We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Humoral immunity to SARS-CoV-2 in kidney transplant recipients and dialysis patients: IgA and IgG patterns unraveled after SARS-CoV-2 infection and vaccination.
- Authors
De Bouver, Caroline; Bouziotis, Jason; Wijtvliet, Veerle P. W. M.; Ariën, Kevin K.; Mariën, Joachim; Heyndrickx, Leo; Couttenye, Marie M.; de Fijter, Hans J. W.; Mestrez, Fabienne; Treille, Serge; Mat, Olivier; Collart, Frederic; Allard, Sabine D.; Vingerhoets, Lies; Moons, Pieter; Abramowicz, Daniel; De Winter, Benedicte Y.; Pipeleers, Lissa; Wissing, Karl Martin; Ledeganck, Kristien J.
- Abstract
Background: Infection with SARS-CoV-2 in high-risk groups such as kidney transplant and dialysis patients is shown to be associated with a more serious course of the disease. Four years after the start of the COVID-19 pandemic, crucial knowledge on the immune responses in these patient groups is still lacking. Therefore, this study aimed at investigating the humoral immune response after a SARS-CoV-2 infection compared to vaccination as well as the evolution of immunoglobulins over time. Methods: Kidney transplant recipients, patients on haemodialysis or on peritoneal dialysis and healthy controls were included in this longitudinal multicenter study. SARS-CoV-2 anti-RBD, anti-NP and anti-S1S2 immunoglobulin G (IgG) and A (IgA) as well as the neutralizing antibody capacity were measured. Results: Kidney transplant recipients had a significantly better humoral response to SARS-CoV-2 after infection (86.4%) than after a two-dose mRNA vaccination (55.8%) while seroconversion was comparable in patients on haemodialysis after infection (95.8%) versus vaccination (89.4%). In individuals without prior COVID-19, the IgG levels after vaccination were significantly lower in kidney transplant recipients when compared to all other groups. However, the IgA titres remained the highest in this patient group at each time point, both after infection and vaccination. A history COVID-19 was associated with higher antibody levels after double-dose vaccination in all patient categories and, while decreasing, titres remained high six months after double-dose vaccination. Conclusion: Kidney transplant recipients had a more robust humoral response to SARS-CoV-2 following infection compared to a two-dose mRNA vaccination, while patients on haemodialysis exhibited comparable seroconversion rates. Notably, individuals with prior COVID-19 exhibited higher IgG levels in response to vaccination. Hybrid immunity is thus the best possible defence against severe COVID-19 disease and seems also to hold up for these populations. Next, it is not clear whether the higher IgA levels in the kidney transplant recipients is beneficial for neutralizing SARS-CoV-2 or if it is a sign of disease severity. Key learning points: What was known - In high-risk groups such as kidney transplant patients and dialysis patients, the immune system does not function optimally due to several metabolic processes and lifelong use of immunosuppressants. - Severe infection with SARS-CoV-2 in these high-risk groups is known to be associated with a more serious course of the disease. - Severe disease after SARS-CoV-2 infection was rarely reported but all concerned KTRs who lacked immune responses after vaccination. - Antibody levels decreased four weeks post-vaccination, which emphasizes the importance of booster vaccines. - Kidney transplant recipients with prior COVID-19 exhibited higher anti-Spike IgG levels after a single dose of a SARS-CoV-2 mRNA-based vaccine. This study adds - Humoral immune response to SARS-CoV-2 in kidney transplant recipients was more robust following infection than vaccination. - Next to kidney transplant recipients, patients on dialysis with prior COVID-19 exhibited higher anti-RBD and anti-S1S2 IgG levels as well, so hybrid immunity seems the best possible defence against severe COVID-19 disease in both populations. - Kidney transplant recipients showed the highest IgA titres compared to any other group after double-dose vaccination and infection, along with the lowest IgG titres after vaccination. Potential impact - Our results strengthen the need to administer all the recommended vaccines to patients with end-stage renal disease, and to consider booster vaccination. - Our findings make an important contribution to the COVID-19 research field by analysing both IgG and IgA serology and neutralizing antibody capacity after infection and vaccination, leading to a better understanding of the quality of the humoral immune response and its relationship with clinical data.
- Subjects
KIDNEYS; KIDNEY transplantation; HUMORAL immunity; HEMODIALYSIS patients; SARS-CoV-2; IMMUNOGLOBULIN G; IMMUNOGLOBULIN M; PREMATURE ejaculation
- Publication
Virology Journal, 2024, Vol 21, Issue 1, p1
- ISSN
1743-422X
- Publication type
Article
- DOI
10.1186/s12985-024-02410-1