期刊
AMERICAN JOURNAL OF TRANSPLANTATION
卷 21, 期 12, 页码 3926-3935出版社
WILEY
DOI: 10.1111/ajt.16746
关键词
clinical research; practice; infection and infectious agents; viral; infectious disease; kidney transplantation; nephrology; patient characteristics
资金
- Ministerstvo Zdravotnictvi Ceske Republiky [NV19-06-00031]
Kidney transplant recipients show a lower anti-SARS-CoV-2 IgG seroprevalence compared to healthcare workers, with those who had SARS-CoV-2 infection being younger and more likely to receive CNI-based immunosuppression. Interestingly, kidney transplant recipients had higher levels of anti-SARS-CoV-2 IgG antibodies compared to healthcare workers, with the presence of moderate to severe symptoms being the main factor affecting IgG levels in kidney transplant recipients.
Data on the immune response to SARS-CoV-2 in kidney transplant recipients are scarce. Thus, we conducted a single-center observational study to assess the anti-SARS-CoV-2 IgG seroprevalence in outpatient kidney transplant recipients (KTR; n = 1037) and healthcare workers (HCW; n = 512) during the second wave of the COVID-19 pandemic in fall 2020 and evaluated the clinical variables affecting antibody levels. Antibodies against S1 and S2 subunit of SARS-CoV-2 were evaluated using immunochemiluminescent assay (cut off 9.5 AU/ml, sensitivity of 91.2% and specificity of 90.2%). Anti-SARS-CoV-2 IgG seroprevalence was lower in KTR than in HCW (7% vs. 11.9%, p = .001). Kidney transplant recipients with SARS-CoV-2 infection were younger (p = .001) and received CNI-based immunosuppression more frequently (p = .029) than seronegative KTR. Anti-SARS-CoV-2 IgG positive symptomatic KTR had a higher BMI (p = .04) than asymptomatic KTR. Interestingly, anti-SARS-CoV-2 IgG levels were higher in KTR than in HCW (median 31 AU/ml, IQR 17-84 vs. median 15 AU/ml, IQR 11-39, p < .001). The presence of moderate to severe symptoms in KTR was found to be the only independent factor affecting IgG levels (Beta coefficient = 41.99, 95% CI 9.92-74.06, p = .011) in the multivariable model. In conclusion, KTR exhibit a well-preserved symptom-dependent humoral response to SARS-CoV-2 infection.
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