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Humoral and cellular response of COVID‐19 vaccine among solid organ transplant recipients: A systematic review and meta‐analysis
Author(s) -
Meshram Hari Shankar,
Kute Vivek,
Rane Hemant,
Dave Ruchir,
Banerjee Subho,
Mishra Vineet,
Chauhan Sanshriti
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.13926
Subject(s) - medicine , immunogenicity , meta analysis , immune system , immunology , odds ratio , vaccination , gastroenterology
Background We aimed to analyze the humoral and cellular response to standard and booster (additional doses) COVID‐19 vaccination in solid organ transplantation (SOT) and the risk factors involved for an impaired response. Methods We did a systematic review and meta‐analysis of studies published up until January 11, 2022, that reported immunogenicity of COVID‐19 vaccine among SOT. The study is registered with PROSPERO, number CRD42022300547. Results Of the 1527 studies, 112 studies, which involved 15391 SOT and 2844 healthy controls, were included. SOT showed a low humoral response (effect size [ES]: 0.44 [0.40–0.48]) in overall and in control studies (log‐Odds‐ratio [OR]: −4.46 [−8.10 to −2.35]). The humoral response was highest in liver (ES: 0.67 [0.61–0.74]) followed by heart (ES: 0.45 [0.32–0.59]), kidney (ES: 0.40 [0.36–0.45]), kidney‐pancreas (ES: 0.33 [0.13–0.53]), and lung (0.27 [0.17–0.37]). The meta‐analysis for standard and booster dose (ES: 0.43 [0.39–0.47] vs. 0.51 [0.43–0.54]) showed a marginal increase of 18% efficacy. SOT with prior infection had higher response (ES: 0.94 [0.92–0.96] vs. ES: 0.40 [0.39–0.41]; p ‐value < .01). The seroresponse with mRNA‐12723 mRNA was highest 0.52 (0.40–0.64). Mycophenolic acid (OR: 1.42 [1.21–1.63]) and Belatacept (OR: 1.89 [1.3–2.49]) had highest risk for nonresponse. SOT had a parallelly decreased cellular response (ES: 0.42 [0.32–0.52]) in overall and control studies (OR: −3.12 [−0.4.12 to −2.13]). Interpretation Overall, SOT develops a suboptimal response compared to the general population. Immunosuppression including mycophenolic acid, belatacept, and tacrolimus is associated with decreased response. Booster doses increase the immune response, but further upgradation in vaccination strategy for SOT is required.