Am J Transplant . Changes in Humoral Immune Response after SARS-CoV-2 Infection in Liver Transplant Recipients Compared to Immunocompetent Patients

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Am J Transplant


. 2021 Apr 9.
doi: 10.1111/ajt.16599. Online ahead of print.
Changes in Humoral Immune Response after SARS-CoV-2 Infection in Liver Transplant Recipients Compared to Immunocompetent Patients


Ar?nzazu Caballero-Marcos ^{1 2} , Magdalena Salcedo ^{1 2} , Roberto Alonso-Fern?ndez ³ , Manuel Rodr?guez-Per?lvarez ^{2 4} , Mar?a Olmedo ³ , Javier Graus Morales ⁵ , Valent?n Cuervas-Mons ^{6 7} , Alba Cachero ⁸ , Carmelo Loinaz-Segurola ⁹ , Mercedes I?arrairaegui ¹⁰ , Llu?s Castells ^{2 11} , Sonia Pascual ¹² , Carmen Vinaixa-Aun?s ^{2 13} , Roc?o Gonz?lez-Grande ¹⁴ , Alejandra Otero ¹⁵ , Santiago Tom? ¹⁶ , Javier Tejedor-Tejada ¹⁷ , Jos? Mar?a ?lamo-Mart?nez ¹⁸ , Luisa Gonz?lez-Di?guez ¹⁹ , Flor Nogueras-Lopez ²⁰ , Gerardo Blanco-Fern?ndez ²¹ , Gema Mu?oz-Bartolo ²² , Francisco Javier Bustamante ²³ , Emilio F?brega ^{2 24} , Mario Romero-Crist?bal ^{1 2} , Rosa Martin-Mateos ⁵ , Julia Del Rio-Izquierdo ² , Ana Arias-Milla ⁶ , Laura Calatayud ²⁵ , Alberto A Marcacuzco-Quinto ⁹ , V?ctor Fern?ndez-Alonso ¹ , Concepci?n G?mez-Gavara ¹¹ , Jordi Colmenero ^{2 26} , Patricia Mu?oz ³ , Jos? Antonio Pons ²⁷ , Spanish Society of Liver Transplantation (SETH)



Affiliations

• PMID: 33835707
• DOI: 10.1111/ajt.16599

Abstract

The protective capacity and duration of humoral immunity after SARS-CoV-2 infection is not yet understood in solid organ transplant recipients. A prospective multicenter study was performed to evaluate the persistence of anti-nucleocapsid IgG antibodies in liver transplant recipients 6 months after coronavirus disease 2019 (COVID-19) resolution. A total of 71 liver transplant recipients were matched with 71 immunocompetent controls by a propensity score including variables with a well-known prognostic impact in COVID-19. Paired case-control serological data was also available in 62 liver transplant patients and 62 controls at month 3 after COVID-19. Liver transplant recipients showed a lower incidence of anti-nucleocapsid IgG antibodies at 3 months (77.4% vs. 100%, p<0.001) and at 6 months (63.4% vs. 90.1%, p<0.001). Lower levels of antibodies were also observed in liver transplant patients at 3 (p=0.001) and 6 months (p<0.001) after COVID-19. In transplant patients, female gender (OR=13.49, 95%CI 2.17-83.8), a longer interval since transplantation (OR=1.19, 95%CI 1.03-1.36), and therapy with renin-angiotensin-aldosterone system inhibitors (OR=7.11, 95%CI 1.47-34.50) were independently associated with persistence of antibodies beyond 6 months after COVID-19. Therefore, as compared with immunocompetent patients, liver transplant recipients show a lower prevalence of anti-SARS-CoV-2 antibodies and more pronounced antibody levels decline.