The impact of frailty syndrome on humoral response to SARS-CoV-2 mRNA vaccines in older kidney transplant recipients.


Journal

International urology and nephrology
ISSN: 1573-2584
Titre abrégé: Int Urol Nephrol
Pays: Netherlands
ID NLM: 0262521

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 01 11 2022
accepted: 11 03 2023
medline: 23 10 2023
pubmed: 8 4 2023
entrez: 7 4 2023
Statut: ppublish

Résumé

Advanced age is associated with an impaired humoral immune response to SARS-CoV-2 mRNA vaccination in kidney transplant recipients (KTR). The mechanisms are, however, poorly understood. Frailty syndrome assessment may determine the most vulnerable population. This study is a secondary analysis of a prospective study (NCT04832841) regarding seroconversion after BNT162b2 vaccination, including 101 SARS-CoV-2 naïve KTR 70 years and older. The Fried frailty components were evaluated, and antibodies against S1 and S2 subunits of SARS-CoV-2 were examined > 14 days after the second dose of BNT162b2 vaccine. Seroconversion was observed in 33 KTR. Male gender, eGFR, MMF-free immunosuppression, and a lower frailty score were associated with higher seroconversion rates in univariable regression. Concerning frailty components, physical inactivity had the most negative effect on seroconversion (OR = 0.36, 95% CI 0.14-0.95, p = 0.039). In a multivariable regression adjusted for eGFR, MMF-free immunosuppression, time from transplant and gender, pre-frail (OR = 0.27, 95% CI 0.07-1.00, p = 0.050), and frail status (OR = 0.14, 95% CI 0.03-0.73, p = 0.019) were associated with an increased risk of unresponsiveness to SARS-CoV-2 vaccines. Frailty was associated with an impaired humoral response to SARS-CoV-2 mRNA vaccination in older SARS-CoV-2 naïve KTR. This study is registered under the identifier NCT04832841 on ClinicalTrials.gov.

Identifiants

pubmed: 37027078
doi: 10.1007/s11255-023-03557-6
pii: 10.1007/s11255-023-03557-6
pmc: PMC10081301
doi:

Substances chimiques

COVID-19 Vaccines 0
BNT162 Vaccine 0
RNA, Messenger 0
Antibodies, Viral 0

Banques de données

ClinicalTrials.gov
['NCT04832841']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2959-2965

Subventions

Organisme : Ministerstvo Zdravotnictví Ceské Republiky
ID : NV19-06-00031
Organisme : Ministerstvo Zdravotnictví Ceské Republiky
ID : NU22-C-126
Organisme : Ministerstvo Zdravotnictví Ceské Republiky
ID : NU21-06-00021

Informations de copyright

© 2023. The Author(s).

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Auteurs

Michal Schmalz (M)

Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
The Third Faculty of Medicine, Charles University, Prague, Czech Republic.

Hana Vankova (H)

The Third Faculty of Medicine, Charles University, Prague, Czech Republic.

Silvie Rajnochova-Bloudickova (S)

Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Petra Hruba (P)

Transplantation Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Martina Fialova (M)

Department of Immunology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Jiri Gurka (J)

Information Technology Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Maria Magicova (M)

Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Ilja Striz (I)

Department of Immunology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Ivan Zahradka (I)

Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.

Ondrej Viklicky (O)

Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. ondrej.viklicky@ikem.cz.
Transplantation Laboratory, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. ondrej.viklicky@ikem.cz.

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