Sutharattanapong Napun, Thotsiri Sansanee, Kantachuvesiri Surasak, Wiwattanathum Punlop
Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand.
Excellent Center for Organ Transplantation, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Vaccines (Basel). 2022 Apr 8;10(4):572. doi: 10.3390/vaccines10040572.
The coronavirus virus disease 2019 (COVID-19) pandemic has impacted the global healthcare system. In Thailand, the first and most available vaccines were inactivated and viral vector vaccines. We reported the impact of those vaccines in preventing severe disease and death in kidney transplant recipients. This retrospective study comprised 45 kidney transplant recipients with COVID-19 infection, classified by vaccination status. Outcomes of interest were death, pneumonia, and allograft dysfunction. There were 23 patients in vaccinated group and 22 patients in unvaccinated group. All baseline characteristics were similar except mean age was older in vaccinated group, 55 vs. 48 years. Total 11 patients (24%) died (13% vaccinated vs. 36% unvaccinated RR, 0.56; 95% CI, 0.29-0.83; = 0.03). Multivariate analysis showed that vaccination significantly decrease mortality (odds ratio, 0.54; 95% CI, 0.10-0.94; = 0.03). Pneumonia developed equally in both groups (70%). There was a trend toward less oxygen requirement as well as ventilator requirement in vaccinated group. The rate of allograft dysfunction was similar (47%). Inactivated and viral vector COVID-19 vaccines have beneficial effect on mortality reduction in kidney transplant recipients. Even partial vaccination can exert some protection against death. However, full vaccination should be encouraged to achieve better prevention.
2019年冠状病毒病(COVID-19)大流行对全球医疗系统产生了影响。在泰国,首批且最容易获得的疫苗是灭活疫苗和病毒载体疫苗。我们报告了这些疫苗在预防肾移植受者严重疾病和死亡方面的影响。这项回顾性研究纳入了45例感染COVID-19的肾移植受者,根据疫苗接种状况进行分类。关注的结局是死亡、肺炎和移植肾功能障碍。接种疫苗组有23例患者,未接种疫苗组有22例患者。除接种疫苗组平均年龄较大(55岁对48岁)外,所有基线特征均相似。共有11例患者(24%)死亡(接种疫苗组为13%,未接种疫苗组为36%;相对危险度,0.56;95%置信区间,0.29 - 0.83;P = 0.03)。多因素分析显示,接种疫苗显著降低了死亡率(比值比,0.54;95%置信区间,0.10 - 0.94;P = 0.03)。两组肺炎发生率相同(70%)。接种疫苗组有氧气需求和呼吸机需求减少的趋势。移植肾功能障碍发生率相似(47%)。灭活和病毒载体COVID-19疫苗对降低肾移植受者的死亡率有有益作用。即使部分接种疫苗也能对死亡起到一定的保护作用。然而,应鼓励全程接种疫苗以实现更好的预防效果。