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. 2021 Oct 15;31(3):030901.
doi: 10.11613/BM.2021.030901.

Seroprevalence of SARS-CoV-2 in Croatian solid-organ transplant recipients

Anna Mrzljak  1   2 , Željka Jureković  3 , Jadranka Pavičić-Šarić  3 , Vladimir Stevanović  4 , Irena Tabain  5 , Željka Hruškar  5 , Danko Mikulić  3 , Ljubo Barbić  4 , Tatjana Vilibić-Čavlek  2   5
Affiliations

Seroprevalence of SARS-CoV-2 in Croatian solid-organ transplant recipients

Anna Mrzljak et al. Biochem Med (Zagreb). .

Abstract

Introduction: The data on the coronavirus disease (COVID-19) in solid-organ transplant recipients (SOTRs) in Croatia is unknown. The aim of this study was to analyze the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Croatian SOTRs.

Materials and methods: From 7 September to 27 November 2020 (beginning of the second COVID-19 pandemic wave), a cross-sectional screening for COVID-19 was performed in the adult outpatient liver (LTRs; N = 280) and kidney transplant recipients (KTRs; N = 232). Serum samples were initially tested for SARS-CoV-2 IgG antibodies using a commercial enzyme-linked immunosorbent assay (ELISA; Vircell Microbiologists, Granada, Spain). All positive samples were confirmed using a virus neutralization test (VNT). Data on risk exposure and COVID-19 related symptoms were collected using a questionnaire.

Results: The transplanted cohort's seroprevalence detected by ELISA and VNT was 20.1% and 3.1%, respectively. Neutralizing (NT) antibodies developed in 15.6% of anti-SARS-CoV-2 ELISA IgG positive SOTRs. The difference in seropositivity rates between LTRs and KTRs was not statistically significant (ELISA 21.1% vs. 19.0%, P = 0.554; VNT 3.6% vs. 2.6%, P = 0.082). Overall VNT positivity rates were higher in patients who reported participation in large community events (5.9% vs. 1.0%; P = 0.027) as well as in patients who reported COVID-19 related symptoms in the past six months. In addition, symptomatic VNT positive patients showed significantly higher (P = 0.031) NT antibody titers (median 128, interquartile range (IQR) = 32-128) compared to asymptomatic patients (median 16, IQR = 16-48).

Conclusions: This study showed that 15.6% of anti-SARS-CoV-2 ELISA positive Croatian SOTRs developed NT antibodies indicating protective immunity. Further studies are needed to determine the dynamic of NT antibodies and COVID-19 immunity duration in immunocompromised populations such as LTRs and KTRs.

Keywords: COVID-19; SARS-CoV-2 antibodies; seroprevalence; solid-organ transplant recipients.

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Conflict of interest statement

Potential conflict of interest None declared.

Figures

Figure 1
Figure 1
Anti-SARS-CoV-2 neutralizing antibody titers in symptomatic (N = 11, dark) and asymptomatic (N = 5, light) transplanted patients (P = 0.031).
See this image and copyright information in PMC

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