RESUMEN
BACKGROUND: The clinical effectiveness of coronavirus disease 2019 (COVID-19) vaccination in kidney transplant (KT) recipients is lower than in the general population. METHODS: From April to October 2021, 481 KT recipients with COVID-19, included in the Spanish Society of Nephrology COVID-19 Registry, were analyzed. Data regarding vaccination status and vaccine type were collected, and outcomes of unvaccinated or partially vaccinated patients (n = 130) were compared with fully vaccinated patients (n = 351). RESULTS: Clinical picture was similar and survival analysis showed no differences between groups: 21.7% of fully vaccinated patients and 20.8% of unvaccinated or partially vaccinated died (P = 0.776). In multivariable analysis, age and pneumonia were independent risk factors for death, whereas vaccination status was not related to mortality. These results remained similar when we excluded patients with partial vaccination, as well as when we analyzed exclusively hospitalized patients. Patients vaccinated with mRNA-1273 (n = 213) showed a significantly lower mortality than those who received the BNT162b2 vaccine (n = 121) (hazard ratio: 0.52; 95% confidence interval, 0.31-0.85; P = 0.010). CONCLUSIONS: COVID-19 severity in KT patients has remained high and has not improved despite receiving 2 doses of the mRNA vaccine. The mRNA-1273 vaccine shows higher clinical effectiveness than BNT162b2 in KT recipients with breakthrough infections. Confirmation of these data will require further research taking into account the new variants and the administration of successive vaccine doses.
Asunto(s)
COVID-19 , Trasplante de Riñón , Vacuna nCoV-2019 mRNA-1273 , Vacuna BNT162 , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/efectos adversos , Humanos , Trasplante de Riñón/efectos adversos , ARN Mensajero , SARS-CoV-2 , Receptores de Trasplantes , Vacunación , Vacunas Sintéticas , Vacunas de ARNmAsunto(s)
Complemento C1q/análisis , Nefrosis Lipoidea/diagnóstico , Biomarcadores/análisis , Complemento C3/análisis , Complemento C4/análisis , Progresión de la Enfermedad , Glomerulonefritis , Humanos , Masculino , Nefrosis Lipoidea/tratamiento farmacológico , Nefrosis Lipoidea/inmunología , Adulto JovenAsunto(s)
Tumores Neuroendocrinos , Neoplasias Pancreáticas , Humanos , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Tumores Neuroendocrinos/complicaciones , Tumores Neuroendocrinos/diagnóstico , Tumores Neuroendocrinos/cirugía , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/cirugía , Fenotipo , Diálisis Renal , Síndrome de Rubinstein-Taybi/complicacionesRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adulto Joven , Complemento C1q/metabolismo , Nefrosis Lipoidea/metabolismo , Nefrosis Lipoidea , Rituximab/uso terapéutico , Factores Inmunológicos/uso terapéutico , Nefrosis Lipoidea/tratamiento farmacológico , Nefrosis Lipoidea/patología , BiopsiaRESUMEN
No disponible