Breakthrough Coronavirus Associated Infectious Disease 2019 After Vaccination Among Kidney Transplant Recipients

Area of Science:

• Immunology
• Transplantation Medicine
• Infectious Diseases

Background:

• Kidney transplant (KT) recipients are highly susceptible to severe COVID-19.
• Vaccine efficacy data in KT patients requires further investigation.
• Understanding breakthrough infection risks is crucial for this high-risk group.

Purpose of the Study:

• To evaluate risk factors for breakthrough COVID-19 infections in KT recipients.
• To compare infection and adverse outcomes between KT recipients and non-KT individuals.
• To assess the impact of vaccination and booster doses on COVID-19 outcomes in KT patients.

Main Methods:

• Retrospective analysis of a US statewide health registry (2019-2022).
• Propensity score matching to compare 1270 KT recipients with 2540 non-KT individuals.
• Cox proportional hazards models and odds ratios used to analyze infection risk and outcomes.

Main Results:

• KT recipients had a 2.61-fold higher risk of breakthrough COVID-19 infection compared to non-KT individuals.
• Booster vaccination significantly reduced breakthrough infection risk (OR: 0.19).
• KT patients with breakthrough infections faced substantially higher odds of hospitalization (OR: 18) and death (OR: 10.2).

Conclusions:

• Kidney transplant recipients remain at elevated risk for breakthrough COVID-19.
• mRNA vaccination and booster doses offer protection against infection and severe outcomes.
• Continued vigilance and vaccination strategies are essential for KT recipients.