Viral Clearance and Serological Response to SARS-CoV-2 in Kidney Transplant Recipients

Autores da FMUP

• Isabel Cristina Pinho Tavares Salomé

  Autor

• Susana Maria Moreira Sampaio Norton

  Autor

• Manuel Jesus Falcão Pestana Vasconcelos

  Autor

Participantes de fora da FMUP

• Silvano, J
• Ferreira, F
• Bustorff, M
• Nunes, AT
• Simoes, JS
• Ramos, A
• Cardoso, MJ

Unidades de investigação

• Medicina

Abstract

Objectives. Knowledge about the impact of coronavirus disease 2019 (COVID-19) on kidney transplant recipients (KTRs) concerning viral shedding and humoral immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is limited. The aim of this study is to analyze viral dynamics and the antibody response to SARS-CoV-2 in KTRs with COVID-19 and study their association with clinical data. Materials and methods. Consecutive KTRs diagnosed with COVID-19 at our center were evaluated for clinical presentation and outcome; duration of viral shedding and viral burden by reverse transcription-polymerase chain reaction assay cycle threshold; and magnitude of seroconversion to SARS-CoV-2. Results. Six KTRs identified with COVID-19 were hospitalized. Presenting symptoms were similar to those in the general population. Four patients had severe disease and, of these, 2 required mechanical ventilation, 4 had acute kidney injury, and 3 had secondary bacterial infections. Immunosuppression was reduced in all patients. Five patients were treated with hydroxychloroquine. No patient required dialysis or died. Patients with severe disease had a longer duration of viral shedding, which lasted more than 40 days, and had IgG antibodies against SARS-CoV-2, which were detected from 3 weeks to as long as 10 weeks after symptom onset. In patients with less severe disease no IgG antibodies where detected between 9 and 14 weeks after symptom onset. Conclusions. In our series, KTRs with severe COVID-19 had prolonged viral shedding and a stronger humoral immune response to SARS-CoV-2. These preliminary data need to be confirmed with further studies and over a longer period of time.

Copyright © 2020 Elsevier Inc. All rights reserved.

Keywords

• Adult; Aged; Antibodies, Viral; COVID-19; Female; Humans; Immunoglobulin G; Kidney Failure, Chronic; Kidney Transplantation; Male; Middle Aged; Reverse Transcriptase Polymerase Chain Reaction; RNA, Viral; SARS-CoV-2; Time Factors; Virus Shedding; C reactive protein; creatinine; hydroxychloroquine; immunoglobulin G antibody; mycophenolate mofetil; prednisolone; immunoglobulin G; virus antibody; virus RNA; acute kidney failure; adult; aged; Article; artificial ventilation; bacterial infection; clinical article; colitis; controlled study; coronavirus disease 2019; creatinine blood level; cytomegalovirus colitis; cytomegalovirus infection; disease course; female; graft recipient; hospital discharge; hospitalization; human; immunosuppressive treatment; kidney transplantation; male; population research; postoperative period; reverse transcription polymerase chain reaction; seroconversion; Severe acute respiratory syndrome coronavirus 2; viral clearance; virus load; virus shedding; blood; cas