Türkkan Sinan, Çelik Başaran Fatmanur, Şahin Mehmet Furkan, Beyoğlu Muhammet Ali, Yılmaz Emre, Yazıcıoğlu Alkın, Yiğit Özay Hülya, Bindal Mustafa, Tezer Tekçe Yasemin, Yekeler Erdal
From the Department of Thoracic Surgery and Lung Transplantation Clinic, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
Exp Clin Transplant. 2023 Mar;21(3):265-271. doi: 10.6002/ect.2022.0088. Epub 2022 Jul 22.
The effectiveness of COVID-19 vaccines in lung transplant recipients is unclear. We retrospectively analyzed lung transplant recipients vaccinated with an inactivated virus vaccine (CoronaVac) and the mRNA vaccine BNT162b2 used against the SARS-CoV-2 virus in Turkey and shared their effects on COVID-19.
Demographic data of lung transplant recipients followed up for >3 months were collected, and vaccination dates and status against the SARS-CoV-2 virus were recorded. Recipients who received at least 3 doses of CoronaVac or 2 doses of BNT162b2, or 1 dose of CoronaVac plus 2 doses of BNT162b2, or 2 doses of CoronaVac plus 1 dose of BNT162b2 were considered fully vaccinated; those who were vaccinated less than this number were considered partially vaccinated. Patients with positive SARS-CoV-2 reverse transcription-polymerase chain reaction tests from respiratory tract samples were accepted as positive for COVID-19. Recipients were classified by number and type of vaccine, and groups were compared for infection, need for intensive care, and death as a result of COVID-19.
Of the 53 lung transplant recipients, 51 were vaccinated (7 partially vaccinated, 44 fully vaccinated) and 2 were not vaccinated. Of fully vaccinated recipients, 13/44 received the inactivated vaccine, 5/44 received the mRNA vaccine, and 26/44 had a combination of the 2 vaccines. During the follow-up period, 13 patients (2/2 not vaccinated, 2/7 [28.5%] partially vaccinated, 9/44 [20.5%] fully vaccinated) were diagnosed with COVID-19. There was no significant difference in protection against infection between the inactivated, the mRNA, and combined vaccine groups. There was no significant association in cycle threshold values that determine the infection load and COVID-19 severity between transplant recipients who died and those who did not.
In lung transplant recipients, 3 doses of inactivated vaccine, 2 doses of mRNA vaccine, or the combined heterologous vaccine provided similar protection. Prevention of exposure is one of the most crucial steps.
新型冠状病毒肺炎（COVID-19）疫苗在肺移植受者中的有效性尚不清楚。我们回顾性分析了土耳其接种灭活病毒疫苗（科兴新冠疫苗）和用于对抗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒的信使核糖核酸（mRNA）疫苗BNT162b2的肺移植受者，并分享了这些疫苗对COVID-19的影响。
收集随访时间超过3个月的肺移植受者的人口统计学数据，并记录接种SARS-CoV-2病毒疫苗的日期和接种情况。接受至少3剂科兴新冠疫苗或2剂BNT162b2、或1剂科兴新冠疫苗加2剂BNT162b2、或2剂科兴新冠疫苗加1剂BNT162b2的受者被视为完全接种；接种剂量少于此数的受者被视为部分接种。呼吸道样本严重急性呼吸综合征冠状病毒2逆转录-聚合酶链反应检测呈阳性的患者被视为COVID-19阳性。根据疫苗的数量和类型对受者进行分类，并比较各小组因COVID-19导致的感染、重症监护需求和死亡情况。
在53例肺移植受者中，51例接种了疫苗（7例部分接种，44例完全接种），2例未接种。在完全接种的受者中，13/44接受了灭活疫苗，5/44接受了mRNA疫苗，26/44同时接种了这两种疫苗。在随访期间，13例患者（2/2未接种，2/7[28.5%]部分接种，9/44[20.5%]完全接种）被诊断为COVID-19。灭活疫苗组、mRNA疫苗组和联合疫苗组在预防感染方面无显著差异。在确定感染负荷和COVID-19严重程度的循环阈值方面，死亡的移植受者和未死亡的移植受者之间无显著关联。
在肺移植受者中，3剂灭活疫苗、2剂mRNA疫苗或联合异源疫苗提供了相似的保护。预防接触是最关键的步骤之一。
