Premium
Reinfection with SARS‐CoV‐2 in solid‐organ transplant recipients: Incidence density and convalescent immunity prior to reinfection
Author(s) -
Morris Stephen,
Anjan Shweta,
Pallikkuth Suresh,
Frattaroli Paola,
Courel Steve,
Fernandez Anmary,
Natori Akina,
Abbo Lilian,
Pahwa Savita,
Guerra Giselle,
Natori Yoichiro
Publication year - 2022
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13827
Subject(s) - medicine , immunology , immunity , incidence (geometry) , antibody , titer , humoral immunity , immunoglobulin g , cellular immunity , transplantation , vaccination , cd8 , immune system , lung transplantation , physics , optics
Background Long‐term protective immunity to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) remains poorly characterized, particularly in solid organ transplant (SOT) patients. Method We determined the incidence density of SARS‐CoV‐2 reinfection in a cohort of adult SOT recipients initially infected between March 1st, 2020 and March 30th, 2021 and included those with initial infection before or after transplantation. Incidence density was the total cases divided by total days after initial diagnosis with active graft. Results Of 210 infected recipients, five (2.4%) developed reinfection, including two who had received full mRNA vaccination, but none developed hypoxia. The incidence density for reinfection was 9.4 (95% confidence interval [CI] 3.9‐22.6) and for primary infection the density was 9.1 (95% CI 7.9–10.5) cases/100,000 patient days. Two recipients had immunity evaluated in the weeks prior to reinfection, by measuring immunoglobulin‐G (IgG) antibody titer to the SARS‐CoV‐2 receptor binding domain and virus‐specific CD4+ and CD8+ T‐cell reactivity following stimulation with SARS‐CoV‐2 peptide pools. Both mounted virus specific CD4 T‐cell responses prior to reinfection (1.19% and 0.28% of total CD4 T cells) and both had reactive IgG testing (1.30 and 4.99 signal/cut off ratio). Conclusions This suggests that SOT recipients infected with SARS‐CoV‐2 remain at high risk for reinfection even after generating cellular and humoral immune responses.