Breakthrough Infections Following mRNA SARS-CoV-2 Vaccination in Kidney Transplant Recipients.

Autor:	Mazuecos A; Department of Nephrology, Hospital Universitario Puerta del Mar, Cádiz, Spain., Villanego F; Department of Nephrology, Hospital Universitario Puerta del Mar, Cádiz, Spain., Zarraga S; Department of Nephrology, Hospital Universitario de Cruces, Bilbao, Spain., López V; Department of Nephrology, Hospital Regional Universitario de Málaga, Universidad de Málaga, IBIMA, REDinREN (RD16/0009/0006), Málaga, Spain., Oppenheimer F; Department of Nephrology, Hospital Clínic, Barcelona, Spain., Llinàs-Mallol L; Department of Nephrology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), REDinREN (RD16/0009/0013), Barcelona, Spain., Hernández AM; Department of Nephrology, Hospital Universitario Doce de Octubre, Institute i+12 for Medical Research, Madrid, Spain., Rivas A; Department of Nephrology, Hospital Universitario Central de Asturias, Oviedo, Spain., Ruiz-Fuentes MC; Department of Nephrology, Hospital Universitario Virgen de las Nieves, Granada, Spain., Toapanta NG; Department of Nephrology, Hospital Vall d´Hebron, Barcelona, Spain., Jiménez C; Department of Nephrology, Hospital Universitario La Paz, Madrid, Spain., Cabello S; Department of Nephrology, Hospital Universitario Son Espases, Palma de Mallorca, Spain., Beneyto I; Department of Nephrology, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Aladrén MJ; Department of Nephrology, Hospital Universitario Miguel Servet, Zaragoza, Spain., Rodríguez-Benot A; Department of Nephrology, Hospital Universitario Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain., Canal C; Department of Nephrology, Fundació Puigvert, Barcelona, Spain., Molina M; Department of Nephrology, Hospital Universitario Germans Trias i Pujol (HUGTiP) & REMAR-IGTP Group, Germans Trias i Pujol Research Institute (IGTP), Can Ruti Campus, Barcelona, Spain., Pérez-Flores I; Department of Nephrology, Hospital Clínico San Carlos, Madrid, Spain., Saura IM; Department of Nephrology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain., Gavela E; Department of Nephrology, Hospital Universitario Doctor Peset, Valencia, Spain., Franco A; Department of Nephrology, Hospital General Universitario de Alicante, Alicante, Spain., Lorenzo I; Department of Nephrology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain., Galeano C; Department of Nephrology, Hospital Universitario Ramón y Cajal, Madrid, Spain., Tabernero G; Department of Nephrology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Pérez-Tamajón L; Department of Nephrology, Complejo Hospitalario Universitario de Canarias, La Laguna, Spain., Martín-Moreno PL; Department of Nephrology, Clínica Universidad de Navarra, Pamplona, Spain., Fernández-Girón F; Department of Nephrology, Hospital Universitario Juan Ramón Jiménez, Huelva, Spain., Siverio O; Department of Nephrology, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain., Labrador PJ; Department of Nephrology, Hospital San Pedro de Alcántara, Cáceres, Spain., De Arriba G; Department of Nephrology, Hospital Universitario de Guadalajara, Guadalajara, Spain., Simal F; Department of Nephrology, Hospital Universitario El Bierzo, Ponferrada, Spain., Cruzado L; Department of Nephrology, Hospital General Universitario de Elche, Elche, Spain., Moina I; Department of Nephrology, Hospital Universitario de Basurto, Bilbao, Spain., Alcalde G; Department of Nephrology, Hospital Universitario de Araba, Araba, Spain., Sánchez-Álvarez E; Department of Nephrology, Hospital Universitario de Cabueñes, Gijón, Spain., Pascual J; Department of Nephrology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), REDinREN (RD16/0009/0013), Barcelona, Spain.; Department of Nephrology, Hospital Universitario Doce de Octubre, Institute i+12 for Medical Research, Madrid, Spain., Crespo M; Department of Nephrology, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), REDinREN (RD16/0009/0013), Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2022 Jul 01; Vol. 106 (7), pp. 1430-1439. Date of Electronic Publication: 2022 Apr 01.
DOI:	10.1097/TP.0000000000004119
Abstrakt:	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. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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