Immunologic Response to SARS-CoV-2 Vaccination in Pediatric Kidney Transplant Recipients: A Systematic Review and Meta-Analysis
The pediatric population is at a lower risk of severe SARS-CoV-2 infection compared to adults. Nevertheless, immunosuppression in pediatric and adolescent kidney transplant recipients (KTRs) increases their hazard compared to the general population. This systematic review evaluates the efficacy of S...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/11/6/1080 |
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| author | Elpida Emmanouilidou-Fotoulaki Vasiliki Karava John Dotis Antonia Kondou Nikoleta Printza |
| author_facet | Elpida Emmanouilidou-Fotoulaki Vasiliki Karava John Dotis Antonia Kondou Nikoleta Printza |
| author_sort | Elpida Emmanouilidou-Fotoulaki |
| collection | DOAJ |
| description | The pediatric population is at a lower risk of severe SARS-CoV-2 infection compared to adults. Nevertheless, immunosuppression in pediatric and adolescent kidney transplant recipients (KTRs) increases their hazard compared to the general population. This systematic review evaluates the efficacy of SARS-CoV-2 vaccines and determines the risk factors of no seroconversion in this population. PubMed-MEDLINE databases were searched for cohort studies. A meta-analysis was performed using fixed and random effect models. In total, seven studies including 254 patients were further analyzed. The random effect model demonstrated a 63% seroconversion rate (95% CI 0.5, 0.76) following a two-dose schedule, which increased to 85% (95% CI 0.76, 0.93) after the third dose administration. Seropositivity was lower in patients under mycophenolate mofetil compared to azathioprine (OR 0.09, 95% CI 0.02, 0.43). Rituximab administration decreased the seroconversion rate (OR 0.12, 95% CI 0.03, 0.43). The glomerular filtration rate (GFR) was 9.25 mL/min/1.73 m<sup>2</sup> lower (95% CI 16.37, 2.13) in patients with no seroconversion. The seroconversion rate was lower in vaccinated compared to infected patients (OR 0.13, 95% CI 0.02, 0.72). In conclusion, vaccination against SARS-CoV-2 in pediatric and adolescent KTRs elicits a humoral response, and a third dose is advised. Previous rituximab administration, antimetabolite therapy with mycophenolate mofetil and lower GFR reduce the likelihood for seroconversion. |
| first_indexed | 2024-03-11T01:50:39Z |
| format | Article |
| id | doaj.art-0a72d78c00b34664a8658395faf0e0c0 |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-11T01:50:39Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-0a72d78c00b34664a8658395faf0e0c02023-11-18T12:58:56ZengMDPI AGVaccines2076-393X2023-06-01116108010.3390/vaccines11061080Immunologic Response to SARS-CoV-2 Vaccination in Pediatric Kidney Transplant Recipients: A Systematic Review and Meta-AnalysisElpida Emmanouilidou-Fotoulaki0Vasiliki Karava1John Dotis2Antonia Kondou3Nikoleta Printza4Pediatric Nephrology Unit, 1st Department of Pediatrics, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreecePediatric Nephrology Unit, 1st Department of Pediatrics, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreecePediatric Nephrology Unit, 1st Department of Pediatrics, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreecePediatric Nephrology Unit, 1st Department of Pediatrics, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreecePediatric Nephrology Unit, 1st Department of Pediatrics, Aristotle University of Thessaloniki, 54642 Thessaloniki, GreeceThe pediatric population is at a lower risk of severe SARS-CoV-2 infection compared to adults. Nevertheless, immunosuppression in pediatric and adolescent kidney transplant recipients (KTRs) increases their hazard compared to the general population. This systematic review evaluates the efficacy of SARS-CoV-2 vaccines and determines the risk factors of no seroconversion in this population. PubMed-MEDLINE databases were searched for cohort studies. A meta-analysis was performed using fixed and random effect models. In total, seven studies including 254 patients were further analyzed. The random effect model demonstrated a 63% seroconversion rate (95% CI 0.5, 0.76) following a two-dose schedule, which increased to 85% (95% CI 0.76, 0.93) after the third dose administration. Seropositivity was lower in patients under mycophenolate mofetil compared to azathioprine (OR 0.09, 95% CI 0.02, 0.43). Rituximab administration decreased the seroconversion rate (OR 0.12, 95% CI 0.03, 0.43). The glomerular filtration rate (GFR) was 9.25 mL/min/1.73 m<sup>2</sup> lower (95% CI 16.37, 2.13) in patients with no seroconversion. The seroconversion rate was lower in vaccinated compared to infected patients (OR 0.13, 95% CI 0.02, 0.72). In conclusion, vaccination against SARS-CoV-2 in pediatric and adolescent KTRs elicits a humoral response, and a third dose is advised. Previous rituximab administration, antimetabolite therapy with mycophenolate mofetil and lower GFR reduce the likelihood for seroconversion.https://www.mdpi.com/2076-393X/11/6/1080COVID-19vaccinekidneytransplantationpediatricrisk factors |
| spellingShingle | Elpida Emmanouilidou-Fotoulaki Vasiliki Karava John Dotis Antonia Kondou Nikoleta Printza Immunologic Response to SARS-CoV-2 Vaccination in Pediatric Kidney Transplant Recipients: A Systematic Review and Meta-Analysis Vaccines COVID-19 vaccine kidney transplantation pediatric risk factors |
| title | Immunologic Response to SARS-CoV-2 Vaccination in Pediatric Kidney Transplant Recipients: A Systematic Review and Meta-Analysis |
| title_full | Immunologic Response to SARS-CoV-2 Vaccination in Pediatric Kidney Transplant Recipients: A Systematic Review and Meta-Analysis |
| title_fullStr | Immunologic Response to SARS-CoV-2 Vaccination in Pediatric Kidney Transplant Recipients: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Immunologic Response to SARS-CoV-2 Vaccination in Pediatric Kidney Transplant Recipients: A Systematic Review and Meta-Analysis |
| title_short | Immunologic Response to SARS-CoV-2 Vaccination in Pediatric Kidney Transplant Recipients: A Systematic Review and Meta-Analysis |
| title_sort | immunologic response to sars cov 2 vaccination in pediatric kidney transplant recipients a systematic review and meta analysis |
| topic | COVID-19 vaccine kidney transplantation pediatric risk factors |
| url | https://www.mdpi.com/2076-393X/11/6/1080 |
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