The RECOVAC Immune-response Study: The Immunogenicity, Tolerability, and Safety of COVID-19 Vaccination in Patients With Chronic Kidney Disease, on Dialysis, or Living With a Kidney Transplant

被引：141

作者：

Sanders, Jan-Stephan F. ^{[1
]}

Bemelman, Frederike J. ^{[2
]}

Messchendorp, A. Lianne ^{[1
]}

Baan, Carla C. ^{[3
]}

van Baarle, Debbie ^{[4
,5
]}

van Binnendijk, Rob ^{[5
]}

Diavatopoulos, Dimitri A. ^{[6
,7
]}

Frolke, Sophie C. ^{[2
]}

Geers, Daryl ^{[8
]}

GeurtsvanKessel, Corine H. ^{[8
]}

den Hartog, Gerco ^{[5
]}

van der Heiden, Marieke ^{[4
]}

Imhof, Celine ^{[1
,4
]}

Kho, Marcia M. L. ^{[3
]}

Koopmans, Marion P. G. ^{[8
]}

Malahe, S. Reshwan K. ^{[8
]}

Mattheussens, Wouter B. ^{[9
]}

van der Molen, Renate ^{[7
]}

van Mourik, Djenolan ^{[8
]}

Remmerswaal, Ester B. M. ^{[10
]}

Rots, Nynke ^{[5
]}

Vart, Priya ^{[1
]}

de Vries, Rory D. ^{[8
]}

Gansevoort, Ron T. ^{[1
]}

Hilbrands, Luuk B. ^{[9
]}

Reinders, Marlies E. J. ^{[3
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Internal Med, Div Nephrol, Groningen, Netherlands

[2] Univ Amsterdam, Renal Transplant Unit, Amsterdam UMC, Amsterdam, Netherlands

[3] Erasmus MC, Erasmus MC Transplant Inst, Dept Internal Med Nephrol & Transplantat, Rotterdam, Netherlands

[4] Univ Med Ctr Groningen, Dept Med Microbiol & Infect Prevent, Groningen, Netherlands

[5] Natl Inst Publ Hlth & Environm, Ctr Infect Dis Control, Bilthoven, Netherlands

[6] Radboud Univ Nijmegen Med Ctr, Radboud Ctr Infect Dis, Nijmegen, Netherlands

[7] Radboud Univ Nijmegen Med Ctr, Radboud Inst Mol Life Sci, Dept Lab Med, Lab Med Immunol, Nijmegen, Netherlands

[8] Erasmus MC, Dept Virosci, Rotterdam, Netherlands

[9] Radboud Univ Nijmegen Med Ctr, Radboud Inst Hlth Sci, Dept Nephrol, Nijmegen, Netherlands

[10] Univ Amsterdam, Amsterdam Infect & Immun Inst, Dept Expt Immunol, Amsterdam UMC, Amsterdam, Netherlands

来源：

TRANSPLANTATION | 2022年 / 106卷 / 04期

关键词：

SARS-COV-2; ANTIBODIES; RECIPIENTS; INFECTION;

D O I：

10.1097/TP.0000000000003983

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. In kidney patients COVID-19 is associated with severely increased morbidity and mortality. A comprehensive comparison of the immunogenicity, tolerability, and safety of COVID-19 vaccination in different cohorts of kidney patients and a control cohort is lacking. Methods. This investigator driven, prospective, controlled multicenter study included 162 participants with chronic kidney disease (CKD) stages G4/5 (eGFR < 30 mL/min/1.73m2), 159 participants on dialysis, 288 kidney transplant recipients, and 191 controls. Participants received 2 doses of the mRNA-1273 COVID-19 vaccine (Moderna). The primary endpoint was seroconversion. Results. Transplant recipients had a significantly lower seroconversion rate when compared with controls (56.9% versus 100%, P < 0.001), with especially mycophenolic acid, but also, higher age, lower lymphocyte concentration, lower eGFR, and shorter time after transplantation being associated with nonresponder state. Transplant recipients also showed significantly lower titers of neutralizing antibodies and T- cell responses when compared with controls. Although a high seroconversion rate was observed for participants with CKD G4/5 (100%) and on dialysis (99.4%), mean antibody concentrations in the CKD G4/5 cohort and dialysis cohort were lower than in controls (2405 [interquartile interval 1287-4524] and 1650 [698-3024] versus 3186 [1896-4911] BAU/mL, P = 0.06 and P < 0.001, respectively). Dialysis patients and especially kidney transplant recipients experienced less systemic vaccination related adverse events. No specific safety issues were noted. Conclusions. The immune response following vaccination in patients with CKD G4/5 and on dialysis is almost comparable to controls. In contrast, kidney transplant recipients have a poor response. In this latter, patient group development of alternative vaccination strategies are warranted.

引用

页码：821 / 834

页数：14

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