ABSTRACT
BACKGROUND: The efficacy of the response to SARS-CoV-2 vaccination in kidney transplant recipients is low. The aim of our study was to evaluate the risk factors correlated with the low antibody response and whether there was an improvement between the second and the third dose. METHODS: A prospective study was conducted on 176 kidney transplant recipients who received the second and the third dose of the anti-SARS-CoV-2 mRNA Comirnaty vaccine. We evaluated the seroconversion process after administration of the second and the third dose and assessed a possible correlation with age, time between transplant and vaccination, and type of immunosuppressive therapy. RESULTS: A total of 98 of the 176 patients (55.7%) responded positively after the inoculation of the second dose and according to the multivariable logistic regression analysis the lack of seroconversion was independently associated with patient age ≥60 (P = .025; odds ratio [OR], 2.094), time since transplant of 1 to 3 months (P = .032; OR, 2.118), and triple therapy (P = .044; OR, 2.327). After the vaccine third dose, the seroconversion increased to 62.5%, and it was negatively influenced by calcineurin inhibitor use (12/21, 57.1% vs 71/78, 91.0%, P = .0006) and triple therapy (13/21, 61.9% vs 72/78, 92.3%, P = .0014). The median of antispike antibody response significantly increased from 18.5 IU/mL after the second dose to 316.9 IU after the third dose (P < .0001). CONCLUSIONS: We demonstrated a correlation between older age and shorter distance from the transplant and triple immunosuppressive therapy with the lack of seroconversion. We noticed a significant improvement in antibody response by a third dose of messenger RNA vaccine.
ABSTRACT
Autism spectrum disorder refers to a neurodevelopment disorder that is cha ra c t e r i z e d by di f fi cul t i e s with social communication and social interaction and restricted and repetitive patterns in behaviors, interests, and activities. During the lockdown, when social isolation and distancing become mandatory for everyone, disruption of daily routines (school, therapy, free time) is a risk factor especially for families with a child with autism disorder, because their children may have a freeze in the progress they had painstakingly achieved up to that point. In this study, we monitored 81 families of children with autism disorder, assessed before the onset of the lockdown and approximately 4 months later, to see which children's behaviors had worsened and which had remained stable or improved. The families were interviewed, in February and July 2020, using standardized rating scales. The results showed an intensification in the children of motor restlessness, difficulty in sleep regulation, while there were no worsening in self-harming or hetero-aggressive behaviors, nor in personal autonomy. It should be considered that all the families involved in the present research were involved in therapeutic paths and did not interrupt the path of psychological support (online), with the specific objective of supporting them in their parental role in the most critical phases experienced by the children, and in making them more active in the processes of consolidation of the competences acquired by the children.