transplant candidates and recipients who met study inclusion criteria. Qualitative anti‐SARS‐CoV‐2 Spike Total Immunoglobulin (Ig) and IgG‐specific assays, and a semi‐quantitative test for anti‐SARS‐CoV‐2 Spike protein IgG were measured in 241 (17.2%) transplant candidates and 1163 (82.8%) transplant recipients; 55.2% of whom were non‐Hispanic White and 44.8% identified as another race. Transplant recipients were a median (IQR) of 3.2 (1.1, 6.8) years from transplantation. Response differed by transplant status: 96.0% versus 43.2% by the anti‐SARS‐CoV‐2 Total Ig (candidates vs. recipients, respectively), 93.5% versus 11.6% by the anti‐SARS‐CoV‐2 IgG assay, and 91.9% versus 30.1% by anti‐spike titers after two doses of vaccine. Multivariable analysis revealed candidates had higher likelihood of response versus recipients (odds ratio [OR], 14.6; 95 %CI 2.19, 98.11; P = .02). A slightly lower response was demonstrated in older patients (OR .96; 95 %CI .94, .99; P = .002), patients taking antimetabolites (OR, .21; 95% CI .08, .51; P = .001). Vaccination prior to transplantation should be encouraged.

Immunogenicity of COVID‐19 vaccines in chronic liver disease patients and liver transplant recipients: A systematic review and meta‐analysis

“…After the removal of duplicates and other articles that were irrelevant to this study (based on title and abstract), 41 potentially relevant articles remained and their full texts were evaluated. Based on the inclusion criteria, 19 studies 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 that included 4191 participants (1624 CLD patients, 1700 LT recipients and 867 healthy controls) were included (Figure 1 ). Seven studies 18 , 24 , 26 , 31 , 33 , 35 , 36 included CLD patients and 15 studies 19 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 included LT recipients.…”

“…Based on the inclusion criteria, 19 studies 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 that included 4191 participants (1624 CLD patients, 1700 LT recipients and 867 healthy controls) were included (Figure 1 ). Seven studies 18 , 24 , 26 , 31 , 33 , 35 , 36 included CLD patients and 15 studies 19 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 included LT recipients. Of the 19 studies, 15 studies 19 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 28 ,…”

“…Seven studies 18 , 24 , 26 , 31 , 33 , 35 , 36 included CLD patients and 15 studies 19 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 included LT recipients. Of the 19 studies, 15 studies 19 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 used mRNA vaccines (BioNTech vaccine: BNT162B2 or Moderna vaccine: mRNA‐1273) and 4 studies 18 , 24 , 35 , 36 used inactivated vaccines (Sinovac vaccine: CoronaVac, Sinopharm vaccine: BBIBP‐CorV and Sinopharm vaccine: WIBP‐CorV). Three studies 31 , 33 , 34 used mRNA vaccines and included a small proportion (0.8%–25%) of patients who received adenovirus vector vaccines (Johnson and Johnson vaccine: JNJ‐78436735 and AstraZeneca vaccine: AZD1222), but data were not reported separately, so these studies were included in the analyses of mRNA vaccines.…”

“…The majority of the studies selected a time frame of 2–5 weeks after the second vaccination to assess the immune responses to COVID‐19 vaccines. Five studies 18 , 21 , 24 , 31 , 36 showed a low risk of bias (7‐8 points), with 14 studies 19 , 20 , 22 , 23 , 25 , 26 , 27 , 28 , 29 , 30 , 32 , 33 , 34 , 35 having a moderate bias risk (5‐6 points). Characteristics of the included studies are summarized in Table 1 .…”

Alterations in arthropod and neuronal exosomes reduce virus transmission and replication in recipient cells

“…Exosomes are membrane-bound small vesicles that have become the highlight of research in infectious diseases [1][2][3][4][5][6][7][8][9][10][11][12] . Several viruses perhaps use exosomes [small extracellular vesicles (EVs) of 30-120 nm, with infectious cargo] for transmission of viral RNA/proteins to the naïve recipient host cells [2][3][4][13][14][15][16][17][18][19][20][21][22] . Our previous studies have shown that arthropod-borne flavivirus full-length RNA genomes and proteins [such as Envelope protein, Non-Structural protein 1 (NS1) and/or polyprotein] are transmitted to the vertebrate host cells via arthropod exosomes [1,3,4,23] .…”