Meta-analysis of immunologic response after COVID-19 mRNA vaccination in solid organ transplant recipients

Tang, Kefu; Wu, Xi; Luo, Ying; Wei, Zhiying; Feng, Li; Wu, Lei

doi:10.1016/j.jinf.2022.02.016

Cited by 15 publications

(14 citation statements)

References 10 publications

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Section: Discussionmentioning

confidence: 99%

“…The immune response after administration of COVID‐19 vaccines may be affected by multiple factors, such as cancer, HIV, autoimmune conditions, transplants, and medications/treatments received. 46 Moreover, it has been shown that post‐COVID‐19 fungal infections may target the immunocompromised population, which might also interfere with the body's inner immunity. 47 Compared with other hematologic malignancies, the Ab response to vaccination appears particularly impaired in CLL patients with seroconversion rates of 40%–60%, while ongoing CLL‐directed therapies and disease status further affected the response.…”

Section: Discussionmentioning

confidence: 99%

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Impaired serological response to COVID‐19 vaccination following anticancer therapy: A systematic review and meta‐analysis

Tang

Wei

2022

Journal of Medical Virology

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Owing to the high coronavirus disease 2019 (COVID‐19)‐related morbidity and fatality rate among patients with cancer, the introduction of COVID‐19 vaccines is of profound significance in this fragile population. Accumulating data suggested that oncologic patients, especially those with anticancer therapy have an impaired immune response to COVID‐19 vaccination. However, the exact effect of anticancer treatments on postvaccination response has not been elucidated yet. We, therefore, conducted a meta‐analysis to evaluate the impact of treatments on response to COVID‐19 vaccination in patients with cancer. A total of 39 studies were finally included comprising 11 075 oncologic patients. Overall, we found the humoral response was significantly decreased in patients undergoing anticancer treatments (odds ratio [OR] = 2.55, 95% confidence interval [CI]: 2.04–3.18) compared with those without active treatment. The seroconversion rates were significantly lower in patients with chemotherapy (OR = 3.04, 95% CI: 2.28–4.05), targeted therapy (OR = 4.72, 95% CI: 3.18–7.01) and steroid usage (OR = 2.19, 95% CI: 1.57–3.07), while there was no significant association between immunotherapy or hormonal therapy and seroconversion after vaccination. Subgroup analyses showed therapies with anti‐CD20 antibody (OR = 11.28, 95% CI: 6.40–19.90), B‐cell lymphoma 2 inhibitor (OR = 5.76, 95% CI: 3.64–9.10), and Bruton tyrosine kinase inhibitor (OR = 6.86, 95% CI: 4.23–11.15) were significantly correlated with the risk of negative humoral response to vaccination. In conclusion, our results demonstrated that specific oncologic therapies may significantly affect serological response to COVID‐19 vaccines in patients with cancer. Thus, an adapted vaccination strategy taking the influence of active treatment into account is in need, and further research on the effect of the third dose of vaccine and the role of postvaccination cellular response in oncologic patients is also needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impaired serological response to COVID‐19 vaccination following anticancer therapy: A systematic review and meta‐analysis

Tang

Wei

2022

Journal of Medical Virology

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“…As such, a significantly lower seroconversion rate following vaccination compared to healthy controls prompts the need for effective treatment modalities in this high-risk patient population. 1 Organ transplant patients have a markedly low seroconversion rate after 2 doses of COVID-19 mRNA vaccine compared with healthy controls. 1 Although COVID-19 vaccines have been effective in mounting an immune response in immunocompetent patients, a more effective alternative is needed for organ transplant recipients.…”

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confidence: 99%

Monoclonal antibody therapy improves severity and mortality of COVID-19 in organ transplant recipients: A meta-analysis

Yang

Wang

et al. 2022

Journal of Infection

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“…In view of this, Hall’s proposal of alternative treatment in patients without established seroconversion, despite vaccination, may be legitimate [ 32 ]. Possibly, the introduction of the fourth and fifth doses of vaccination in these patients might also be a solution [ 47 , 48 ].…”

Section: Vaccinations In Patients Awaiting Transplantationmentioning

confidence: 99%

A Review of Humoral and Cellular Immune Responses to SARS-CoV-2 Vaccination Following Solid Organ Transplantation

et al. 2022

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The introduction of vaccines preventing a severe course of COVID-19 disease is particularly important in immunocompromised patients, among whom organ recipients and patients awaiting transplantation constitute a large group. The article is a critical review of 68 recent publications on the impact of the SARS-CoV-2 pandemic on transplantology worldwide. The study discusses research results concerning various aspects of SARS-CoV-2 vaccination in transplant patients; it also lists important factors influencing vaccination effectiveness. A suboptimal immune response to 2 doses of vaccine in this group of patients is a major challenge prompting further research. Therefore, this review aims to provide an update on the humoral and cellular immune responses to SARS-CoV-2 vaccination following solid organ transplantation.

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Meta-analysis of immunologic response after COVID-19 mRNA vaccination in solid organ transplant recipients

Cited by 15 publications

References 10 publications

Impaired serological response to COVID‐19 vaccination following anticancer therapy: A systematic review and meta‐analysis

Impaired serological response to COVID‐19 vaccination following anticancer therapy: A systematic review and meta‐analysis

Monoclonal antibody therapy improves severity and mortality of COVID-19 in organ transplant recipients: A meta-analysis

A Review of Humoral and Cellular Immune Responses to SARS-CoV-2 Vaccination Following Solid Organ Transplantation

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