Despite the lower virulence of current SARS-CoV-2 variants and high rates of vaccinated and previously infected subjects, COVID-19 remains a persistent threat in kidney transplant recipients (KTRs). This study evaluated the parameters of anti-SARS-CoV-2 antibody production in 120 KTRs. The production of neutralizing antibodies in KTRs, following booster vaccination with the mRNA vaccine BNT162b2, was significantly decreased and their decline was faster than in healthy subjects. Factors predisposing to the downregulation of anti-SARS-CoV-2 neutralizing antibodies included age, lower estimated glomerular filtration rate, and a full dose of mycophenolate mofetil. Neutralizing antibodies correlated with those targeting the SARS-CoV-2 receptor binding domain (RBD), SARS-CoV-2 Spike trimmer, total SARS-CoV-2 S1 protein, as well as with antibodies to the deadly SARS-CoV-1 virus. No cross-reactivity was found with antibodies against seasonal coronaviruses. KTRs exhibited lower postvaccination production of neutralizing antibodies against SARS-CoV-2; however, the specificity of their humoral response did not differ compared to healthy subjects.

• Klíčová slova
• Antibodies, COVID-19, Kidney transplantation, SARS-CoV-2, Vaccination,
• MeSH
• COVID-19 * imunologie   prevence a kontrola   MeSH
• dospělí MeSH
• glykoprotein S, koronavirus imunologie   MeSH
• humorální imunita MeSH
• lidé středního věku MeSH
• lidé MeSH
• neutralizující protilátky * krev   imunologie   MeSH
• příjemce transplantátu * MeSH
• protilátky virové * krev   imunologie   MeSH
• SARS-CoV-2 * imunologie   MeSH
• sekundární imunizace MeSH
• senioři MeSH
• transplantace ledvin * škodlivé účinky   MeSH
• vakcína BNT162 imunologie   aplikace a dávkování   MeSH
• vakcíny proti COVID-19 imunologie   aplikace a dávkování   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• glykoprotein S, koronavirus MeSH
• neutralizující protilátky * MeSH
• protilátky virové * MeSH
• spike protein, SARS-CoV-2 MeSH Prohlížeč
• vakcína BNT162 MeSH
• vakcíny proti COVID-19 MeSH

AIMS: The primary aim of our monitoring was to determine the duration of persistence of antibody levels following administration of the Comirnaty (Pfizer/BioNTech) mRNA vaccine. The second aim was to analyse the effect of selected factors on the level of antibodies. METHODS: The study cohort consisted of 250 employees of the Medirex JSC laboratories. For the quantitative determination of specific IgG anti-S1 and anti-S2 antibodies to SARS-CoV-2, chemiluminescence immunoassay was used. Twenty-nine subjects were excluded from the analysis due to extreme values of antibody levels in individual measurements. The effect of gender, age, BMI, comorbidity, and adverse reactions after vaccination with the Comirnaty (Pfizer/BioNTech) mRNA vaccine on antibody levels was analysed. Comparisons were made for five samples collected from two weeks after the 1st dose to 36 weeks after the 2nd dose of the mRNA vaccine. After the fifth sampling, the cohort was divided into two groups. Group 1 received the 3rd dose, and Group 2 were controls. We performed the last (sixth) sample collection two weeks after booster administration in Group 1and 11 months after the 2nd dose of the vaccine in controls. Between months 8 and 10 after the 2nd dose, we performed a cellular immunity test. RESULTS: Altogether 99.6% of the participants had a positive antibody level at week 36. Antibodies were still present in controls at month 11 after the 2nd dose. Significantly higher antibody levels were found in females, younger subjects, and those with selected adverse reactions. Reactive specific T lymphocytes were present in 65.6% of the subjects between weeks 36 and 44. CONSLUSION: The antibody response decreased with the time since the 2nd dose but was still present in the control group at week 48. The effect of booster on antibody levels was clearly demonstrated. We have not confirmed an association of cellular immunity with the level of antibodies or with the antibodies present.

• Klíčová slova
• adverse effects, adverse events, age, antibody response dynamics, antibody response dynamics – mRNA vaccine – age – gender – adverse effects, gender, mRNA vaccine,
• MeSH
• COVID-19 * prevence a kontrola   MeSH
• lidé MeSH
• následné studie MeSH
• protilátky virové MeSH
• protilátky MeSH
• SARS-CoV-2 * MeSH
• vakcína BNT162 MeSH
• vakcinace MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• protilátky virové MeSH
• protilátky MeSH
• vakcína BNT162 MeSH

PURPOSE: Advanced age is associated with an impaired humoral immune response to SARS-CoV-2 mRNA vaccination in kidney transplant recipients (KTR). The mechanisms are, however, poorly understood. Frailty syndrome assessment may determine the most vulnerable population. METHODS: This study is a secondary analysis of a prospective study (NCT04832841) regarding seroconversion after BNT162b2 vaccination, including 101 SARS-CoV-2 naïve KTR 70 years and older. The Fried frailty components were evaluated, and antibodies against S1 and S2 subunits of SARS-CoV-2 were examined > 14 days after the second dose of BNT162b2 vaccine. RESULTS: Seroconversion was observed in 33 KTR. Male gender, eGFR, MMF-free immunosuppression, and a lower frailty score were associated with higher seroconversion rates in univariable regression. Concerning frailty components, physical inactivity had the most negative effect on seroconversion (OR = 0.36, 95% CI 0.14-0.95, p = 0.039). In a multivariable regression adjusted for eGFR, MMF-free immunosuppression, time from transplant and gender, pre-frail (OR = 0.27, 95% CI 0.07-1.00, p = 0.050), and frail status (OR = 0.14, 95% CI 0.03-0.73, p = 0.019) were associated with an increased risk of unresponsiveness to SARS-CoV-2 vaccines. CONCLUSION: Frailty was associated with an impaired humoral response to SARS-CoV-2 mRNA vaccination in older SARS-CoV-2 naïve KTR. TRAIL REGISTRATION: This study is registered under the identifier NCT04832841 on ClinicalTrials.gov.

• Klíčová slova
• Frailty, Kidney transplantation, SARS-CoV-2 infection, Vaccination,
• MeSH
• COVID-19 * prevence a kontrola   MeSH
• křehkost * MeSH
• křehký senior MeSH
• lidé MeSH
• messenger RNA MeSH
• příjemce transplantátu MeSH
• prospektivní studie MeSH
• protilátky virové MeSH
• SARS-CoV-2 MeSH
• senioři MeSH
• transplantace ledvin * MeSH
• vakcína BNT162 MeSH
• vakcíny proti COVID-19 MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• messenger RNA MeSH
• protilátky virové MeSH
• vakcína BNT162 MeSH
• vakcíny proti COVID-19 MeSH

IntroductionTwo large multicentre European hospital networks have estimated vaccine effectiveness (VE) against COVID-19 since 2021.AimWe aimed to measure VE against PCR-confirmed SARS-CoV-2 in hospitalised severe acute respiratory illness (SARI) patients ≥ 20 years, combining data from these networks during Alpha (March-June)- and Delta (June-December)-dominant periods, 2021.MethodsForty-six participating hospitals across 14 countries follow a similar generic protocol using the test-negative case-control design. We defined complete primary series vaccination (PSV) as two doses of a two-dose or one of a single-dose vaccine ≥ 14 days before onset.ResultsWe included 1,087 cases (538 controls) and 1,669 cases (1,442 controls) in the Alpha- and Delta-dominant periods, respectively. During the Alpha period, VE against hospitalisation with SARS-CoV2 for complete Comirnaty PSV was 85% (95% CI: 69-92) overall and 75% (95% CI: 42-90) in those aged ≥ 80 years. During the Delta period, among SARI patients ≥ 20 years with symptom onset ≥ 150 days from last PSV dose, VE for complete Comirnaty PSV was 54% (95% CI: 18-74). Among those receiving Comirnaty PSV and mRNA booster (any product) ≥ 150 days after last PSV dose, VE was 91% (95% CI: 57-98). In time-since-vaccination analysis, complete all-product PSV VE was > 90% in those with their last dose < 90 days before onset; ≥ 70% in those 90-179 days before onset.ConclusionsOur results from this EU multi-country hospital setting showed that VE for complete PSV alone was higher in the Alpha- than the Delta-dominant period, and addition of a first booster dose during the latter period increased VE to over 90%.

• Klíčová slova
• Alpha, Delta, Europe, SARS-CoV-2, hospital, vaccine effectiveness,
• MeSH
• COVID-19 * epidemiologie   prevence a kontrola   MeSH
• dospělí MeSH
• hospitalizace MeSH
• lidé MeSH
• RNA virová MeSH
• SARS-CoV-2 MeSH
• účinost vakcíny MeSH
• vakcína BNT162 MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Názvy látek
• RNA virová MeSH
• vakcína BNT162 MeSH

Although vaccines against COVID-19 are effective tools in preventing severe disease, recent studies have shown enhanced protection after vaccine boosters. The aim of our study was to examine the dynamics and duration of both humoral and cellular immune responses following a three-dose regimen of the BNT162b2 mRNA vaccine. In a longitudinal prospective study we enrolled 86 adults who received the BNT162b2 vaccine, 35 unvaccinated individuals with a history of mild COVID-19 and a control group of 30 healthy SARS-CoV-2 seronegative persons. We assessed the SARS-CoV-2-specific T cell responses and IgG production up to 12 months post the third BNT162b2 dose in 24 subjects. The vaccinated group had significantly higher IgG antibody levels after two doses compared to the convalescent group (p<0.001). After the third dose, IgG levels surged beyond those detected after the second dose (p<0.001). Notably, these elevated IgG levels were maintained 12 months post the third dose. After two doses, specific T cell responses were detected in 87.5% of the vaccinated group. Additionally, there was a significant decrease before the third dose. However, post the third dose, specific T cell responses surged and remained stable up to the 12-month period. Our findings indicate that the BNT162b2 vaccine induces potent and enduring humoral and cellular responses, which are notably enhanced by the third dose and remain persistant without a significant decline a year after the booster. Further research is essential to understand the potential need for subsequent boosters.

• Klíčová slova
• BNT162b2, COVID-19; SARS-CoV-2, T cell immunity, humoral immunity, vaccination,
• MeSH
• COVID-19 * prevence a kontrola   MeSH
• dospělí MeSH
• imunita MeSH
• imunoglobulin G MeSH
• lidé MeSH
• messenger RNA MeSH
• prospektivní studie MeSH
• SARS-CoV-2 MeSH
• vakcína BNT162 MeSH
• vakcinace MeSH
• vakcíny proti COVID-19 MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• imunoglobulin G MeSH
• messenger RNA MeSH
• vakcína BNT162 MeSH
• vakcíny proti COVID-19 MeSH

BACKGROUND: Kidney transplant recipients are at risk for a severe course of COVID-19 with a high mortality rate. A considerable number of patients remains without a satisfactory serological response after the baseline and adjuvant SARS-CoV-2 vaccination schedule. METHODS: In this prospective, randomized study, we evaluated the efficacy and safety of one and two booster doses of mRNA vaccines (either mRNA-1273 or BNT162b2) in 125 COVID-19 naive, adult kidney transplant recipients who showed an insufficient humoral response (SARS-CoV-2 IgG <10 AU/ml) to the previous 2-dose vaccination schedule. The primary outcome was the difference in the rate of a positive antibody response (SARS-CoV-2 IgG ≥10 AU/ml) between one and two booster doses at 1 month after the final booster dose. RESULTS: A positive humoral response was observed in 36 (62%) patients receiving two booster doses and in 28 (44%) patients receiving one booster dose (odds ratio [OR], 2.10, 95% confidence interval [CI], 1.02-4.34, p = .043). Moreover, median SARS-CoV-2 IgG levels were higher with two booster doses (p = .009). The number of patients with positive virus neutralizing antibody (VNA) levels was numerically higher with two booster doses compared to one booster dose, but without statistical significance (66% vs. 50%, p = .084). There was no significant difference in positive seroconversions rate and antibody levels between mRNA-1273 and BNT162b2. CONCLUSION: A higher number of kidney transplant recipients achieved a positive antibody response after two booster doses compared to one booster dose.

• Klíčová slova
• COVID-19, SARS-CoV-2 mRNA vaccine, SARS-CoV-2 vaccination, kidney transplantation, randomized trial,
• MeSH
• COVID-19 * prevence a kontrola   MeSH
• dospělí MeSH
• imunoglobulin G MeSH
• lidé MeSH
• mRNA vakcíny MeSH
• příjemce transplantátu MeSH
• protilátky virové MeSH
• SARS-CoV-2 MeSH
• transplantace ledvin * škodlivé účinky   MeSH
• vakcína BNT162 MeSH
• vakcína firmy Moderna proti COVID-19 MeSH
• vakcíny proti COVID-19 škodlivé účinky   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• imunoglobulin G MeSH
• mRNA vakcíny MeSH
• protilátky virové MeSH
• vakcína BNT162 MeSH
• vakcína firmy Moderna proti COVID-19 MeSH
• vakcíny proti COVID-19 MeSH

The pandemic of the disease COVID-19 (COronaVIrus Disease 2019) caused by the SARS-CoV-2 coronavirus (severe acute respiratory syndrome coronavirus 2) resulted in millions of deaths and many patients have chronic consequences after overcoming the acute condition. Several vaccines have been developed in an effort to stop the spread of the virus, but they have potentially serious adverse effects. We present a case report of a patient with acute (myocarditis, exacerbation of bronchial asthma) and long-term (postural orthostatic tachycardia syndrome - POTS) complications after vaccination with the second dose of mRNA vaccine BNT162b2 (Comirnaty®). Treatment consists of regimen measures, numerous pharmacotherapy (metoprolol, ivabradine, corticosteroids, antihistamines, antiphlogistics, bronchodilators) and several nutraceuticals (maritime pine bark extract, quercetin, vitamins, magnesium, phosphatidylcholine). In the discussion, we analyze post-vaccination injury and present a short review of the current literature.

• Klíčová slova
• Asthma, COVID-19, POTS, myocarditis, nutraceuticals, vaccination,
• MeSH
• COVID-19 * prevence a kontrola   MeSH
• lidé MeSH
• SARS-CoV-2 MeSH
• vakcína BNT162 MeSH
• vakcinace MeSH
• vakcíny proti COVID-19 * škodlivé účinky   MeSH
• vitaminy MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• vakcína BNT162 MeSH
• vakcíny proti COVID-19 * MeSH
• vitaminy MeSH

BACKGROUND: Rituximab (RTX) and ocrelizumab (OCR), B cell-depleting therapy targeting CD20 molecules, affect the humoral immune response after vaccination. How these therapies influence T-cell-mediated immune response against SARS-CoV-2 after immunization remains unclear. We aimed to evaluate the humoral and cellular immune response to the COVID-19 vaccine in a cohort of patients with multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), and myasthenia gravis (MG). METHODS: Patients with MS (83), NMOSD (19), or MG (7) undergoing RTX (n=47) or OCR (n=62) treatment were vaccinated twice with the mRNA BNT162b2 vaccine. Antibodies were quantified using the SARS-CoV-2 IgG chemiluminescence immunoassay, targeting the spike protein. SARS-CoV-2-specific T cell responses were quantified by interferon γ release assays (IGRA). The responses were evaluated at two different time points (4-8 weeks and 16-20 weeks following the 2nd dose of the vaccine). Immunocompetent vaccinated individuals (n=41) were included as controls. RESULTS: Almost all immunocompetent controls developed antibodies against the SARS-CoV-2 trimeric spike protein, but only 34.09% of the patients, without a COVID-19 history and undergoing anti-CD20 treatment (via RTX or OCR), seroconverted. This antibody response was higher in patients with intervals of longer than 3 weeks between vaccinations. The duration of therapy was significantly shorter in seroconverted patients (median 24 months), than in the non-seroconverted group. There was no correlation between circulating B cells and the levels of antibodies. Even patients with a low proportion of circulating CD19+ B cells (<1%, 71 patients) had detectable SARS-CoV-2 specific antibody responses. SARS-CoV-2 specific T cell response measured by released interferon γ was detected in 94.39% of the patients, independently of a humoral immune response. CONCLUSION: The majority of MS, MG, and NMOSD patients developed a SARS-CoV-2-specific T cell response. The data suggest that vaccination can induce SARS-CoV-2-specific antibodies in a portion of anti-CD20 treated patients. The seroconversion rate was higher in OCR-treated patients compared to those on RTX. The response represented by levels of antibodies was better in individuals, with intervals of longer than 3 weeks between vaccinations.

• Klíčová slova
• IFN gamma release assay, SARS-CoV-2, SARS-CoV-2 mRNA vaccine, humoral immune response, multiple sclerosis, myasthenia gravis, neuromyelitis optica spectrum disorder,
• MeSH
• autoimunitní nemoci nervového systému * MeSH
• COVID-19 * MeSH
• glykoprotein S, koronavirus MeSH
• humanizované monoklonální protilátky terapeutické užití   MeSH
• lidé MeSH
• myasthenia gravis * MeSH
• protilátky virové MeSH
• rituximab terapeutické užití   MeSH
• roztroušená skleróza * farmakoterapie   MeSH
• SARS-CoV-2 MeSH
• vakcína BNT162 MeSH
• vakcinace MeSH
• vakcíny proti COVID-19 MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• glykoprotein S, koronavirus MeSH
• humanizované monoklonální protilátky MeSH
• ocrelizumab MeSH Prohlížeč
• protilátky virové MeSH
• rituximab MeSH
• spike protein, SARS-CoV-2 MeSH Prohlížeč
• vakcína BNT162 MeSH
• vakcíny proti COVID-19 MeSH

• MeSH
• COVID-19 * prevence a kontrola   MeSH
• dítě MeSH
• lidé MeSH
• SARS-CoV-2 MeSH
• vakcína BNT162 MeSH
• vakcíny proti COVID-19 * MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• komentáře MeSH
• Názvy látek
• vakcína BNT162 MeSH
• vakcíny proti COVID-19 * MeSH

OBJECTIVES: We prospectively compared the postvaccination immunity to messenger ribonucleic acid BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine of our pediatric patients over 12 years old with inflammatory bowel disease (IBD) to that of healthy controls and looked for predictors of its robustness. METHODS: Anti-receptor binding domain, anti-spike S2, and anti-nucleocapsid immunoglobin-G (IgG) and immunoglobin-A levels were measured in 139 pediatric patients with IBD [65 fully vaccinated (2 doses), median age 16.3, interquartile range (IQR) 15.2-17.8 years, median time from vaccination (IQR) 61.0 (42.0-80.0) days] and 1744 controls (46, 37-57 years) using microblot array. RESULTS: All IBD and control patients developed positive anti-receptor binding domain IgG antibodies at comparable titers. The proportion of observations with positive anti-spike S2 IgG was higher in patients with IBD than in controls [63% vs 21%, odds ratio 2.99 (1.51-5.90)], as was its titer [median (IQR) 485 (92-922) vs 79 [33-180] IU/mL]. Anti-receptor binding domain and anti-spike S2 IgG levels were associated with IBD status. We found an association between anti-spike S2 IgG levels and time since vaccination (β -4.85, 95% CI -7.14 to 2.71, P = 0.0001), history of SARS-CoV-2 polymerase chain reaction positivity (206.76, 95% CI 39.93-374.05, P = 0.0213), and anti-tumor necrosis factor treatment (-239.68, 95% CI -396.44-83.55, P = 0.0047). Forty-three percent of patients reported vaccination side effects (mostly mild). Forty-six percent of observations with positive anti-nucleocapsid IgG had a history of SARS-CoV-2 infection. CONCLUSIONS: Patients with IBD produced higher levels of postvaccination anti-spike S2 antibodies than controls. Previous SARS-CoV-2 infection is associated with higher production of postvaccination antibodies and anti-tumor necrosis factor treatment with lower production.

• MeSH
• COVID-19 * prevence a kontrola   MeSH
• dospělí MeSH
• idiopatické střevní záněty * MeSH
• imunoglobulin G MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• nekróza MeSH
• protilátky virové MeSH
• SARS-CoV-2 MeSH
• TNF-alfa MeSH
• vakcína BNT162 MeSH
• vakcinace MeSH
• vakcíny proti COVID-19 MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• imunoglobulin G MeSH
• protilátky virové MeSH
• TNF-alfa MeSH
• vakcína BNT162 MeSH
• vakcíny proti COVID-19 MeSH