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Immunogenicity of COVID-19 vaccines in solid organ transplant recipients: a systematic review and meta-analysis.
Chen, Xinpei; Luo, De; Mei, Bingjie; Du, Juan; Liu, Xiangdong; Xie, Hui; Liu, Lin; Su, Song; Mai, Gang.
  • Chen X; Department of Hepatobiliary Surgery, People's Hospital of Deyang City, Deyang, China; Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany. Electronic address: xinpei.chen@outlook.com.
  • Luo; Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China; Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. Electronic address: 13679688714@163.com.
  • Mei B; Sichuan Cancer Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. Electronic address: bingjie.mei@outlook.com.
  • Du J; Department of Clinical Medicine, Southwest Medical University, Luzhou, China. Electronic address: 1575743460@qq.com.
  • Liu X; Department of Hepatobiliary Surgery, The 4th People's Hospital of Zigong City, Zigong, China. Electronic address: 807903650@qq.com.
  • Xie H; Department of Hepatobiliary Surgery, People's Hospital of Deyang City, Deyang, China. Electronic address: 328560402@qq.com.
  • Liu L; Department of Hepatobiliary Surgery, People's Hospital of Deyang City, Deyang, China. Electronic address: liulin660060@163.com.
  • Su S; Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China. Electronic address: 13882778554@163.com.
  • Mai G; Department of Hepatobiliary Surgery, People's Hospital of Deyang City, Deyang, China. Electronic address: maigang68@hotmail.com.
Clin Microbiol Infect ; 29(4): 441-456, 2023 Apr.
Article in English | MEDLINE | ID: covidwho-2254651
ABSTRACT

BACKGROUND:

Solid organ transplant (SOT) recipients are at increased risks of morbidity and mortality associated with COVID-19.

OBJECTIVES:

This study aimed to evaluate the immunogenicity of COVID-19 vaccines in SOT recipients. DATA SOURCES Electronic databases were searched for eligible reports published from 1 December 2019 to 31 May 2022. STUDY ELIGIBILITY CRITERIA We included reports evaluating the humoral immune response (HIR) or cellular immune response rate in SOT recipients after the administration of COVID-19 vaccines.

PARTICIPANTS:

SOT recipients who received COVID-19 vaccines. ASSESSMENT OF RISK OF BIAS We used the Newcastle-Ottawa scale to assess bias in case-control and cohort studies. For randomised-controlled trials, the Jadad Scale was used.

METHODS:

We used a random-effects model to calculate the pooled rates of immune response with 95% CI. We used a risk ratio (RR) with 95% CI for a comparison of immune responses between SOT and healthy controls.

RESULTS:

A total of 91 reports involving 11 886 transplant recipients (lung 655; heart 539; liver 1946; and kidney 8746) and 2125 healthy controls revealed pooled HIR rates after the 1st, 2nd, and 3rd COVID-19 vaccine doses in SOT recipients were 9.5% (95% CI, 7-11.9%), 43.6% (95% CI, 39.3-47.8%) and 55.1% (95% CI, 44.7-65.6%), respectively. For specific organs, the HIR rates were still low after 1st vaccine dose (lung 4.4%; kidney 9.4%; heart 13.2%; liver 29.5%) and 2nd vaccine dose (lung 28.4%; kidney 37.6%; heart 50.3%; liver 64.5%).

CONCLUSIONS:

A booster vaccination enhances the immunogenicity of COVID-19 vaccines in SOT; however, a significant share of the recipients still has not built a detectable HIR after receiving the 3rd dose. This finding calls for alternative approaches, including the use of monoclonal antibodies. In addition, lung transplant recipients need urgent booster vaccination to improve the immune response.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / Organ Transplantation / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Vaccines Limits: Humans Language: English Journal: Clin Microbiol Infect Journal subject: Communicable Diseases / Microbiology Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / Organ Transplantation / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Vaccines Limits: Humans Language: English Journal: Clin Microbiol Infect Journal subject: Communicable Diseases / Microbiology Year: 2023 Document Type: Article