Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Division of Nephrology, Department of Internal Medicine, Sakarya University Training and Research Hospital, Sakarya, Turkey.
Vaccine. 2022 May 26;40(24):3313-3319. doi: 10.1016/j.vaccine.2022.04.066. Epub 2022 Apr 27.
The remarkable efficacy and effectiveness of COVID-19 vaccines have been described in healthy individuals, but kidney transplant recipients have been excluded from these studies. Therefore, real-world evidence of these vaccines can guide clinicians in predicting complications in kidney transplant recipients and how many doses of vaccines are protective. In this study, we aimed to investigate the impact of the COVID-19 vaccines on kidney transplant recipients with SARS-CoV-2 infection.
This matched case-control study included vaccinated kidney transplant recipients with COVID-19 from two centers between 1 May and 1 October 2021. All patients in the vaccinated group received a minimum of two doses of the vaccine and were diagnosed with COVID-19 at least one month after the last dose. Each vaccinated patient was matched with an unvaccinated kidney transplant recipient diagnosed with COVID. The endpoints were all-cause mortality, hospitalization, intensive care unit admission, acute kidney injury, cytokine storm, and acute respiratory distress syndrome.
The median age of vaccinated seventy-two participants was 45 years, and 41 of the participants were men in the vaccinated group. Four patients in the vaccinated group and nine patients in the control group died during follow-up (p = 0.247). Seventeen patients in the vaccinated group, thirty-four participants in the control group were hospitalized (p = 0.004); five vaccinated patients and ten unvaccinated patients were followed-up in the ICU during follow-up (p = 0.168). Thirteen of the vaccinated and twelve unvaccinated patients developed acute kidney injury (p = 0.16). The occurrence of cytokine storm (n = 4 vs. n = 11; p = 0.061) and acute respiratory distress syndrome (n = 5 vs. n = 10; p = 0.168) was higher in the patient group compared to the control group.
COVID-19 remains a fatal disease despite advancing treatment modalities and preventive strategies. COVID-19 vaccines can't prevent death in all kidney transplant recipients, but they decrease hospitalization rate and duration in most patients.
COVID-19 疫苗在健康人群中的显著疗效和效果已经得到了描述，但这些研究排除了肾移植受者。因此，这些疫苗的真实世界证据可以指导临床医生预测肾移植受者的并发症以及需要多少剂疫苗才能起到保护作用。在这项研究中，我们旨在研究 COVID-19 疫苗对肾移植受者 SARS-CoV-2 感染的影响。
这项匹配的病例对照研究包括 2021 年 5 月 1 日至 10 月 1 日期间来自两个中心的接种 COVID-19 疫苗的肾移植受者。接种组的所有患者均至少接受了两剂疫苗的接种，并在最后一剂接种后至少一个月被诊断出 COVID-19。每个接种患者都与一名被诊断为 COVID 的未接种肾移植受者相匹配。主要终点为全因死亡率、住院、重症监护病房入院、急性肾损伤、细胞因子风暴和急性呼吸窘迫综合征。
72 名接种者的中位年龄为 45 岁，接种组中 41 名为男性。接种组中有 4 名患者和对照组中有 9 名患者在随访期间死亡（p=0.247）。接种组中有 17 名患者和对照组中有 34 名患者住院（p=0.004）；在随访期间，接种组中有 5 名患者和对照组中有 10 名患者入住重症监护病房（p=0.168）。接种组中有 13 名患者和未接种组中有 12 名患者发生急性肾损伤（p=0.16）。与对照组相比，细胞因子风暴（n=4 比 n=11；p=0.061）和急性呼吸窘迫综合征（n=5 比 n=10；p=0.168）的发生率在患者组中更高。
尽管治疗方法和预防策略不断进步，但 COVID-19 仍然是一种致命疾病。COVID-19 疫苗并不能预防所有肾移植受者的死亡，但可以降低大多数患者的住院率和住院时间。
