Anti-SARS-CoV-2 Seroconversion in COVID-19 Convalescent Kidney Transplant Recipients Compared with Non-transplanted Patients

Author(s):Show less -

Ricardo Martins Garcia ^[1] ; Vinicius Lafico Teixeira Gomes ^[2] ; Renato Demarchi Foresto ^[3] ; Mônica Rika Nakamura ^[4] ; Marcia Araújo Toffoli de Jesus ^[5] ; Elisabeth França Lucena ^[6] ; Renata Pimentel Rissoni ^[7] ; Marina Pontello Cristelli ^[8] ; Helio Tedesco Silva Junior ^[9] ; Lúcio Requião-Moura ^[10] ; José Medina Pestana ^[11]

Affiliation:Show less -

^[1] Hospital do Rim e Hipertensão. Fundação Oswaldo Ramos - Brasil

^[2] Hospital do Rim e Hipertensão. Fundação Oswaldo Ramos - Brasil

^[3] Hospital do Rim e Hipertensão. Fundação Oswaldo Ramos - Brasil

^[4] Hospital do Rim e Hipertensão. Fundação Oswaldo Ramos - Brasil

^[5] Hospital do Rim e Hipertensão. Fundação Oswaldo Ramos - Brasil

^[6] Hospital do Rim e Hipertensão. Fundação Oswaldo Ramos - Brasil

^[7] Prefeitura de Ipaussu. Secretaria Municipal de Saúde e Higiene - Brasil

^[8] Hospital do Rim e Hipertensão. Fundação Oswaldo Ramos - Brasil

^[9] Hospital do Rim e Hipertensão. Fundação Oswaldo Ramos - Brasil

^[10] Hospital do Rim e Hipertensão. Fundação Oswaldo Ramos - Brasil

^[11] Hospital do Rim e Hipertensão. Fundação Oswaldo Ramos - Brasil

• Document type: Journal article
• Source: Brazilian Journal of Transplantation; v. 26, 2024-09-13.

Abstract

ABSTRACT Objective: Due to immunosuppression, kidney transplant recipients (KTRs) might have lower seroconversion after COVID-19 than non-KTRs. Thus, we aimed to evaluate the seroconversion rate after COVID-19 between KTRs and non-KTRs. Methods: This cohort study enrolled three non-paired groups of patients with COVID-19: 601 KTRs, 211 healthcare workers (HCWs), and 170 non-transplanted inhabitants (INHs) in a countryside city in Brazil. The anti-severe acute respiratory syndrome coronavirus 2 nucleocapsid antibody was assessed 14 days after diagnosis. The primary outcome was seroconversion. Results: The KTRs were older, had more comorbidities and severe COVID-19. Compared to HCWs and INHs, admission to the intensive care unit (ICU; 44.9% vs. 0% vs. 1.8%, p<0.001), mechanical ventilation requirement (32.3% vs. 0% vs. 1.8%, p<0.001), and death (28.8% vs. 0% vs. 1.2%, p<0.001) were significantly higher in KTRs. Seroconversion did not differ between the groups: 76.2% in KTRs, 74.9% in HCWs, and 82.2% in INHs (p=0.35). In a group-adjusted multivariable logistic regression, while a short period between infection and blood sample collection reduced the probability of seroconversion (adjusted odds ratio [aOR]=0.986), the presence of fever (aOR=1.737, p=0.017), cough (aOR=1.785, p=0.005), and requirement for ventilatory support (OR=1.981, p=0.017) increased the risk. Conclusions: Clinical severity, mechanical ventilation requirement and death by COVID-19 were significantly higher among the KTRs. However, among the survivors, KTRs had a similar seroconversion prevalence associated with clinical severity parameters and a shorter time of blood sample collection. (AU)

• FAPESP's process: 21/13680-6 - Evaluation of SARS-CoV-2 infection and Coronavirus vaccine response in transplant recipients, dialysis patients, and health workers
• Grantee: Jose Osmar Medina de Abreu Pestana
• Support Opportunities: Research Projects - Thematic Grants