The Influence of Initial Immunosuppression on the Kinetics of Humoral Response after SARS-CoV-2 Vaccination in Patients Undergoing Kidney Transplantation
Renato Demarchi Foresto,
Roberto Matias Souza,
Gustavo Rodrigues dos Anjos,
Mônica Rika Nakamura,
Haryanne de Souza Goulart,
Rayra Sampaio,
Daniela Pereira França,
Emanuelle Ferreira Marques,
Elisabeth França Lucena,
Marina Pontello Cristelli,
Helio Tedesco Silva,
Lúcio Requião-Moura,
José Medina Pestana
Affiliations
Renato Demarchi Foresto
Nephrology Division, Universidade Federal de São Paulo, 960 Borges Lagoa Street, São Paulo 04038-002, Brazil
Roberto Matias Souza
Nephrology Division, Universidade Federal de São Paulo, 960 Borges Lagoa Street, São Paulo 04038-002, Brazil
Gustavo Rodrigues dos Anjos
Nephrology Division, Universidade Federal de São Paulo, 960 Borges Lagoa Street, São Paulo 04038-002, Brazil
Mônica Rika Nakamura
Hospital do Rim, Fundação Oswaldo Ramos, São Paulo 04039-000, Brazil
Haryanne de Souza Goulart
Hospital do Rim, Fundação Oswaldo Ramos, São Paulo 04039-000, Brazil
Rayra Sampaio
Hospital do Rim, Fundação Oswaldo Ramos, São Paulo 04039-000, Brazil
Daniela Pereira França
Hospital do Rim, Fundação Oswaldo Ramos, São Paulo 04039-000, Brazil
Emanuelle Ferreira Marques
Hospital do Rim, Fundação Oswaldo Ramos, São Paulo 04039-000, Brazil
Elisabeth França Lucena
Hospital do Rim, Fundação Oswaldo Ramos, São Paulo 04039-000, Brazil
Marina Pontello Cristelli
Hospital do Rim, Fundação Oswaldo Ramos, São Paulo 04039-000, Brazil
Helio Tedesco Silva
Nephrology Division, Universidade Federal de São Paulo, 960 Borges Lagoa Street, São Paulo 04038-002, Brazil
Lúcio Requião-Moura
Nephrology Division, Universidade Federal de São Paulo, 960 Borges Lagoa Street, São Paulo 04038-002, Brazil
José Medina Pestana
Nephrology Division, Universidade Federal de São Paulo, 960 Borges Lagoa Street, São Paulo 04038-002, Brazil
Background: The effect of initial immunosuppressive therapy on the kinetics of the SARS-CoV-2 vaccine-induced humoral response is unknown. Here, we compared the kinetics of SARS-CoV-2 vaccine-induced humoral response in chronic kidney disease patients undergoing kidney transplantation (KTRs) and compared to patients remaining on dialysis during the Omicron circulation. Methods: This prospective, non-randomized, real-world study included 113 KTRs and 108 patients on dialysis. Those with previous COVID-19 or negative IgG at screening were excluded. Blood samples were collected to assess SARS-CoV-2 IgG titers and neutralizing antibodies at months (M) 1, 3, 6, and 12. Results: Seroreversion occurred in one KTR and in three patients on dialysis. KTRs had lower IgG titers over time (M1: 10,809.3 ± 12,621.7 vs. 15,267.8 ± 16,096.2 AU/mL; M3: 12,215.5 ± 12,885.8 vs. 15,016.2 ± 15,346.1 AU/mL; M6: 12,540.4 ± 13,010.7 vs. 18,503.5 ± 14,581.0 AU/mL; p = 0.005), but neutralizing antibodies were similar (M1: 94.0 vs. 90.3%; M3: 92.9 vs. 90.5%; M6: 99.0 vs. 95.5%; M12: 98.9 vs. 97.5%; p = 0.812). During follow-up, KTRs received more vaccines (141 vs. 73; p p = 0.002). Conclusions: Compared to patients on dialysis, KTRs had lower SARS-CoV-2 IgG titers and similar rates of seroreversion and neutralizing antibodies over time. Although KTRs received more boosters, they had a higher incidence of COVID-19.
