Evaluation of the Kinetics of Antibody Response to COVID-19 Vaccine in Solid Organ Transplant Recipients: The Prospective Multicenter ORCHESTRA Cohort
Abstract
:1. Introduction
2. Materials and Methods
3. Results
Statistical Analysis
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Total n = 1062 (%) | Positive Antibody Response at 3 ± 1 Month N = 556 (%) | Negative Antibody Response at 3 ± 1 Month N = 506 (%) | p | |
---|---|---|---|---|
Demographic data | ||||
Age (mean ± SD) (years) | 58.28 ± 13.10 | 56.47 ± 13.61 | 60.26 ± 12.23 | <0.001 |
Age group | <0.001 | |||
<39 y | 93 (8.76%) | 63 (67.74%) | 30 (32.26%) | |
40–49 y | 156 (14.69%) | 93 (59.62%) | 63 (40.38%) | |
50–59 y | 268 (25.24%) | 146 (54.48%) | 122 (45.52%) | |
60–69 y | 309 (29.10%) | 148 (47.90%) | 161 (52.10%) | |
≥70 y | 236 (22.22%) | 106 (44.92%) | 130 (55.08%) | |
Sex | 0.967 | |||
Male | 704 (66.29%) | 368 (52.27%) | 336 (47.73%) | |
Female | 353 (33.40%) | 185 (52.41%) | 168 (47.59%) | |
Comorbidities | 0.005 | |||
No | 347 (32.67%) | 203 (58.50%) | 144 (41.5%) | |
Yes | 715 (67.33%) | 353 (49.37%) | 362 (50.63%) | |
Type of graft | <0.001 | |||
Kidney | 677 (63.75%) | 312 (46.09%) | 365 (53.91%) | |
Heart | 177 (16.67%) | 86 (48.59%) | 91 (51.41%) | |
Liver | 182 (17.14%) | 144 (79.12%) | 38 (20.88%) | |
Lung | 26 (2.45%) | 14 (53.85%) | 12 (46.15%) | |
Type of vaccine | <0.001 | |||
BNT162b2 | 928 (87.38%) | 463 (49.89%) | 465 (50.11%) | |
mRNA-1273 | 134 (12.62%) | 93 (69.40%) | 41 (30.60%) | |
Time from transplant to vaccination | <0.001 | |||
Less than 1 year | 58 (5.46%) | 21 (36.21%) | 37 (63.79%) | |
1 to 3 years | 166 (15.63%) | 68 (40.96%) | 98 (59.04%) | |
More than 3 years | 836 (78.72%) | 465 (55.62%) | 371 (44.38%) | |
Induction regimen in the last 6 months | 0.340 | |||
No | 1061 (99.90%) | 555 (52.31%) | 506 (47.69%) | |
Any | 1 (0.09%) | 1 (100%) | 0 (0.00%) | |
Immunosuppressive drugs at the time of vaccination | ||||
Calcineurin inhibitors | 1007 (94.82%) | 520 (51.64%) | 487 (48.36%) | 0.046 |
Tacrolimus | 763 (71.85%) | 384 (50.33%) | 379 (49.67%) | 0.035 |
Cyclosporine | 246 (23.16%) | 136 (55.28%) | 110 (44.72%) | 0.294 |
Anti-metabolites | 663 (62.43%) | 284 (42.84%) | 379 (57.16%) | <0.001 |
Mycophenolate mofetil | 626 (58.95%) | 252 (40.26%) | 374 (59.74%) | <0.001 |
Azathioprine | 37 (3.48%) | 32 (86.49%) | 5 (13.51%) | <0.001 |
mTOR | 144 (13.56%) | 90 (62.50%) | 54 (37.50%) | 0.009 |
Everolimus | 128 (12.05%) | 78 (60.94%) | 50 (39.06%) | 0.038 |
Sirolimus | 16 (1.51%) | 12 (75.00%) | 4 (25.00%) | 0.068 |
Steroids | 709 (66.76%) | 312 (44.01%) | 397 (55.99%) | <0.001 |
Impaired graft function | <0.001 | |||
Good | 830 (78.15%) | 475 (57.23%) | 355 (42.77%) | |
Impaired or Failure | 222 (20.90%) | 75 (33.78%) | 147 (66.22%) | |
Time between first dose and assessment of antibody response | 0.038 | |||
40–70 d | 170 (16.01%) | 74 (43.53%) | 96 (56.47%) | |
70–100 d | 500 (47.08%) | 262 (52.40%) | 238 (47.60%) | |
100–130 d | 298 (28.06%) | 170 (57.05%) | 128 (42.95%) | |
130–160 d | 75 (7.06%) | 37 (49.33%) | 38 (50.67%) | |
>160 d | 19 (1.79%) | 13 (68.42%) | 6 (31.58%) |
Variable | OR (95% CI) | p-Value (α = 0.05) |
---|---|---|
Sex | - | - |
Male | 1 (ref) | - |
Female | 0.91 (0.67 1.24) | 0.568 |
Age | - | - |
Categorical increase (<39 y; 40–49 y; 50–59 y; 60–69 y; ≥70 y) | 0.67 (0.60 0.76) | <0.001 |
Type of graft | - | - |
Kidney | 1 (ref) | |
Heart | 0.64 (0.39 1.07) | 0.090 |
Liver | 2.71 (1.55 4.72) | <0.001 |
Lung | 1.16 (0.46 2.95) | 0.750 |
Time from transplant to vaccination | - | - |
Less than 1 year | 1 (ref) | |
1 to 3 years | 1.79 (0.87 3.67) | 0.111 |
More than 3 years | 4.92 (2.56 9.45) | 0.000 |
Time from vaccination onset to serological assessment | ||
Categorical increase (40–70 d; 70–100 d; 100–130 d; 130–160 d; >160 d) | 1.30 (1.10 1.53) | <0.001 |
Comorbidities | ||
No | 1 (ref) | |
Yes | 0.60 (0.43 0.83) | 0.002 |
Type of vaccine | ||
BNT162b2 | 1 (ref) | |
mRNA-1273 | 3.57 (2.25 5.67) | <0.001 |
Immunosuppressive drugs at the time of vaccination | ||
Cyclosporine | 0.71 (0.30 1.67) | 0.429 |
Tacrolimus | 0.52 (0.23 1.16) | 0.111 |
Azathioprine | 3.43 (1.20 9.82) | 0.022 |
Mycophenolates | 0.29 (0.20 0.43) | <0.001 |
Sirolimus | 0.70 (0.18 2.66) | 0.598 |
Everolimus | 0.72 (0.43 1.20) | 0.212 |
Steroids | 0.44 (0.30 0.65) | 0.000 |
Impaired graft function | ||
Good | 1 (ref) | |
Impaired, Failure, and others | 0.38 (0.26 0.55) | <0.001 |
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Giannella, M.; Righi, E.; Pascale, R.; Rinaldi, M.; Caroccia, N.; Gamberini, C.; Palacios-Baena, Z.R.; Caponcello, G.; Morelli, M.C.; Tamè, M.; Busutti, M.; Comai, G.; Potena, L.; Salvaterra, E.; Feltrin, G.; Cillo, U.; Gerosa, G.; Cananzi, M.; Piano, S.; Benetti, E.; Burra, P.; Loy, M.; Furian, L.; Zaza, G.; Onorati, F.; Carraro, A.; Gastaldon, F.; Nordio, M.; Kumar-Singh, S.; Abedini, M.; Boffetta, P.; Rodríguez-Baño, J.; Lazzarotto, T.; Viale, P.; Tacconelli, E.; on behalf of The ORCHESTRA Study Group Workpackage. Evaluation of the Kinetics of Antibody Response to COVID-19 Vaccine in Solid Organ Transplant Recipients: The Prospective Multicenter ORCHESTRA Cohort. Microorganisms 2022, 10, 1021. https://doi.org/10.3390/microorganisms10051021
Giannella M, Righi E, Pascale R, Rinaldi M, Caroccia N, Gamberini C, Palacios-Baena ZR, Caponcello G, Morelli MC, Tamè M, Busutti M, Comai G, Potena L, Salvaterra E, Feltrin G, Cillo U, Gerosa G, Cananzi M, Piano S, Benetti E, Burra P, Loy M, Furian L, Zaza G, Onorati F, Carraro A, Gastaldon F, Nordio M, Kumar-Singh S, Abedini M, Boffetta P, Rodríguez-Baño J, Lazzarotto T, Viale P, Tacconelli E, on behalf of The ORCHESTRA Study Group Workpackage. Evaluation of the Kinetics of Antibody Response to COVID-19 Vaccine in Solid Organ Transplant Recipients: The Prospective Multicenter ORCHESTRA Cohort. Microorganisms. 2022; 10(5):1021. https://doi.org/10.3390/microorganisms10051021
Chicago/Turabian StyleGiannella, Maddalena, Elda Righi, Renato Pascale, Matteo Rinaldi, Natascia Caroccia, Chiara Gamberini, Zaira R. Palacios-Baena, Giulia Caponcello, Maria Cristina Morelli, Mariarosa Tamè, Marco Busutti, Giorgia Comai, Luciano Potena, Elena Salvaterra, Giuseppe Feltrin, Umberto Cillo, Gino Gerosa, Mara Cananzi, Salvatore Piano, Elisa Benetti, Patrizia Burra, Monica Loy, Lucrezia Furian, Gianluigi Zaza, Francesco Onorati, Amedeo Carraro, Fiorella Gastaldon, Maurizio Nordio, Samir Kumar-Singh, Mahsa Abedini, Paolo Boffetta, Jesús Rodríguez-Baño, Tiziana Lazzarotto, Pierluigi Viale, Evelina Tacconelli, and on behalf of The ORCHESTRA Study Group Workpackage. 2022. "Evaluation of the Kinetics of Antibody Response to COVID-19 Vaccine in Solid Organ Transplant Recipients: The Prospective Multicenter ORCHESTRA Cohort" Microorganisms 10, no. 5: 1021. https://doi.org/10.3390/microorganisms10051021