Changes in humoral immune response after SARS-CoV-2 infection in liver transplant recipients compared to immunocompetent patients
Changes in humoral immune response after SARS-CoV-2 infection in liver transplant recipients compared to immunocompetent patients
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DOI：
10.1111/ajt.16599
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发表时间：
2021-04-27
影响因子：
8.8
通讯作者：
Pons, Jose A.
中科院分区：
文献类型：
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作者：
Caballero-Marcos, Aranzazu;Salcedo, Magdalena;Pons, Jose A.
实体器官移植受者感染 SARS-CoV-2 后体液免疫的保护能力和持续时间尚不清楚。进行了一项前瞻性多中心研究，以评估 2019 年冠状病毒病 (COVID-19) 消退 6 个月后肝移植受者体内抗核衣壳 IgG 抗体的持续性。共有 71 名肝移植受者与 71 名免疫功能正常的对照者通过倾向评分进行匹配，其中包括对 COVID-19 具有众所周知的预后影响的变量。在 COVID-19 发生后第 3 个月，还获得了 62 名肝移植患者和 62 名对照者的配对病例对照血清学数据。肝移植受者在 3 个月（77.4% vs. 100%，p < .001）和 6 个月（63.4% vs. 90.1%，p < .001）时表现出抗核衣壳 IgG 抗体的发生率较低。在 COVID-19 后 3 个月 (p = .001) 和 6 个月 (p < .001) 时，肝移植患者的抗体水平也较低。在移植患者中，女性（OR = 13.49，95% CI：2.17-83.8）、移植后间隔时间较长（OR = 1.19，95% CI：1.03-1.36）以及肾素-血管紧张素-醛固酮系统抑制剂治疗（OR = 7.11，95% CI：1.47-34.50）与抗体持续存在独立相关COVID-19 发生后超过 6 个月。因此，与免疫功能正常的患者相比，肝移植受者的抗SARS-CoV-2抗体患病率较低，抗体水平下降更明显。
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.