The Prevalence of Anti-SARS-CoV-2 Antibodies After COVID-19 is Similar in Kidney Transplant Recipients to Non-Transplanted Patients, and the Clinical Severity is a Predictor of Seroconversion
Nephrology Division - Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil
Meeting: 2022 American Transplant Congress
Abstract number: 249
Keywords: COVID-19, Kidney transplantation
Topic: Clinical Science » Infection Disease » 24 - All Infections (Excluding Kidney & Viral Hepatitis)
Session Information
Session Name: COVID-19 Infections Part 2: All Organs
Session Type: Rapid Fire Oral Abstract
Date: Monday, June 6, 2022
Session Time: 3:30pm-5:00pm
Presentation Time: 4:30pm-4:40pm
Location: Hynes Ballroom B
*Purpose: To evaluate the seroconversion rate in kidney transplant recipients (KTR), compared to two non-transplanted groups of patients, and identify predictors of seroconversion in COVID-19 convalescent patients.
*Methods: A retrospective cohort study enrolled RT-PCR COVID-19 diagnosed patients (Mar/20 and Oct/2020) of three groups: 601 KTR, 211 health care workers (HCW), and 170 non-transplanted inhabitants (INH) in a countryside city in the state of São Paulo – Brazil. At least 14 days after diagnosis, all survivors underwent antibody testing by chemiluminescent microparticle immunoassay (titter expressed in RLU). The primary outcome was seroconversion. The group-adjusted multivariable model for the probability of seroconversion was built by generalized linear mixed models with binary logistic regression and the discrimination performance by AUC-ROC.
*Results: Several differences were observed among groups regarding demographic data and COVID-19 clinical presentation. Of note, KTR were older (54.0 years old vs. 37.0 in HCW vs. 42.0 in INH, P<0.001), more frequently had comorbidities (P<0.001), and severe COVID-19 (P<0.001). Compared to HCW and INH, respectively, admission to ICU (44.9% vs. 0% vs. 1.8%), MV requirement (32.3% vs. 0% vs. 1.8%), and death (28.8% vs. 0% vs. 1.2%) were significantly more frequent in KTR (P<0.001). On the other hand, the seroconversion rate was not different among survivors: 76.2% for KTR, 74.9% for HCW, and 82.2% for INH (P=0.35). The IgG anti-SARS-CoV-2 was slightly higher among INH: 5.8 RLU vs. 5.4 for KTR and 4.4 for HCW (P=0.009). Seroconversion was associated with a shorter time between infection and blood sample collection (OR for each day= 0.986; P<0.001) and increased by 64% if the fever was a COVID-19 symptom (OR=1.737; P=0.017), 78% if the cough was present (OR=1.785; P=0.005) and 98% if the ventilatory support was required (OR=1.981; P=0.017). This predictive model achieved an AU-ROC of 0.730 (P<0.001).
*Conclusions: As expected, the rates of clinical deterioration to ICU admission, MV requirement, and death were significantly higher among KTR. However, among the survivors, KTR had a similar rate of seroconversion, associated with clinical severity parameters and a shorter time of blood sample collection.
To cite this abstract in AMA style:
Requião-Moura LR, Garcia R, Nakamura MR, Foresto RD, Gomes V, Ferreira T, Meira I, Cristelli M, Jesus M, Rissoni R, Lucena E, Tedesco-Silva H, Medina-Pestana J. The Prevalence of Anti-SARS-CoV-2 Antibodies After COVID-19 is Similar in Kidney Transplant Recipients to Non-Transplanted Patients, and the Clinical Severity is a Predictor of Seroconversion [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/the-prevalence-of-anti-sars-cov-2-antibodies-after-covid-19-is-similar-in-kidney-transplant-recipients-to-non-transplanted-patients-and-the-clinical-severity-is-a-predictor-of-seroconversion/. Accessed November 21, 2024.« Back to 2022 American Transplant Congress