Effectiveness, Immunogenicity and Harms of Additional SARS-CoV-2 Vaccine Doses in Kidney Transplant Recipients: A Systematic Review

Hausinger, Renate; Bachmann, Quirin; Crone-Rawe, Timotius; Hannane, Nora; Monsef, Ina; Haller, Bernhard; Heemann, Uwe; Skoetz, Nicole; Kreuzberger, Nina; Schmaderer, Christoph

doi:10.3390/vaccines11040863

Cited by 2 publications

(2 citation statements)

References 80 publications

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“…Notably, only just four hospital admissions or deaths occurred in 564 patients. 41 Consequently, more multicenter studies with longer observation periods are needed to accurately assess the role of COVID-19 vaccine in HSCT patients and to evaluate whether its effectiveness is similar to that in other immunocompromised populations.…”

Section: Outcomes In Car-t Cell Therapy Recipientsmentioning

confidence: 99%

COVID‐19 in hematopoietic stem‐cell transplant recipients: A systematic review and meta‐analysis of clinical characteristics and outcomes

Randi,

Higashino,

Silva

et al. 2023

Reviews in Medical Virology

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Patients who undergo hematopoietic stem‐cell transplantation (HSCT) are more susceptible to developing severe forms of COVID‐19 with an increased risk of mortality. The aim of this study was to analyze, by performing a systematic review and meta‐analysis, all studies that evaluated COVID‐19 in HSCT adult recipients and present clinical characteristics and outcomes. Studies were eligible for inclusion if they: (I) described the clinical characteristics of COVID‐19 in adult (aged 18 years old or above) HSCT recipients; (II) described outcomes of COVID‐19 in this population, mainly lethality; (III) were full‐text articles. We searched MedLine, Embase, SCOPUS, LILACS and Web of Science for full‐text studies that evaluated COVID‐19 in adult HSCT patients until 26 Apr 2023. Two independent reviewers screened the articles and extracted the data. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Studies Reporting Prevalence Data was used to assess quality of the included studies. Meta‐analysis was performed and the pooled prevalence of severe/critical disease and of death with a 95% CI was calculated with the random‐effects model. Sixteen studies were included; seven (43.7%) were multicenter. Most of the studies were from Europe (37.5%). All of them had a low risk of bias using the JBI Checklist. A total of 1186 patients were included. Allogeneic HSCT patients were the majority in most studies, with a total of 861 patients (72.5%). The symptomatic rate was 79.4%. The pooled prevalence of severe/critical COVID‐19 was 24.0% (95% CI 0.13–0.36; I2 = 94%; n = 334/990). The pooled prevalence of death for the entire population was 17% (95% CI 0.13–0.22; I2 = 76%; n = 221/1117), 17% (95% CI 0.12–0.23; I2 = 67%; n = 152/822) for allogeneic‐HSCT and 14% (95% CI 0.08–0.22; I4 = 65%; n = 48/293) for autologous‐HSCT. In conclusion, frequently the infection of SARS‐CoV‐2 in HSCT was symptomatic and lethality is higher than in general population. Thus, it is essential to focus on the implementation of measures to mitigate the risk of SARS‐CoV‐2 infection in this population, as well as to carefully assess HSCT recipients who develop COVID‐19.

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Section: Outcomes In Car-t Cell Therapy Recipientsmentioning

confidence: 99%

COVID‐19 in hematopoietic stem‐cell transplant recipients: A systematic review and meta‐analysis of clinical characteristics and outcomes

Randi,

Higashino,

Silva

et al. 2023

Reviews in Medical Virology

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“…Severe disease after infection was rarely reported, but all involved KTRs who had no immune response after vaccination [ 22 ]. Breakthrough infections thus occur in KTRs when the vaccine was ineffective.…”

Section: Introductionmentioning

confidence: 99%

Humoral immunity to SARS-CoV-2 in kidney transplant recipients and dialysis patients: IgA and IgG patterns unraveled after SARS-CoV-2 infection and vaccination

De Bouver,

Bouziotis,

Wijtvliet

et al. 2024

Virol J

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Background Infection with SARS-CoV-2 in high-risk groups such as kidney transplant and dialysis patients is shown to be associated with a more serious course of the disease. Four years after the start of the COVID-19 pandemic, crucial knowledge on the immune responses in these patient groups is still lacking. Therefore, this study aimed at investigating the humoral immune response after a SARS-CoV-2 infection compared to vaccination as well as the evolution of immunoglobulins over time. Methods Kidney transplant recipients, patients on haemodialysis or on peritoneal dialysis and healthy controls were included in this longitudinal multicenter study. SARS-CoV-2 anti-RBD, anti-NP and anti-S1S2 immunoglobulin G (IgG) and A (IgA) as well as the neutralizing antibody capacity were measured. Results Kidney transplant recipients had a significantly better humoral response to SARS-CoV-2 after infection (86.4%) than after a two-dose mRNA vaccination (55.8%) while seroconversion was comparable in patients on haemodialysis after infection (95.8%) versus vaccination (89.4%). In individuals without prior COVID-19, the IgG levels after vaccination were significantly lower in kidney transplant recipients when compared to all other groups. However, the IgA titres remained the highest in this patient group at each time point, both after infection and vaccination. A history COVID-19 was associated with higher antibody levels after double-dose vaccination in all patient categories and, while decreasing, titres remained high six months after double-dose vaccination. Conclusion Kidney transplant recipients had a more robust humoral response to SARS-CoV-2 following infection compared to a two-dose mRNA vaccination, while patients on haemodialysis exhibited comparable seroconversion rates. Notably, individuals with prior COVID-19 exhibited higher IgG levels in response to vaccination. Hybrid immunity is thus the best possible defence against severe COVID-19 disease and seems also to hold up for these populations. Next, it is not clear whether the higher IgA levels in the kidney transplant recipients is beneficial for neutralizing SARS-CoV-2 or if it is a sign of disease severity.

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Effectiveness, Immunogenicity and Harms of Additional SARS-CoV-2 Vaccine Doses in Kidney Transplant Recipients: A Systematic Review

Cited by 2 publications

References 80 publications

COVID‐19 in hematopoietic stem‐cell transplant recipients: A systematic review and meta‐analysis of clinical characteristics and outcomes

COVID‐19 in hematopoietic stem‐cell transplant recipients: A systematic review and meta‐analysis of clinical characteristics and outcomes

Humoral immunity to SARS-CoV-2 in kidney transplant recipients and dialysis patients: IgA and IgG patterns unraveled after SARS-CoV-2 infection and vaccination

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