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논문 기본 정보

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저자정보
Han Ahram (Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.) Min Sangil (Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.) Jo Eun-Ah (Department of Surgery, Seoul National University College of Medicine, Seoul, Korea) Lee Hajeong (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.) Kim Yong Chul (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.) Han Seung Seok (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea) Kang Hee Gyung (Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.Kidney Research In) Ahn Yo Han (Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.) Oh Inseong (Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea) Song Eun Young (Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea) Ha Jongwon (Department of Surgery, Seoul National University College of Medicine, Seoul, KoreaTransplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea)
저널정보
대한진단검사의학회 Annals of Laboratory Medicine Annals of Laboratory Medicine 제44권 제1호
발행연도
2024.1
수록면
64 - 73 (10page)
DOI
10.3343/alm.2024.44.1.64

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Background: Whether anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels post-third coronavirus disease (COVID-19) vaccination correlate with worse outcomes due to breakthrough infection is unclear. We evaluated the association between anti-SARS-CoV-2 antibody levels and symptomatic breakthrough infection or hospitalization during the Omicron surge in kidney transplant recipients. Methods: In total, 287 kidney transplant recipients expected to receive a third vaccination were enrolled between November 2021 and February 2022. The Abbott SARS-CoV-2 IgG II Quant test (Abbott, Chicago, IL, USA) was performed within three weeks before and four weeks after the third vaccination. The incidence of symptomatic breakthrough infection and hospitalization from two weeks to four months post-third vaccination was recorded. Results: After the third vaccination, the seropositive rate and median antibody titer of the 287 patients increased from 57.1% to 82.2% and from 71.7 (interquartile range [IQR] 7.2–402.8) to 1,612.1 (IQR 153.9–5,489.1) AU/mL, respectively. Sixty-four (22.3%) patients had symptomatic breakthrough infections, of whom 12 required hospitalization. Lower anti-receptor-binding domain (RBD) IgG levels (<400 AU/mL) post-third vaccination were a risk factor for symptomatic breakthrough infection (hazard ratio [HR]=3.46, P<0.001). Anti-RBD IgG levels <200 AU/mL were a critical risk factor for hospitalization (HR=36.4, P=0.007). Conclusions: Low anti-spike IgG levels after third vaccination in kidney transplant recipients were associated with symptomatic breakthrough infection and, particularly, with hospitalization during the Omicron surge. These data can be used to identify patients requiring additional protective measures, such as passive immunization using monoclonal antibodies.
#Anti-SARS-CoV2 antibody #Breakthrough infection #COVID-19 #Kidney transplant #Vaccine

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