Scientific publications
Breakthrough Infections Following mRNA SARS-CoV-2 Vaccination in Kidney Transplant Recipients. Scientific Publication
Auxiliadora Mazuecos 1 , Florentino Villanego 1 , Sofía Zarraga 2 , Verónica López 3 , Federico Oppenheimer 4 , Laura Llinàs-Mallol 5 , Ana M Hernández 6 , Alba Rivas 7 , María C Ruiz-Fuentes 8 , Néstor G Toapanta 9 , Carlos Jiménez 10 , Sheila Cabello 11 , Isabel Beneyto 12 , María J Aladrén 13 , Alberto Rodríguez-Benot 14 , Cristina Canal 15 , María Molina 16 , Isabel Pérez-Flores 17 , Isabel M Saura 18 , Eva Gavela 19 , Antonio Franco 20 , Inmaculada Lorenzo 21 , Cristina Galeano 22 , Guadalupe Tabernero 23 , Lourdes Pérez-Tamajón 24 , Paloma L Martín-Moreno 25 , Fernando Fernández-Girón 26 , Orlando Siverio 27 , Pedro J Labrador 28 , Gabriel De Arriba 29 , Fernando Simal 30 , Leónidas Cruzado 31 , Inigo Moina 32 , Guillermo Alcalde 33 , Emilio Sánchez-Álvarez 34 , Julio Pascual 5 6 , Marta Crespo 5 , Spanish Society of Nephrology COVID-19 Group
Background: The clinical effectiveness of coronavirus disease 2019 (COVID-19) vaccination in kidney transplant (KT) recipients is lower than in the general population.
Methods: From April to October 2021, 481 KT recipients with COVID-19, included in the Spanish Society of Nephrology COVID-19 Registry, were analyzed. Data regarding vaccination status and vaccine type were collected, and outcomes of unvaccinated or partially vaccinated patients (n = 130) were compared with fully vaccinated patients (n = 351).
Results: Clinical picture was similar and survival analysis showed no differences between groups: 21.7% of fully vaccinated patients and 20.8% of unvaccinated or partially vaccinated died (P = 0.776). In multivariable analysis, age and pneumonia were independent risk factors for death, whereas vaccination status was not related to mortality.
These results remained similar when we excluded patients with partial vaccination, as well as when we analyzed exclusively hospitalized patients. Patients vaccinated with mRNA-1273 (n = 213) showed a significantly lower mortality than those who received the BNT162b2 vaccine (n = 121) (hazard ratio: 0.52; 95% confidence interval, 0.31-0.85; P = 0.010).
Conclusions: COVID-19 severity in KT patients has remained high and has not improved despite receiving 2 doses of the mRNA vaccine. The mRNA-1273 vaccine shows higher clinical effectiveness than BNT162b2 in KT recipients with breakthrough infections. Confirmation of these data will require further research taking into account the new variants and the administration of successive vaccine doses.
CITATION Transplantation. 2022 Apr 1. doi: 10.1097/TP.0000000000004119
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