Humoral response to SARS-CoV-2 adenovirus vector vaccination (ChAdOx1 nCoV-19 [AZD1222]) in heart transplant recipients aged 18 to 70 years of age

Tanner, Richard; Starr, Neasa; Chan, Grace; Dempsey, Eimear; Heffernan, Emma; Newman, Ellen; O’Neill, James Paul; Hannan, Margaret M.; Lynch, Breda; Joyce, Emer

doi:10.1016/j.healun.2022.01.005

Cited by 14 publications

(32 citation statements)

References 26 publications

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“…ChAdOx1 nCoV-19 appeared to have ble immunogenicity in patients with varying degrees of immunocompromised statu tably, ChAdOx1 nCoV-19 has shown promising immunogenicity in ESRD patient HD compared with those undergoing kidney transplantation [33]. Similarly, ChA nCoV-19 did not work well in heart transplant recipients [34]. On the other hand, pa with HIV had favorable immune responses after two doses of ChAdOx1 nCoV-1…”

Section: Discussionmentioning

confidence: 99%

ChAdOx1 nCoV-19 Immunogenicity and Immunological Response Following COVID-19 Infection in Patients Receiving Maintenance Hemodialysis

et al. 2022

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Patients with end-stage renal disease (ESRD) receiving hemodialysis (HD) were found to have a decreased immune response following mRNA COVID-19 immunization. ChAdOx1 nCoV-19 was a promising COVID-19 vaccine that performed well in the general population, but the evidence on immunogenicity in ESRD with HD patients was limited. Moreover, the immunological response to COVID-19 infection was inconclusive in patients with ESRD and HD. The aim of this study was to investigate the immunogenicity of ChAdOx1 nCoV-19 vaccination and the immunological response after COVID-19 infection in ESRD patients with HD. The blood samples were obtained at baseline, 1-month, and 3-month follow-up after each shot or recovery. All participants were measured for anti-spike IgG by the ELISA method, using Euroimmun. This study found a significant increase in anti-spike IgG after 1 month of two-shot ChAdOx1 nCoV-19 vaccination, followed by a significant decrease after 3 months. On the other hand, the anti-spike IgG was maintained in the post-recovery group. There was no significant difference in the change of anti-spike IgG between the one-shot ChAdOx1 nCoV-19-vaccinated and post-recovery groups for both 1-month and 3-month follow-ups. The seroconversion rate for the vaccinated group was 60.32% at 1 month after one-shot vaccination and slightly dropped to 58.73% at the 3-month follow-up, then was 92.06% at 1 month after two-shot vaccination and reduced to 82.26% at the 3-month follow-up. For the recovered group, the seroconversion rate was 95.65% at 1 month post-recovery and 92.50% at 3-month follow-up. This study demonstrated the immunogenicity of two-dose ChAdOx1 nCoV-19 in ESRD patients with HD for humoral immunity. After COVID-19 infection, the humoral immune response was strong and could be maintained for at least three months.

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Section: Discussionmentioning

confidence: 99%

ChAdOx1 nCoV-19 Immunogenicity and Immunological Response Following COVID-19 Infection in Patients Receiving Maintenance Hemodialysis

et al. 2022

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“…in the Israeli cohort in association with postdose 3 results. 5 , 6 In the current study, a mycophenolate‐based regimen was numerically more likely in those with a nondetectable antibody response compared to detectable (80% vs. 62%) but only trended toward significance ( p = .08), likely reflecting the modestly smaller numbers completing this study. Furthermore, shorter time interval since transplant and triple versus dual immunosuppressant regimens were significantly more common in those with a nondetectable response; similar signals were seen in both the postkidney transplant population in the randomized clinical trial noted above and a recent meta‐analysis on SOT recipients.…”

Section: Discussionmentioning

confidence: 56%

“…Each patient had a known antibody status after each of the initial two vaccines from phase one of our study. 5 …”

Section: Methodsmentioning

confidence: 99%

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Humoral response to heterologous prime‐booster vaccination in heart transplant recipients aged 18–70 years primed with a viral vector SARS‐CoV‐2 vaccine

Tanner

Starr

Perez-Garcia

et al. 2022

Transplant Infectious Dis

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Solid organ transplant recipients have demonstrated a blunted immune response to standard 2‐dose vaccination against SARS‐CoV‐2. This study sought to determine the humoral response to heterologous booster vaccination (viral vector vaccine dose 1 and 2 + mRNA booster). Heart transplant recipients, aged 18 to 70 years of age who initially received two doses of the viral vector ChAdOx1 nCoV‐19 vaccine followed by a BNT162b2 mRNA booster were recruited. A detectable antibody response in the absence of prior SARS‐CoV‐2 was the primary outcome measured. This was defined as an anti‐spike titre of ≥0.8 U/mL on the Elecsys anti‐SARS‐CoV‐2 S immunoassay. A total of 80 heart transplant patients (mean age 49 ± 13 years, 28% female) were included. Blood samples were drawn at a median of 30 (IQR 28‐33) days after the BNT162b2 mRNA booster. The frequency of a detectable antibody response increased from 37.5% ( n = 30) after dose 2 to 56% ( n = 45) post dose 3 ( p < 0.001). A non‐detectable antibody response was significantly more common in recipients with a shorter time interval from transplantation ( p < 0.001), lower likelihood of cardiac allograft vasculopathy (p = 0.003) and in those prescribed a triple versus dual immunosuppressant regime ( p = 0.009) and a tacrolimus versus cyclosporine basedregimen ( p = 0.007). Despite heterologous prime‐booster vaccination 44% of this vulnerable population ultimately continue to have no detectable antibodies.

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“…2,11 The overall seroconversion rate ranged from 20.7% to 71.9% and most studies described reduced seroconversion (and lower serum concentration of antibodies) in patients receiving MMF compared to patients receiving MMF-free immunosuppression regimes. In some studies, a dose-dependent impairment of the humoral response was observed, 6,8,9,16 particularly when daily dose of MMF was higher than 1000 mg per day. 8 In all, 11 studies allowed quantitative synthesis comprising 2694 solid organ transplant recipients, 67.9% of them receiving MMF-containing immunosuppression regimes.…”

Section: Mycophenolate and Sars-cov-2 Vaccination: Mixing Oil And Watermentioning

confidence: 99%

Mycophenolate and SARS‐CoV‐2 vaccination: Mixing oil and water

Larriva

Rodríguez‐Perálvarez

2022

Liver International

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Forest plot diagram illustrating the likelihood of seroconversion after vaccination against SARS-CoV-2 among 11 observational studies performed in solid organ transplant recipients (n = 2694), which compared patients receiving mycophenolate-containing and mycophenolate-free immunosuppression regimes in opposite arms F I G U R E 2 Forest plot diagram illustrating the likelihood of seroconversion after vaccination against SARS-CoV-2 among four observational studies performed in liver transplant patients (n = 655), which compared patients receiving mycophenolate-containing and mycophenolate-free immunosuppression regimes in opposite arms

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Humoral response to SARS-CoV-2 adenovirus vector vaccination (ChAdOx1 nCoV-19 [AZD1222]) in heart transplant recipients aged 18 to 70 years of age

Cited by 14 publications

References 26 publications

ChAdOx1 nCoV-19 Immunogenicity and Immunological Response Following COVID-19 Infection in Patients Receiving Maintenance Hemodialysis

ChAdOx1 nCoV-19 Immunogenicity and Immunological Response Following COVID-19 Infection in Patients Receiving Maintenance Hemodialysis

Humoral response to heterologous prime‐booster vaccination in heart transplant recipients aged 18–70 years primed with a viral vector SARS‐CoV‐2 vaccine

Mycophenolate and SARS‐CoV‐2 vaccination: Mixing oil and water

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