Data on the immune response to SARS-CoV-2 in kidney transplant recipients are scarce. Thus, we conducted a single-center observational study to assess the anti-SARS-CoV-2 IgG seroprevalence in outpatient kidney transplant recipients (KTR; n = 1037) and healthcare workers (HCW; n = 512) during the second wave of the COVID-19 pandemic in fall 2020 and evaluated the clinical variables affecting antibody levels. Antibodies against S1 and S2 subunit of SARS-CoV-2 were evaluated using immunochemiluminescent assay (cut off 9.5 AU/ml, sensitivity of 91.2% and specificity of 90.2%). Anti-SARS-CoV-2 IgG seroprevalence was lower in KTR than in HCW (7% vs. 11.9%, p = .001). Kidney transplant recipients with SARS-CoV-2 infection were younger (p = .001) and received CNI-based immunosuppression more frequently (p = .029) than seronegative KTR. Anti-SARS-CoV-2 IgG positive symptomatic KTR had a higher BMI (p = .04) than asymptomatic KTR. Interestingly, anti-SARS-CoV-2 IgG levels were higher in KTR than in HCW (median 31 AU/ml, IQR 17-84 vs. median 15 AU/ml, IQR 11-39, p < .001). The presence of moderate to severe symptoms in KTR was found to be the only independent factor affecting IgG levels (Beta coefficient = 41.99, 95% CI 9.92-74.06, p = .011) in the multivariable model. In conclusion, KTR exhibit a well-preserved symptom-dependent humoral response to SARS-CoV-2 infection.

Department of Immunology Institute for Clinical and Experimental Medicine Prague Czech Republic

Department of Informatics Institute for Clinical and Experimental Medicine Prague Czech Republic

Department of Nephrology Transplant Center Institute for Clinical and Experimental Medicine Prague Czech Republic

Zobrazit více v PubMed

Clift AK, Coupland CAC, Keogh RH, Hemingway H, Hippisley-Cox J. COVID-19 mortality risk in down syndrome: results from a cohort study of 8 million adults [published online ahead of print October 21, 2020] Ann Intern Med. 2021;174(4):572–576. PubMed PMC

Phanish M, Ster IC, Ghazanfar A, et al. Systematic review and meta-analysis of COVID-19 and kidney transplant recipients, the South West London Kidney Transplant Network experience [published online ahead of print December 19, 2020] Kidney Int Rep. 2021;6(3):574–585. PubMed PMC

Choi M, Bachmann F, Naik MG, et al. Low seroprevalence of SARS-CoV-2 antibodies during systematic antibody screening and serum responses in patients after COVID-19 in a German Transplant Center. J Clin Med. 2020;9(11):3401. Published October 23, 2020. PubMed PMC

Prendecki M, Clarke C, Gleeson S, et al. Detection of SARS-CoV-2 antibodies in kidney transplant recipients. J Am Soc Nephrol. 2020;31(12):2753–2756. PubMed PMC

Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein [published correction appears in Cell. 2020;183(6):1735] Cell. 2020;181(2):281–292. e6. PubMed PMC

Galipeau Y, Greig M, Liu G, Driedger M, Langlois MA. Humoral responses and serological assays in SARS-CoV-2 infections. Front Immunol. 2020;11:610688. Published December 18, 2020. PubMed PMC

COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/. Accessed 25 Mar 2021. PubMed

Bonelli F, Sarasini A, Zierold C, et al. Clinical and analytical performance of an automated serological test that identifies S1/S2-neutralizing IgG in COVID-19 patients semiquantitatively. J Clin Microbiol. 2020;58(9):e01224–e01320. Published August 24, 2020. PubMed PMC

National SARS-CoV-2 Serology Assay Evaluation Group Performance characteristics of five immunoassays for SARS-CoV-2: a head-to-head benchmark comparison [published correction appears in Lancet Infect Dis. 2020 Dec;20(12):e298] Lancet Infect Dis. 2020;20(12):1390–1400. PubMed PMC

Burack D, Pereira MR, Tsapepas DS, et al. Prevalence and predictors of SARS-CoV-2 antibodies among solid organ transplant recipients with confirmed infection [published online ahead of print February 16, 2021] Am J Transplant. 2021;21(6):2254–2261. PubMed PMC

Sakhi H, Dahmane D, Attias P, et al. Kinetics of anti-SARS-CoV-2 IgG antibodies in hemodialysis patients six months after infection [published online ahead of print February 26, 2021] J Am Soc Nephrol. 2021;32(5):1033–1036. PubMed PMC

Boyarsky BJ, Werbel WA, Avery RK, et al. Antibody response to 2-dose SARS-CoV-2 mRNA vaccine series in solid organ transplant recipients [published online ahead of print May 5, 2021] JAMA. 2021;325(21):2204–2206. PubMed PMC

Marion O, Del Bello A, Abravanel F, et al. Safety and immunogenicity of anti-SARS-CoV-2 messenger RNA vaccines in recipients of solid organ transplants [published online ahead of print May 25, 2021]. Ann Intern Med. 2021. 10.7326/M21-1341. PubMed DOI PMC

Aslam S, Danziger-Isakov L, Mehra MR. COVID-19 vaccination immune paresis in heart and lung transplantation [published online ahead of print May 13, 2021]. J Heart Lung Transplant. 2021. 10.1016/j.healun.2021.04.018. PubMed DOI PMC

Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis. J Hosp Infect. 2021;108:120–134. PubMed PMC

Pallett SJC, Rayment M, Patel A, et al. Point-of-care serological assays for delayed SARS-CoV-2 case identification among health-care workers in the UK: a prospective multicentre cohort study [published correction appears in Lancet Respir Med. July 30, 2020] Lancet Respir Med. 2020;8(9):885–894. PubMed PMC

Huang YI, Lu Y, Huang Y-M, et al. Obesity in patients with COVID-19: a systematic review and meta-analysis. Metabolism. 2020;113:154378. PubMed PMC

Ko JH, Joo EJ, Park SJ, et al. Neutralizing antibody production in asymptomatic and mild COVID-19 patients, in comparison with pneumonic COVID-19 patients. J Clin Med. 2020;9(7):2268. Published July 17, 2020. PubMed PMC

Cervia C, Nilsson J, Zurbuchen Y, et al. Systemic and mucosal antibody responses specific to SARS-CoV-2 during mild versus severe COVID-19. J Allergy Clin Immunol. 2021;147(2):545–557. e9. PubMed PMC

Zhou W, Xu X, Chang Z, et al. The dynamic changes of serum IgM and IgG against SARS-CoV-2 in patients with COVID-19. J Med Virol. 2021;93(2):924–933. PubMed PMC

Chavarot N, Leruez-Ville M, Scemla A, et al. Decline and loss of anti-SARS-CoV-2 antibodies in kidney transplant recipients in the 6 months following SARS-CoV-2 infection. Kidney Int. 2021;99(2):486–488. PubMed PMC

COVID-19 map – Johns Hopkins Coronavirus Resource Center. https://coronavirus.jhu.edu/map.html. Accessed May 18, 2021.

The impact of frailty syndrome on humoral response to SARS-CoV-2 mRNA vaccines in older kidney transplant recipients

Determinants of Immune Response to Anti-SARS-CoV-2 mRNA Vaccines in Kidney Transplant Recipients: A Prospective Cohort Study

Insufficient response to mRNA SARS-CoV-2 vaccine and high incidence of severe COVID-19 in kidney transplant recipients during pandemic