tetano
Editor, Senior Moderator
Transpl Immunol
. 2024 Mar 5:84:102019.
doi: 10.1016/j.trim.2024.102019. Online ahead of print. Impact of COVID-19 vaccination on clinical outcomes in kidney transplant patients
Ana Flávia Vieira Ferreira de Assis[SUP] 1 [/SUP], Letícia de Oliveira Santos[SUP] 1 [/SUP], Mariana Almeida Botelho[SUP] 1 [/SUP], Evaldo Nascimento[SUP] 2 [/SUP], Raquel A Fabreti-Oliveira[SUP] 3 [/SUP]
Affiliations
Introduction: The global health crisis caused by the COVID-19 pandemic has resulted in severe mortality and morbidity. Immunosuppressed patients, such as kidney transplant recipients, are particularly susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections.
Objective: The aim of this cohort study was to evaluate the impact of COVID-19 vaccination on clinical outcomes in patients with kidney transplants.
Materials and methods: In this retrospective study, 254 patients with kidney transplants were vaccinated against SARS-CoV-2 and a fraction of these contracted COVID-19. The diagnosis of COVID-19 was carried out by reverse transcriptase-polymerase chain reaction testing, and the patients received treatment involving immunosuppressive and COVID-19-specific protocols.
Results: SARS-CoV-2 infection was diagnosed in 38 (14.96%) patients before the COVID-19 vaccine was administered. After vaccination, an additional 29 (11.42%) patients were diagnosed with COVID-19. Risk factors for hospitalization included age, body mass index (BMI), comorbidities, and time elapsed since renal transplantation (p = 0.025, 0.038, 0.012, and 0.046, respectively). COVID-19 vaccination resulted in a significant decrease in the rate of hospital-acquired SARS-CoV-2 infection from 63.16% to 34.48% (p = 0.020). The proportion of patients from this cohort placed in intensive care units decreased from 23.68% to zero. Allograft rejections exhibited a decreasing trend from 13.16% to 6.90% (p = 0.690). This patient cohort displayed 15.79% mortality prior to COVID-19 vaccination that was reduced to nil after immunization.
Conclusion: COVID-19 vaccination significantly reduced COVID-19 severity and mortality in this cohort of patients with kidney transplants. The risk factors for hospitalization were determined to be age, BMI, comorbidities, and time since renal transplantation. COVID-19 vaccination resulted in a clinical outcome of reduced hospitalization and a decrease in clinical complications. The COVID-19 vaccination-derived adverse effects in this cohort were found to be comparable to those in the immunocompetent population.
Keywords: Adverse effects; COVID-19 vaccines; Immunosuppression therapy; Kidney transplantation outcome; Severe acute respiratory syndrome coronavirus 2.
. 2024 Mar 5:84:102019.
doi: 10.1016/j.trim.2024.102019. Online ahead of print. Impact of COVID-19 vaccination on clinical outcomes in kidney transplant patients
Ana Flávia Vieira Ferreira de Assis[SUP] 1 [/SUP], Letícia de Oliveira Santos[SUP] 1 [/SUP], Mariana Almeida Botelho[SUP] 1 [/SUP], Evaldo Nascimento[SUP] 2 [/SUP], Raquel A Fabreti-Oliveira[SUP] 3 [/SUP]
Affiliations
- PMID: 38447737
- DOI: 10.1016/j.trim.2024.102019
Introduction: The global health crisis caused by the COVID-19 pandemic has resulted in severe mortality and morbidity. Immunosuppressed patients, such as kidney transplant recipients, are particularly susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections.
Objective: The aim of this cohort study was to evaluate the impact of COVID-19 vaccination on clinical outcomes in patients with kidney transplants.
Materials and methods: In this retrospective study, 254 patients with kidney transplants were vaccinated against SARS-CoV-2 and a fraction of these contracted COVID-19. The diagnosis of COVID-19 was carried out by reverse transcriptase-polymerase chain reaction testing, and the patients received treatment involving immunosuppressive and COVID-19-specific protocols.
Results: SARS-CoV-2 infection was diagnosed in 38 (14.96%) patients before the COVID-19 vaccine was administered. After vaccination, an additional 29 (11.42%) patients were diagnosed with COVID-19. Risk factors for hospitalization included age, body mass index (BMI), comorbidities, and time elapsed since renal transplantation (p = 0.025, 0.038, 0.012, and 0.046, respectively). COVID-19 vaccination resulted in a significant decrease in the rate of hospital-acquired SARS-CoV-2 infection from 63.16% to 34.48% (p = 0.020). The proportion of patients from this cohort placed in intensive care units decreased from 23.68% to zero. Allograft rejections exhibited a decreasing trend from 13.16% to 6.90% (p = 0.690). This patient cohort displayed 15.79% mortality prior to COVID-19 vaccination that was reduced to nil after immunization.
Conclusion: COVID-19 vaccination significantly reduced COVID-19 severity and mortality in this cohort of patients with kidney transplants. The risk factors for hospitalization were determined to be age, BMI, comorbidities, and time since renal transplantation. COVID-19 vaccination resulted in a clinical outcome of reduced hospitalization and a decrease in clinical complications. The COVID-19 vaccination-derived adverse effects in this cohort were found to be comparable to those in the immunocompetent population.
Keywords: Adverse effects; COVID-19 vaccines; Immunosuppression therapy; Kidney transplantation outcome; Severe acute respiratory syndrome coronavirus 2.