ABSTRACT
Introduction: It has been reported that after vaccination with RNAm or viral vectors from SARS-CoV-2 a significant number of solid organ transplant recipients do not develop an effective immune response. In this scenario, the use of tixagevimab-cilgavimab was approved by the European Medicines Agency for COVID-19 prophylaxis in immunocompromised patients in March 2022. We present our experience with a group of kidney transplant recipients who received prophylactic treatment with tixagevimab-cilgavimab. Material and methods: Prospective study from a cohort of kidney transplant recipients who had been previously vaccinated with 4 doses and did not achieve a satisfactory immune response to vaccination, presenting antibody titers lower than 260 BAU/mL when measured by ELISA. A total of 55 patients who received a single dose of 150 mg of tixagevimab and 150 mg of cilgavimab between May and September of 2022 were included in this study. Results: No immediate or severe adverse reactions, including worsening of kidney function, were observed after administering the drug or during follow up. All patients who had received the drug 3 months prior presented positive antibody titers (> 260 BAU/mL). Seven patients were diagnosed with COVID, and one of those patients had to be admitted to the hospital and died 5 days later from infectious complications and a suspected diagnosis of bacterial coinfection. Conclusions: In our experience, all kidney transplant recipients reached antibody titers higher than 260 BAU/mL 3 months after receiving prophylactic treatment with tixagevimab-cilgavimab with no severe or irreversible adverse reactions.
Subject(s)
COVID-19 , Pre-Exposure Prophylaxis , Humans , COVID-19/prevention & control , Immunocompromised HostABSTRACT
BACKGROUND AND OBJECTIVE: SARS-CoV-2 has been and is a major global Public Health challenge. Since the beginning of the pandemic, different comorbidities have been postulated and associated with spectra of increased severity and mortality. The objectives of this research are: 1) to analyse the factors associated with SARS-CoV-2 infection (COVID-19) in a health area in northern Spain; 2) to understand the possible role of influenza vaccination and pneumococcal vaccination in the development of COVID-19. MATERIALS AND METHOD: A test-negative case-control study was conducted. Variables related to personal and vaccination history were considered. Although the epidemiological definition of the case varied over time, the reference definition was that corresponding to 31/01/2020 in Spain. A bivariate and multivariate analysis was performed. RESULTS: The sample included 188 patients, of which 63 were cases and 125 controls. The results show that obesity increases the risk 2.4-fold of suffering this infection (IC 95% 1,301-4,521) and ARA-2 increases it 2.2-fold (95% CI 1,256-6,982). On the other hand, anti-pneumococcal vaccination of 13 serotypes showed results close to statistical significance (OR = 0.4; 95% CI 0.170-1,006). CONCLUSION: Obesity and the use of ARA-2 increases the risk of COVID-19. Scientific knowledge about factors associated with COVID-19 should be expanded. The authors consider that the present research raises the need further investigate the role of vaccines in this infection and their possible heterologous properties.
ANTECEDENTES Y OBJETIVO: El SARS-CoV-2 ha supuesto un importante reto de salud pública. Desde el inicio de la pandemia, se han postulado diferentes comorbilidades que se han asociado con espectros de mayor gravedad y mortalidad. Los objetivos de la presente investigación son: 1) analizar los factores asociados a la infección por SARS-CoV-2 (COVID-19) en un área sanitaria del norte de España; 2) conocer el posible papel de la vacunación antigripal y antineumocócica en el desarrollo de la COVID-19. MATERIALES Y MÉTODOS: Se ha realizado un estudio de casos y controles de test negativo. Se tuvieron en cuenta variables relacionadas con los antecedentes personales y vacunales. A pesar de que la definición epidemiológica de caso fue variando a lo largo del tiempo, se tuvo como referencia la correspondiente al 31 de enero del 2020 en España. Se efectuó un análisis bivariante y multivariante. RESULTADOS: La muestra incluyó a 188 pacientes, de los cuales 63 fueron casos y 125 controles. Los resultados muestran que la obesidad aumenta 2,4 veces el riesgo de padecer esta infección (IC 95% 1.301 a 4.521) y los antagonistas de los receptores de la angiotensina II (ARA-2) lo aumentan 2,2 veces (IC 95% 1.256 a 6.982). Por otro lado, la vacunación antineumocócica conjugada de 13 serotipos mostró resultados cercanos a la significación estadística (OR = 0,4; IC 95% 0,170 a 1.006). CONCLUSIONES: La obesidad y el uso de fármacos ARA-2 aumentan el riesgo de la COVID-19. El conocimiento científico sobre los factores asociados a la COVID-19 debe seguir ampliándose. La presente investigación plantea la necesidad de profundizar en el papel de las vacunas sobre esta infección y sus posibles propiedades heterólogas.
ABSTRACT
BACKGROUND AND OBJECTIVE: SARS-CoV-2 has been and is a major global Public Health challenge. Since the beginning of the pandemic, different comorbidities have been postulated and associated with spectra of increased severity and mortality. The objectives of this research are: 1) to analyse the factors associated with SARS-CoV-2 infection (COVID-19) in a health area in northern Spain; 2) to understand the possible role of influenza vaccination and pneumococcal vaccination in the development of COVID-19. MATERIALS AND METHOD: A test-negative case-control study was conducted. Variables related to personal and vaccination history were considered. Although the epidemiological definition of the case varied over time, the reference definition was that corresponding to 31/01/2020 in Spain. A bivariate and multivariate analysis was performed. RESULTS: The sample included 188 patients, of which 63 were cases and 125 controls. The results show that obesity increases the risk 2.4-fold of suffering this infection (IC 95% 1,301-4,521) and ARA-2 increases it 2.2-fold (95% CI 1,256-6,982). On the other hand, anti-pneumococcal vaccination of 13 serotypes showed results close to statistical significance (OR = 0.4; 95% CI 0.170-1,006). CONCLUSION: Obesity and the use of ARA-2 increases the risk of COVID-19. Scientific knowledge about factors associated with COVID-19 should be expanded. The authors consider that the present research raises the need further investigate the role of vaccines in this infection and their possible heterologous properties.
Subject(s)
COVID-19 , SARS-CoV-2 , Case-Control Studies , Humans , Pandemics , VaccinationABSTRACT
Monitoring adverse reactions following immunisation is essential, particularly for new vaccines such as those against COVID-19. We describe 20 cases of acute onset of a single supraclavicular lymphadenopathy manifesting between 24 h and 9 days after ipsilateral intramuscular administration of an mRNA-based COVID-19 vaccine, referred to our WHO Collaborating Centre for Vaccine Safety. Our results indicate that the swelling of supraclavicular lymph nodes following immunisation may constitute a benign and self-limited condition, related to a higher than recommended injection site.