Breakthrough Infections Following mRNA SARS-CoV-2 Vaccination in Kidney Transplant Recipients
Background. The clinical effectiveness of coronavirus disease 2019 (COVID-19) vaccination in kidney transplant (KT) recipients is lower than in the general population. Methods. From April to October 2021, 481 KT recipients with COVID-19, included in the Spanish Society of Nephrology COVID-19 Registr...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2022 |
| País: | España |
| Institución: | Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau) |
| Repositorio: | r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau |
| OAI Identifier: | oai:iibsantpau.fundanetsuite.com:p11986 |
| Acceso en línea: | https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=11986 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85131067587&doi=10.1097%2fTP.0000000000004119&partnerID=40&md5=7e14ef061861c11ac7e9fe32b01d804f |
| Access Level: | acceso abierto |
| Palabra clave: | ad26.cov2.s vaccine angiotensin receptor antagonist basiliximab belatacept chadox1 cyclosporine dipeptidyl carboxypeptidase inhibitor elasomeran glucocorticoid mammalian target of rapamycin inhibitor mycophenolic acid prednisone rituximab tacrolimus thymocyte antibody tocilizumab tozinameran vaxzevria messenger RNA recombinant vaccine RNA vaccine adult age distribution aged Article breakthrough infection clinical effectiveness clinical feature controlled study coronavirus disease 2019 disease severity female hospital patient human kidney graft rejection kidney transplantation major clinical study male mortality pneumonia risk factor Severe acute respiratory syndrome coronavirus 2 single drug dose survival vaccination adverse event epidemiology graft recipient prevention and control 2019-nCoV Vaccine mRNA-1273 BNT162 Vaccine COVID-19 COVID-19 Vaccines Humans Kidney Transplantation mRNA Vaccines RNA, Messenger SARS-CoV-2 Transplan |
| Sumario: | Background. The clinical effectiveness of coronavirus disease 2019 (COVID-19) vaccination in kidney transplant (KT) recipients is lower than in the general population. Methods. From April to October 2021, 481 KT recipients with COVID-19, included in the Spanish Society of Nephrology COVID-19 Registry, were analyzed. Data regarding vaccination status and vaccine type were collected, and outcomes of unvaccinated or partially vaccinated patients (n = 130) were compared with fully vaccinated patients (n = 351). Results. Clinical picture was similar and survival analysis showed no differences between groups: 21.7% of fully vaccinated patients and 20.8% of unvaccinated or partially vaccinated died (P = 0.776). In multivariable analysis, age and pneumonia were independent risk factors for death, whereas vaccination status was not related to mortality. These results remained similar when we excluded patients with partial vaccination, as well as when we analyzed exclusively hospitalized patients. Patients vaccinated with mRNA-1273 (n = 213) showed a significantly lower mortality than those who received the BNT162b2 vaccine (n = 121) (hazard ratio: 0.52; 95% confidence interval, 0.31-0.85; P = 0.010). Conclusions. COVID-19 severity in KT patients has remained high and has not improved despite receiving 2 doses of the mRNA vaccine. The mRNA-1273 vaccine shows higher clinical effectiveness than BNT162b2 in KT recipients with breakthrough infections. Confirmation of these data will require further research taking into account the new variants and the administration of successive vaccine doses. |
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