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Caballero‐Marcos A, Salcedo M, Alonso‐Fernández R, Rodríguez‐Perálvarez M, Olmedo M, Graus Morales J, Cuervas‐Mons V, Cachero A, Loinaz‐Segurola C, Iñarrairaegui M, Castells L, Pascual S, Vinaixa‐Aunés C, González‐Grande R, Otero A, Tomé S, Tejedor‐Tejada J, Álamo‐Martínez JM, González‐Diéguez L, Nogueras‐Lopez F, Blanco‐Fernández G, Muñoz‐Bartolo G, Bustamante FJ, Fábrega E, Romero‐Cristóbal M, Martin‐Mateos R, Del Rio‐Izquierdo J, Arias‐Milla A, Calatayud L, Marcacuzco‐Quinto AA, Fernández‐Alonso V, Gómez‐Gavara C, Colmenero J, Muñoz P, Pons JA. Changes in humoral immune response after SARS-CoV-2 infection in liver transplant recipients compared to immunocompetent patients. Am J Transplant 2021; 21:2876-2884. [PMID: 33835707 PMCID: PMC8251470 DOI: 10.1111/ajt.16599] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/29/2021] [Accepted: 03/29/2021] [Indexed: 01/25/2023]
Abstract
The protective capacity and duration of humoral immunity after SARS-CoV-2 infection are not yet understood in solid organ transplant recipients. A prospective multicenter study was performed to evaluate the persistence of anti-nucleocapsid IgG antibodies in liver transplant recipients 6 months after coronavirus disease 2019 (COVID-19) resolution. A total of 71 liver transplant recipients were matched with 71 immunocompetent controls by a propensity score including variables with a well-known prognostic impact in COVID-19. Paired case-control serological data were also available in 62 liver transplant patients and 62 controls at month 3 after COVID-19. Liver transplant recipients showed a lower incidence of anti-nucleocapsid IgG antibodies at 3 months (77.4% vs. 100%, p < .001) and at 6 months (63.4% vs. 90.1%, p < .001). Lower levels of antibodies were also observed in liver transplant patients at 3 (p = .001) and 6 months (p < .001) after COVID-19. In transplant patients, female gender (OR = 13.49, 95% CI: 2.17-83.8), a longer interval since transplantation (OR = 1.19, 95% CI: 1.03-1.36), and therapy with renin-angiotensin-aldosterone system inhibitors (OR = 7.11, 95% CI: 1.47-34.50) were independently associated with persistence of antibodies beyond 6 months after COVID-19. Therefore, as compared with immunocompetent patients, liver transplant recipients show a lower prevalence of anti-SARS-CoV-2 antibodies and more pronounced antibody levels decline.
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Affiliation(s)
- Aránzazu Caballero‐Marcos
- Hepatology and Liver Transplantation UnitHospital General Universitario Gregorio MarañónUniversidad ComplutenseMadridSpain,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)BarcelonaSpain
| | - Magdalena Salcedo
- Hepatology and Liver Transplantation UnitHospital General Universitario Gregorio MarañónUniversidad ComplutenseMadridSpain,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)BarcelonaSpain
| | - Roberto Alonso‐Fernández
- Deparment of Clinical Microbiology and Infectious DiseasesHospital General Universitario Gregorio MarañónMadridSpain
| | - Manuel Rodríguez‐Perálvarez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)BarcelonaSpain,Department of Hepatology and Liver TransplantationHospital Universitario Reina SofíaIMIBICCordobaSpain
| | - María Olmedo
- Deparment of Clinical Microbiology and Infectious DiseasesHospital General Universitario Gregorio MarañónMadridSpain
| | | | - Valentín Cuervas‐Mons
- Hepatology and Liver Transplant UnitHospital Puerta de HierroIDIPHIMSAUniversidad Autónoma de MadridMadridSpain,Instituto de Investigación Puerta de Hierro Segovia de Aran (IDIPHISA)MadridSpain
| | - Alba Cachero
- Liver Transplant UnitHospital Universitari de BellvitgeIDIBELL, L'Hospitalet de LlobregatBarcelonaSpain
| | - Carmelo Loinaz‐Segurola
- Department of Hepatology/HPB‐surgery/TransplantationHospital Universitario 12 de OctubreMadridSpain
| | | | - Lluís Castells
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)BarcelonaSpain,Department of Internal MedicineLiver UnitHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Sonia Pascual
- Liver UnitHospital General Universitario de AlicanteAlicanteSpain
| | - Carmen Vinaixa‐Aunés
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)BarcelonaSpain,Department of Hepatology and Liver TransplantationHospital Universitario y Politécnico La FeValenciaSpain
| | - Rocío González‐Grande
- Department of Liver TransplantationHospital Regional Universitario de MálagaMalagaSpain
| | | | - Santiago Tomé
- Department of Liver TransplantationHospital Universitario de SantiagoSantiago de CompostelaSpain
| | - Javier Tejedor‐Tejada
- Department of GastroenterologyHepatology and Liver Transplantation UnitHospital Universitario Rio HortegaValladolidSpain
| | | | - Luisa González‐Diéguez
- Liver Unit and Division of Gastroenterology and HepatologyHospital Universitario Central de AsturiasOviedoSpain
| | - Flor Nogueras‐Lopez
- Department of Hepatology and Liver TransplantationHospital Virgen de las NievesGranadaSpain
| | - Gerardo Blanco‐Fernández
- Department of HPB surgery and Liver TransplantationComplejo Hospitalario Universitario de BadajozBadajozSpain
| | | | | | - Emilio Fábrega
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)BarcelonaSpain,Department of Digestive DiseasesIDIVAL, Hospital Universitario Marqués de ValdecillaSantanderSpain
| | - Mario Romero‐Cristóbal
- Hepatology and Liver Transplantation UnitHospital General Universitario Gregorio MarañónUniversidad ComplutenseMadridSpain,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)BarcelonaSpain
| | | | - Julia Del Rio‐Izquierdo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)BarcelonaSpain
| | - Ana Arias‐Milla
- Hepatology and Liver Transplant UnitHospital Puerta de HierroIDIPHIMSAUniversidad Autónoma de MadridMadridSpain
| | - Laura Calatayud
- Deparment of Clinical Microbiology and Infectious DiseasesHospital Universitari de BellvitgeIDIBELL, L'Hospitalet de LlobregatBarcelonaSpain
| | | | - Víctor Fernández‐Alonso
- Hepatology and Liver Transplantation UnitHospital General Universitario Gregorio MarañónUniversidad ComplutenseMadridSpain
| | - Concepción Gómez‐Gavara
- Department of Internal MedicineLiver UnitHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelonaSpain
| | - Jordi Colmenero
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd)BarcelonaSpain,Liver Transplant UnitHospital ClínicIDIBAPSUniversity of BarcelonaBarcelonaSpain
| | - Patricia Muñoz
- Deparment of Clinical Microbiology and Infectious DiseasesHospital General Universitario Gregorio MarañónMadridSpain
| | - José A. Pons
- Liver Transplantation Unit, Liver UnitDepartment of SurgeryIMIB, Hospital Universitario Virgen de la ArrixacaMurciaSpain
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