Impact of COVID-19 vaccination on clinical outcomes in kidney transplant patients

IF 1.6 4区医学 Q4 IMMUNOLOGY

Transplant immunology Pub Date : 2024-03-05 DOI:10.1016/j.trim.2024.102019

Ana Flávia Vieira Ferreira de Assis , Letícia de Oliveira Santos , Mariana Almeida Botelho , Evaldo Nascimento , Raquel A. Fabreti-Oliveira

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Abstract

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.

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接种 COVID-19 疫苗对肾移植患者临床疗效的影响

引言 COVID-19 大流行引发的全球健康危机造成了严重的死亡率和发病率。这项队列研究旨在评估 COVID-19 疫苗接种对肾移植患者临床预后的影响。材料和方法在这项回顾性研究中，254 名肾移植患者接种了 SARS-CoV-2 疫苗，其中部分患者感染了 COVID-19。COVID-19 的诊断是通过反转录酶聚合酶链反应检测进行的，患者接受的治疗包括免疫抑制和 COVID-19 特异性方案。接种疫苗后，又有 29 名（11.42%）患者被诊断感染了 COVID-19。住院的风险因素包括年龄、体重指数 (BMI)、合并症和肾移植后的时间（p 分别为 0.025、0.038、0.012 和 0.046）。接种 COVID-19 疫苗后，医院获得性 SARS-CoV-2 感染率从 63.16% 显著降至 34.48%（p = 0.020）。该队列中入住重症监护室的患者比例从 23.68% 降至零。异体移植排斥率呈下降趋势，从 13.16% 降至 6.90%（p = 0.690）。结论接种 COVID-19 疫苗可显著降低 COVID-19 的严重程度和肾移植患者的死亡率。住院的风险因素包括年龄、体重指数、合并症和肾移植后的时间。接种 COVID-19 疫苗后，住院率降低，临床并发症减少。研究发现，COVID-19疫苗接种在该人群中产生的不良反应与免疫功能正常人群中的不良反应相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplant immunology 医学-免疫学

CiteScore

2.10

自引率

13.30%

发文量

198

审稿时长

48 days

期刊介绍： Transplant Immunology will publish up-to-date information on all aspects of the broad field it encompasses. The journal will be directed at (basic) scientists, tissue typers, transplant physicians and surgeons, and research and data on all immunological aspects of organ-, tissue- and (haematopoietic) stem cell transplantation are of potential interest to the readers of Transplant Immunology. Original papers, Review articles and Hypotheses will be considered for publication and submitted manuscripts will be rapidly peer-reviewed and published. They will be judged on the basis of scientific merit, originality, timeliness and quality.