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Decreased Long-Term Severe Acute Respiratory Syndrome Coronavirus 2-Specific Humoral Immunity in Liver
Aránzazu Caballero-Marcos1, María Jesús Citores, Roberto Alonso-Fernández
1Hepatology and Liver Transplantation Unit, Hospital General Universitario Gregorio Marañón, Facultad de Medicina Universidad Complutense Madrid Spain Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd) Barcelona Spain Department of Internal Medicine Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA) Majadahonda Madrid Spain Deparment of Clinical Microbiology and Infectious Diseases Hospital General Universitario Gregorio Marañón Madrid Spain Department of Hepatology and Liver Transplantation Hospital Universitario Reina SofíaIMIBIC Córdoba Spain Department of Digestive Diseases Hospital Ramón y CajalIRYCIS Madrid Spain Hepatology and Liver Transplant Unit Hospital Puerta de HierroIDIPHIMSAUniversidad Autónoma de Madrid Madrid Spain Instituto de Investigación Puerta de Hierro Segovia de Aran (IDIPHISA) Madrid Spain Liver Transplant Unit Hospital Universitari de BellvitgeIDIBELL, L'Hospitalet de Llobregat Barcelona Spain Department of Hepatology/HPB-surgery/Transplantation Hospital Universitario 12 de Octubre Madrid Spain Liver Unit Clinica Universidad de Navarra Pamplona Spain Department of Internal Medicine, Liver Unit Hospital Universitari Vall d'HebronUniversitat Autònoma de Barcelona Barcelona Spain Liver Unit Hospital General Universitario de Alicante Alicante Spain Department of Hepatology and Liver Transplantation Hospital Universitario y Politécnico La Fe Valencia Spain Department of Liver Transplantation Hospital Regional Universitario de Málaga Malaga Spain Liver Transplant Unit Hospital de A Coruña A Coruña Spain Department of Liver Transplantation Hospital Universitario de Santiago Santiago de Compostela Spain Department of GastroenterologyHepatology and Liver Transplantation Unit Hospital Universitario Rio Hortega Valladolid Spain Liver Unit and Division of Gastroenterology and Hepatology Hospital Universitario Central de Asturias Oviedo Spain Department of Hepatology and Liver Transplantation Hospital Virgen de las Nieves Granada Spain Department of HPB Surgery and Liver Transplantation Complejo Hospitalario Universitario de Badajoz Badajoz Spain Liver Transplant and Hepatology Unit Cruces University Hospital Baracaldo Spain Deparment of Clinical Microbiology and Infectious Diseases Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat Barcelona Spain Liver Transplantation Unit, Liver UnitDepartment of Surgery IMIB, Hospital Universitario Virgen de la Arrixaca Murcia Spain.
Abstract:
Long-term humoral immunity and its protective role in liver transplantation (LT) patients have not been elucidated. We performed a prospective multicenter study to assess the persistence of immunoglobulin G (IgG) antibodies in LT recipients 12 months after coronavirus disease 2019 (COVID-19). A total of 65 LT recipients were matched with 65 nontransplanted patients by a propensity score including variables with recognized impact on COVID-19. LT recipients showed a lower prevalence of anti-nucleocapsid (27.7% versus 49.2%; P = 0.02) and anti-spike IgG antibodies (88.2% versus 100.0%; P = 0.02) at 12 months. Lower index values of anti-nucleocapsid IgG antibodies were also observed in transplantation patients 1 year after COVID-19 (median, 0.49 [interquartile range, 0.15-1.40] versus 1.36 [interquartile range, 0.53-2.91]; P < 0.001). Vaccinated LT recipients showed higher antibody levels compared with unvaccinated patients (P < 0.001); antibody levels reached after vaccination were comparable to those observed in nontransplanted individuals (P = 0.70). In LT patients, a longer interval since transplantation (odds ratio, 1.10; 95% confidence interval, 1.01-1.20) was independently associated with persistence of anti-nucleocapsid IgG antibodies 1 year after infection. In conclusion, compared with nontransplanted patients, LT recipients show a lower long-term persistence of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies. However, SARS-CoV-2 vaccination after COVID-19 in LT patients achieves a significant increase in antibody levels, comparable to that of nontransplanted patients.
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