Serologic response to COVID-19 infection or vaccination in pediatric kidney transplant recipients compared to healthy children

Noa Ziv*, Yulia Gimelraikh, Liat Ashkenazi-Hoffnung, Hadas Alfandary, Yael Borovitz, Amit Dagan, Shelly Levi, Gilad Hamdani, Daniella Levy-Erez, Daniel Landau, Gili Koren, Efrat Talgam-Horshi, Orly Haskin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Differences in serologic response to COVID-19 infection or vaccination were reported in adult kidney transplant recipients (KTR) compared to non-immunocompromised patients. This study aims to compare the serologic response of naturally infected or vaccinated pediatric KTR to that of controls. Methods: Thirty-eight KTR and 42 healthy children were included; aged ≤18 years, with a previously confirmed COVID-19 infection or post COVID-19 vaccination. Serological response was measured by anti-spike protein IgG antibody titers. Response post third vaccine was additionally assessed in KTR. Results: Fourteen children in each group had previously confirmed infection. KTR were significantly older and developed a 2-fold higher antibody titer post-infection compared to controls [median (interquartile range [IQR]) age: 14.9 (7.8, 17.5) vs. 6.3 (4.5, 11.5) years, p = 0.02; median (IQR) titer: 1695 (982, 3520) vs. 716 (368, 976) AU/mL, p = 0.03]. Twenty-four KTR and 28 controls were vaccinated. Antibody titer was lower in KTR than in controls [median (IQR): 803 (206, 1744) vs. 8023 (3032, 30,052) AU/mL, p < 0.001]. Fourteen KTR received third vaccine. Antibody titer post booster in KTR reached similar levels to those of controls post two doses [median (IQR) 5923 (2295, 12,278) vs. 8023 (3034, 30,052) AU/mL, p = 0.37] and to KTR post natural infection [5282 AU/mL (2583, 13,257) p = 0.8]. Conclusion: Serologic response to COVID-19 infection was significantly higher in KTR than in controls. Antibody level in KTR was higher in response to infection vs. vaccination, contrary to reports in the general population. Response to vaccination in KTR reached levels comparable to controls only after third vaccine.

Original languageEnglish
Article number101839
JournalTransplant Immunology
Volume78
DOIs
StatePublished - Jun 2023

Funding

FundersFunder number
Lydia Eviatar Foundation for Clinical Research by Residents of Schneider Children's Medical Center of Israel

    Keywords

    • COVID-19
    • Infectious
    • Nephrology
    • Pediatric
    • Transplantation

    Fingerprint

    Dive into the research topics of 'Serologic response to COVID-19 infection or vaccination in pediatric kidney transplant recipients compared to healthy children'. Together they form a unique fingerprint.

    Cite this