Immunogenicity of COVID-19 vaccines in solid organ transplant recipients: a systematic review and meta-analysis.
Clin Microbiol Infect
; 29(4): 441-456, 2023 Apr.
Artículo
en Inglés
| 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.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Vacunas
/
Trasplante de Órganos
/
COVID-19
Tipo de estudio:
Estudio de cohorte
/
Estudio experimental
/
Estudio observacional
/
Estudio pronóstico
/
Ensayo controlado aleatorizado
/
Revisiones
/
Revisión sistemática/Meta análisis
Tópicos:
Vacunas
Límite:
Humanos
Idioma:
Inglés
Revista:
Clin Microbiol Infect
Asunto de la revista:
Enfermedades Transmisibles
/
Microbiologia
Año:
2023
Tipo del documento:
Artículo
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