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Nephrology Dialysis Transplantation ; 37(SUPPL 3):i152-i153, 2022.
Article in English | EMBASE | ID: covidwho-1915685


BACKGROUND AND AIMS: Immunosuppressed patients are in general less likely to achieve a detectable antibody response to SARS-CoV-2 after the primary doses of vaccine administration. However, there are limited data for the effect of a third booster dose in this patient population, especially for those with vasculitides and renal involvement treated with rituximab (RTX). METHOD: We retrospectively assessed the antibody responses to SARS-CoV-2 vaccination, after completion of the primary vaccine series (two doses) and after the booster third dose, in patients with vasculitides and renal involvement. IgG antibodies to the spike protein S1 subunit of SARS-CoV-2 were measured using ELISA >1 month after completion of the primary vaccination series (two doses of Pfizer or AstraZeneca vaccines) and 15-30 days after the third booster dose (Pfizer, given 3-6 months after the second dose). RESULTS: We included 20 patients with vasculitis [AAV, n = 16 (80%), IgAV, n = 4 (20%)] and renal involvement. All patients received immunosuppressives, including RTX (80%), MMF/AZA (15%), cyclophosphamide (5%), while half of patients were on glucocorticoids. The seroconversion rate after the primary two doses (Pfizer n = 8/16, Astra-Zeneca n = 1/1) was 53%, which increased to 67% after the third booster dose (Pfizer, n = 12/18). Similarly, the median antibody titers increased from 451 U/mL [interquartile range (IQR) 81-10.845] after the second dose to 1016 U/mL (IQR: 64- 37.568) after the booster dose. Regarding patients treated with RTX, the respective response rates after the second and third dose were 58% and 62%. Seropositive patients after the third dose tended to have lower previous cumulative exposure to RTX compared with seronegative ones (4.55 versus 5.5 g, P = .62, respectively). No vaccine side effects or disease relapses were noted after the three vaccine doses. CONCLUSION: In our patient cohort with systemic vasculitis and renal involvement treated mainly with RTX, a third booster vaccine dose increased the seropositivity rate from 53% to 67%. Nevertheless, one-third of patients did not achieve seroconversion. Whether a fourth booster dose could benefit these patients is still unknown.

Hellenic Journal of Vascular and Endovascular Surgery ; 3(3):89-92, 2021.
Article in English | EMBASE | ID: covidwho-1848808


Purpose: The purpose of our report is to present two patients with acute peripheral arterial thrombosis as a result of COVID-19 infection and discuss the unique features of arterial thrombosis in patients suffering from COVID-19. Case Report: We present a 66-year-old female and a 53-year-old male with proven COVID-19 infection who developed acute lower limb ischemia. Common features in both patients were a multi-segment arterial occlusion in previously healthy arteries, developing despite prophylactic anticoagulation about 15 days after the onset of COVID-19 symptoms. Limb salvage was achieved by early diagnosis and expedited thrombectomy. Conclusion: COVID-19 associated arterial thromboembolism has several unique features reflecting the underlying pathogenetic mechanism which involves a combination of coagulopathy and endothelial dysfunction. Clinical vigilance allowing early diagnosis and expedited surgery remains the key to a successful outcome.