Kidney Week

Abstract: PO0170

Lower CD3 and CD4 Counts in Kidney Transplant Recipients Who Did Not Respond to COVID-19 Vaccination

Session Information

• COVID-19: Vaccines, Diagnosis, and Treatment
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Al Azzi, Yorg, Montefiore Medical Center, Bronx, New York, United States

Yorg Al Azzi, MD, FASN

• Raees, Harith, Montefiore Medical Center, Bronx, New York, United States

Harith Raees,

• Cleare, Levi Gabriel/g, Montefiore Medical Center, Bronx, New York, United States

Levi Gabriel/g Cleare,

• Bao, Yi, Montefiore Medical Center, Bronx, New York, United States

Yi Bao,

• Loarte Campos, Pablo, Montefiore Medical Center, Bronx, New York, United States

Pablo Loarte Campos,

• Liriano-Ward, Luz E., Montefiore Medical Center, Bronx, New York, United States

Luz E. Liriano-Ward,

• Pynadath, Cindy T., Montefiore Medical Center, Bronx, New York, United States

Cindy T. Pynadath,

• Ajaimy, Maria, Montefiore Medical Center, Bronx, New York, United States

Maria Ajaimy,

• Alani, Omar, Montefiore Medical Center, Bronx, New York, United States

Omar Alani,

• Pirofski, Liise-anne, Montefiore Medical Center, Bronx, New York, United States

Liise-anne Pirofski,

• Akalin, Enver, Montefiore Medical Center, Bronx, New York, United States

Enver Akalin,

Background

Kidney transplant recipient’s response rate to COVID-19 vaccination is reportedly less than 54% after the 2^nd dose, significantly lower than general population and dialysis patients, reported as between 85-90% and 95-100%, respectively.

Methods

We studied SARS-CoV-2 anti-spike IgG levels in our kidney transplant recipients after their COVID-19 vaccination using the OrthoV IgG platform.

Results

69 kidney transplant recipients received a SARS-CoV-2 vaccine (47 Pfizer, 20 Moderna and 2 Johnson and Johnson) at a median 36 months after transplantation (range, 3 months to 22 years). 61% were male, 39% Black, 29% Hispanic with a median age of 60 (range 22-82). 72% were deceased-donor kidney transplant recipients. 23 patients had previous history of COVID-19 diagnosed by SARS-CoV-2 PCR and/or anti-nucleocapsid antibody and 21 of those patients (91%) developed anti-spike IgG after 1^st or 2^nd dose with a median level of 13.2 (11.2-16.2). 46 patients without history of previous COVID-19, 17 (37%) developed anti-spike IgG at a median of 28 days (range 10-72) after the second vaccine dose with a median level of 5.7 (1.22-15.4). Patients who didn’t develop anti-spike IgG tended to be older, of African-American descent, on MMF > 1 g/day, have lower CD3 and CD4 counts.

Conclusion

In summary, most kidney transplant recipients without history of COVID-19 did not produce anti-spike IgG after being fully vaccinated and it is associated with augmented immunosuppression, lower T cell counts, African-American race and older age.