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. 2022 May;22(5):1467-1474.
doi: 10.1111/ajt.16950. Epub 2022 Jan 20.

Anti-SARS-CoV-2 spike protein and neutralizing antibodies at 1 and 3 months after three doses of SARS-CoV-2 vaccine in a large cohort of solid organ transplant patients

Nassim Kamar  1   2   3 , Florence Abravanel  2   3   4 , Olivier Marion  1   2   3 , Laure Esposito  1 , Anne Laure Hebral  1 , Chloé Médrano  1 , Joelle Guitard  1 , Laurence Lavayssière  1 , Olivier Cointault  1 , Marie Bétriace Nogier  1 , Julie Bellière  1   2   5 , Stanislas Faguer  1   2   5 , Chloé Couat  1 , Arnaud Del Bello  1   3 , Jacques Izopet  2   3   4
Affiliations

Anti-SARS-CoV-2 spike protein and neutralizing antibodies at 1 and 3 months after three doses of SARS-CoV-2 vaccine in a large cohort of solid organ transplant patients

Nassim Kamar et al. Am J Transplant. 2022 May.

Abstract

The immunogenicity of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccine was improved by the administration of a third dose. The aim of our retrospective study was to assess the evolution of binding and neutralizing antibody concentration until 3 months after the third dose in a large cohort of solid organ transplant (SOT) patients (n = 872). At 1 month after the third dose, anti-SARS-CoV-2 antibodies were detected by means of enzyme-linked immunosorbent assay tests in 578 patients (66.3%). In a subgroup of patients, 70% (180 out of 257) had anti-SARS-CoV-2 antibody concentrations ranging from 1.2 to 18 411 binding antibody units (BAU)/ml and 48.5% (115 out of 239) had a neutralizing antibodies titer that can confer clinical protection against SARS-CoV-2. Three-hundred ninety-three patients out of the 416 (94.5%) who were seropositive at month 1 and were tested at 3 months after vaccination remained seropositive. Between months 1 and 3 after vaccination, binding and neutralizing antibodies concentrations decreased significantly. The proportion of protected patients against the SARS-CoV-2 also slightly decreased. In conclusion, this study shows that although two-third of SOT develop anti-SARS-CoV-2 antibodies after three doses, one-third of them remain weak or non-protected. It is important to measure anti-SARS-CoV-2 antibodies to define the strategy that can optimize SOT protection against SARS-CoV-2.

Keywords: COVID-19; humoral response; neutralization; organ transplantation; vaccine.

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Figures

FIGURE 1
FIGURE 1
Humoral response after three doses of SARS-CoV-2 vaccine in a cohort of solid organ transplant patients. SARS-CoV-2, severe acute respiratory syndrome-coronavirus 2
FIGURE 2
FIGURE 2
Distribution of patients according to anti-SARS-CoV-2 antibodies assessed by Wantai ELISA test (A) and to neutralizing antibodies (B) at 1 and 3 months after three vaccine doses. Among the 578 transplant patients who were tested positive at 1 month after the third dose, 257 were tested using the Wantai test that was previously used to identify that was used to determine a protection rate in a population of health care workers, and neutralizing antibodies were assessed in 238 patients. Among the 393 transplant patients who were tested positive at 3 months after the third dose, 167 were tested using the Wantai test, and neutralizing antibodies were assessed in 145 patients. ELISA, enzyme-linked immunosorbent assay; SARS-CoV-2, severe acute respiratory syndrome-coronavirus 2
FIGURE 3
FIGURE 3
Distribution of patients according to anti-SARS-CoV-2 antibodies assessed by Wantai ELISA test (A) and to neutralizing antibodies (B) in a subgroup of patients tested at 1 and 3 months after three doses. Among the 578 transplant patients who were tested positive at 1 month after the third dose, 154 were tested using the Wantai test both at 1 and 3 months, and neutralizing antibodies were assessed in 133 patients at both time points. ELISA, enzyme-linked immunosorbent assay; SARS-CoV-2, severe acute respiratory syndrome-coronavirus 2
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