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Multicenter Study
. 2022 Apr;24(2):e13774.
doi: 10.1111/tid.13774. Epub 2022 Jan 31.

Clinical characteristics of COVID-19 in solid organ transplant recipients following COVID-19 vaccination: A multicenter case series

Kapil K Saharia  1 , Shweta Anjan  2 , Judy Streit  3 , Susan E Beekmann  3 , Philip M Polgreen  3 , Matthew Kuehnert  4 , Dorry L Segev  5 , John W Baddley  1 , Rachel A Miller  6 ; EIN COVID-19 Study Team
Affiliations
Multicenter Study

Clinical characteristics of COVID-19 in solid organ transplant recipients following COVID-19 vaccination: A multicenter case series

Kapil K Saharia et al. Transpl Infect Dis. 2022 Apr.

Abstract

Background: Solid organ transplant recipients (SOTR) have diminished humoral immune responses to COVID-19 vaccination and higher rates of COVID-19 vaccine breakthrough infection than the general population. Little is known about COVID-19 disease severity in SOTR with COVID-19 vaccine breakthrough infections.

Methods: Between 4/7/21 and 6/21/21, we requested case reports via the Emerging Infections Network (EIN) listserv of SARS-CoV-2 infection following COVID-19 vaccination in SOTR. Online data collection included patient demographics, dates of COVID-19 vaccine administration, and clinical data related to COVID-19. We performed a descriptive analysis of patient factors and evaluated variables contributing to critical disease or need for hospitalization.

Results: Sixty-six cases of SARS-CoV-2 infection after vaccination in SOTR were collected. COVID-19 occurred after the second vaccine dose in 52 (78.8%) cases, of which 43 (82.7%) occurred ≥14 days post-vaccination. There were six deaths, three occurring in fully vaccinated individuals (7.0%, n = 3/43). There was no difference in the percentage of patients who recovered from COVID-19 (70.7% vs. 72.2%, p = .90) among fully and partially vaccinated individuals. We did not identify any differences in hospitalization (60.5% vs. 55.6%, p = .72) or critical disease (20.9% vs. 33.3%, p = .30) among those who were fully versus partially vaccinated.

Conclusions: SOTR vaccinated against COVID-19 can still develop severe, and even critical, COVID-19 disease. Two doses of mRNA COVID-19 vaccine may be insufficient to protect against severe disease and mortality in SOTR. Future studies to define correlates of protection in SOTR are needed.

Keywords: COVID-19 vaccine; breakthrough infection; mRNA vaccines; severe COVID-19; solid organ transplantation.

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References

REFERENCES

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