Breakthrough Infections Following mRNA SARS-CoV-2 Vaccination in Kidney Transplant Recipients
Por:
Mazuecos, A, Villanego, F, Zarraga, S, Lopez, V, Oppenheimer, F, Llinas-Mallol, L, Hernandez, AM, Rivas, A, Ruiz-Fuentes, MC, Toapanta, NG, Jimenez, C, Cabello, S, Beneyto, I, Aladren, MJ, Rodriguez-Benot, A, Canal, C, Molina, M, Perez-Flores, I, Saura, IM, Gavela, E, Franco, A, Lorenzo, I, Galeano, C, Tabernero, G, Perez-Tamajon, L, Martin-Moreno, PL, Fernandez-Giron, F, Siverio, O, Labrador, PJ, De Arriba, G, Simal, F, Cruzado, L, Moina, I, Alcalde, G, Sanchez-Alvarez, E, Pascual, J, Crespo, M
Publicada:
1 jul 2022
Resumen:
Background. The clinical effectiveness of coronavirus disease 2019 (COVID-19) vaccination in kidney transplant (KT) recipients is lower than in the general population. Methods. From April to October 2021, 481 KT recipients with COVID-19, included in the Spanish Society of Nephrology COVID-19 Registry, were analyzed. Data regarding vaccination status and vaccine type were collected, and outcomes of unvaccinated or partially vaccinated patients (n = 130) were compared with fully vaccinated patients (n = 351). Results. Clinical picture was similar and survival analysis showed no differences between groups: 21.7% of fully vaccinated patients and 20.8% of unvaccinated or partially vaccinated died (P = 0.776). In multivariable analysis, age and pneumonia were independent risk factors for death, whereas vaccination status was not related to mortality. These results remained similar when we excluded patients with partial vaccination, as well as when we analyzed exclusively hospitalized patients. Patients vaccinated with mRNA-1273 (n = 213) showed a significantly lower mortality than those who received the BNT162b2 vaccine (n = 121) (hazard ratio: 0.52; 95% confidence interval, 0.31-0.85; P = 0.010). Conclusions. COVID-19 severity in KT patients has remained high and has not improved despite receiving 2 doses of the mRNA vaccine. The mRNA-1273 vaccine shows higher clinical effectiveness than BNT162b2 in KT recipients with breakthrough infections. Confirmation of these data will require further research taking into account the new variants and the administration of successive vaccine doses.
Filiaciones:
Mazuecos, A:
Hosp Univ Puerta Mar, Dept Nephrol, Av Ana Viya 21, Cadiz 1009, Spain
Villanego, F:
Hosp Univ Puerta Mar, Dept Nephrol, Av Ana Viya 21, Cadiz 1009, Spain
Zarraga, S:
Hosp Univ Cruces, Dept Nephrol, Bilbao, Spain
Lopez, V:
Univ Malaga, Dept Nephrol, Hosp Reg Univ Malaga, IBIMA,REDinREN RD16 0009 0006, Malaga, Spain
Oppenheimer, F:
Hosp Clin Barcelona, Dept Nephrol, Barcelona, Spain
Llinas-Mallol, L:
Hosp Mar, Dept Nephrol, Hosp Mar Med Res Inst IMIM, REDinREN RD16 0009 0013, Barcelona, Spain
Hernandez, AM:
Hosp Univ Doce Octubre, Dept Nephrol, Inst I 12 Med Res, Madrid, Spain
Rivas, A:
Hosp Univ Cent Asturias, Dept Nephrol, Oviedo, Spain
Ruiz-Fuentes, MC:
Hosp Univ Virgen Nieves, Dept Nephrol, Granada, Spain
Toapanta, NG:
Hosp Valle De Hebron, Dept Nephrol, Barcelona, Spain
Jimenez, C:
Hosp Univ La Paz, Dept Nephrol, Madrid, Spain
Cabello, S:
Hosp Univ Son Espases, Dept Nephrol, Palma De Mallorca, Spain
Beneyto, I:
Hosp Univ & Politecn La Fe, Dept Nephrol, Valencia, Spain
Aladren, MJ:
Hosp Univ Miguel Servet, Dept Nephrol, Zaragoza, Spain
Rodriguez-Benot, A:
Univ Cordoba, Dept Nephrol, Hosp Univ Reina Sofia, Inst Maimonides Invest Biomed Cordoba IMIBIC, Cordoba, Spain
Canal, C:
Fdn Puigvert, Dept Nephrol, Barcelona, Spain
Molina, M:
Hosp Univ Germans Trias & Pujol HUGTiP, Dept Nephrol, Can Ruti Campus, Barcelona, Spain
Germans Trias & Pujol Res Inst IGTP, REMAR IGTP Grp, Can Ruti Campus, Barcelona, Spain
Perez-Flores, I:
Hosp Clin San Carlos, Dept Nephrol, Madrid, Spain
Saura, IM:
Hosp Clin Univ Virgen Arrixaca, Dept Nephrol, Murcia, Spain
Gavela, E:
Hosp Univ Doctor Peset, Dept Nephrol, Valencia, Spain
Franco, A:
Hosp Gen Univ Alicante, Dept Nephrol, Alicante, Spain
Lorenzo, I:
Complejo Hosp Univ Albacete, Dept Nephrol, Albacete, Spain
Galeano, C:
Hosp Univ Ramon y Cajal, Dept Nephrol, Madrid, Spain
Tabernero, G:
Complejo Asistencial Univ Salamanca, Dept Nephrol, Salamanca, Spain
Perez-Tamajon, L:
Complejo Hosp Univ Canarias, Dept Nephrol, San Cristobal la Laguna, Spain
Martin-Moreno, PL:
Clin Univ Navarra, Dept Nephrol, Pamplona, Spain
Fernandez-Giron, F:
Hosp Univ Juan Ramon Jimenez, Dept Nephrol, Huelva, Spain
Siverio, O:
Hosp Univ Nuestra Senora Candelaria, Dept Nephrol, Santa Cruz De Tenerife, Spain
Labrador, PJ:
Hosp San Pedro Alcantara, Dept Nephrol, Caceres, Spain
De Arriba, G:
Hosp Univ Guadalajara, Dept Nephrol, Guadalajara, Spain
Simal, F:
Hosp Univ El Bierzo, Dept Nephrol, Ponferrada, Spain
Cruzado, L:
Hosp Gen Univ Elche, Dept Nephrol, Elche, Spain
Moina, I:
Hosp Univ Basurto, Dept Nephrol, Bilbao, Spain
Alcalde, G:
Hosp Univ Araba, Dept Nephrol, Araba, Spain
Sanchez-Alvarez, E:
Hosp Univ Cabuenes, Dept Nephrol, Gijon, Spain
Pascual, J:
Hosp Mar, Dept Nephrol, Hosp Mar Med Res Inst IMIM, REDinREN RD16 0009 0013, Barcelona, Spain
Hosp Univ Doce Octubre, Dept Nephrol, Inst I 12 Med Res, Madrid, Spain
Crespo, M:
Hosp Mar, Dept Nephrol, Hosp Mar Med Res Inst IMIM, REDinREN RD16 0009 0013, Barcelona, Spain
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