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Vaccines
Special Issues
SARS-CoV-2 Infection and Vaccines for Patients with Renal Diseases
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SARS-CoV-2 Infection and Vaccines for Patients with Renal Diseases

A special issue of Vaccines (ISSN 2076-393X). This special issue belongs to the section "COVID-19 Vaccines and Vaccination".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 10138

Special Issue Editors

Dr. Mariarosaria Campise

E-Mail Website
Guest Editor
Department of Nephrology, Dialysis, and Renal Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Interests: kidney transplantation; immunosuppression; kidney transplant complications and chronic allograft dysfunction; FSGS
Dr. Giuseppe Castellano

E-Mail Website
Guest Editor
1. Department of Nephrology, Dialysis, and Renal Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
2. Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
Interests: chronic kidney disease (CKD); chronic inflammation; glomerulonephritis; kidney transplantation; acute kidney disease (AKI)
Special Issues, Collections and Topics in MDPI journals
Dr. Carlo Maria Alfieri

E-Mail Website
Guest Editor
1. Department of Nephrology, Dialysis, and Renal Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
2. Department of Clinical Sciences and Community Health, University of Milan, 20122 Milano, Italy
Interests: kidney transplantation; chronic kidney disease; mineral bone disorders in CKD and kidney transplantation; markers of CKD progression

Special Issue Information

Dear Colleagues,

Vaccinations as well as specific vaccines are still a critical topic for kidney transplant candidates and recipients who are at increased risk of infection-related morbidity and mortality due to the immunosuppressive therapy that will impact their immune response.

Therefore, patients eligible for kidney or other solid organ transplantation should be immunized with live vaccines given at least 4 weeks prior to transplant in order to ensure that vaccine-related viral replication has resolved prior to transplant, while inactivated vaccines may be administered after transplantation.

The SARS-CoV-19 pandemic has caused an immense loss of lives, particularly among fragile populations such as kidney transplant patients, pointing out the need of secure and effective vaccines in this population. Although the availability of COVID-19 vaccines has changed the fate of this life-threatening infection, it has also raised some concerns on safety and efficacy. Some recent papers have indeed reported new-onset glomerulonephritis: IgA nephritis, necrotizing vasculitis and lupus nephritis. We can therefore understand the growing hesitancy that has arisen among patients.

Stemming from these considerations is a clear need to further explore the treatment for COVID-19 infections and the attitude of specialists about vaccines other than the COVID-19 vaccine for patients with kidney disease, in order to share opinions and experiences that will improve the standard of care for these patients.

Dr. Mariarosaria Campise
Dr. Giuseppe Castellano
Dr. Carlo Maria Alfieri
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Vaccines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • vaccine safety
  • vaccine efficacy
  • COVID-19 infection
  • renal diseases
  • kidney transplantation

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Published Papers (5 papers)

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12 pages, 708 KiB  
Article
Predictors of Acute Kidney Injury (AKI) among COVID-19 Patients at the US Department of Veterans Affairs: The Important Role of COVID-19 Vaccinations
by Lilia R. Lukowsky, Claudia Der-Martirosian, Heather Northcraft, Kamyar Kalantar-Zadeh, David S. Goldfarb and Aram Dobalian
Vaccines 2024, 12(2), 146; https://doi.org/10.3390/vaccines12020146 - 30 Jan 2024
Viewed by 2590
Abstract
Background: There are knowledge gaps about factors associated with acute kidney injury (AKI) among COVID-19 patients. To examine AKI predictors among COVID-19 patients, a retrospective longitudinal cohort study was conducted between January 2020 and December 2022. Logistic regression models were used to examine [...] Read more.
Background: There are knowledge gaps about factors associated with acute kidney injury (AKI) among COVID-19 patients. To examine AKI predictors among COVID-19 patients, a retrospective longitudinal cohort study was conducted between January 2020 and December 2022. Logistic regression models were used to examine predictors of AKI, and survival analysis was performed to examine mortality in COVID-19 patients. Results: A total of 742,799 veterans diagnosed with COVID-19 were included and 95,573 were hospitalized within 60 days following COVID-19 diagnosis. A total of 45,754 developed AKI and 28,573 AKI patients were hospitalized. Use of vasopressors (OR = 14.73; 95% CL 13.96–15.53), history of AKI (OR = 2.22; CL 2.15–2.29), male gender (OR = 1.90; CL 1.75–2.05), Black race (OR = 1.62; CL 1.57–1.65), and age 65+ (OR = 1.57; CL 1.50–1.63) were associated with AKI. Patients who were vaccinated twice and boosted were least likely to develop AKI (OR = 0.51; CL 0.49–0.53) compared to unvaccinated COVID-19 patients. Patients receiving two doses (OR = 0.77; CL = 0.72–0.81), or a single dose (OR = 0.88; CL = 0.81–0.95) were also less likely to develop AKI compared to the unvaccinated. AKI patients exhibited four times higher mortality compared to those without AKI (HR = 4.35; CL 4.23–4.50). Vaccinated and boosted patients had the lowest mortality risk compared to the unvaccinated (HR = 0.30; CL 0.28–0.31). Conclusion: Use of vasopressors, being unvaccinated, older age, male gender, and Black race were associated with post COVID-19 AKI. Whether COVID-19 vaccination, including boosters, decreases the risk of developing AKI warrants additional studies. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infection and Vaccines for Patients with Renal Diseases)
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12 pages, 563 KiB  
Article
Vaccination and COVID-19 in Polish Dialysis Patients: Results from the European Clinical Dialysis Database
by Wojciech Marcinkowski, Konrad Zuzda, Jacek Zawierucha, Tomasz Prystacki, Paweł Żebrowski, Jacek S. Małyszko, Ewa Wojtaszek and Jolanta Małyszko
Vaccines 2022, 10(9), 1565; https://doi.org/10.3390/vaccines10091565 - 19 Sep 2022
Cited by 3 | Viewed by 1763
Abstract
Background: Patients with end-stage kidney disease undergoing hemodialysis are particularly vulnerable to severe COVID-19 as a result of older age and multimorbidities. Objectives: Data are still limited and there are no published data on mortality in hemodialyzed patients in Poland, in particular when [...] Read more.
Background: Patients with end-stage kidney disease undergoing hemodialysis are particularly vulnerable to severe COVID-19 as a result of older age and multimorbidities. Objectives: Data are still limited and there are no published data on mortality in hemodialyzed patients in Poland, in particular when vaccines became available. We assessed the epidemiologic and clinical data of patients with laboratory-confirmed COVID-19 and assessed the mortality in 2019, 2020, and 2021, as well as the vaccination rate in 2021. Patients and Methods: Retrospectively collected data from 73 Fresenius Nephrocare Poland hemodialysis centers and one public unit were analyzed. Results: In 2021, the vaccination rate was 96%. The unadjusted mortality (number of deaths divided by number of patients) in 2019 was 18.8%, while the unadjusted (after exclusion of COVID-related deaths) mortality in 2020 was 20.8%, and mortality in 2021 was 16.22%. The prevalence of cardiovascular deaths in 2019 and 2020 was almost identical (41.4% vs. 41.2%, respectively), and in 2021, the figures increased slightly to 44.1%. The prevalence of sudden cardiac deaths in 2019 was higher than in 2020 (19.6% vs. 17.3%, respectively) and consequently decreased in 2021 (10.0%), as well as strokes (6.2% vs. 5.4%, and 3.31% in 2021), whereas deaths due to gastrointestinal tract diseases were lower (2.5% vs. 3.2%, and 2.25% in 2021), diabetes complications (0.5% vs. 1.3%, and 0.5% in 2021), sepsis (5.1% vs. 6.3%, and 8.79% in 2021), respiratory failure (1.2 vs. 1.6%, and 2.83% in 2021), and pneumonia (1.4% vs. 2.0%, and 0.82%). There were 1493 hemodialyzed COVID-19 positive patients, and among them, 191 died in 2020 (12.79%). In 2021, there were 1224 COVID-19 positive patients and 260 died (21.24%). The mortality of COVID-19 positive dialyzed patients contributed 13.39% in 2020 and 16.21% in 2021 of all recorded deaths. Conclusions: The mortality among HD patients was higher in 2021 than in 2020 and 2019, despite the very high vaccination rate of up to 96%. The higher non-COVID-19 mortality may be due to the limited possibility of hospitalization and dedicated care during the pandemic. This information is extremely important in order to develop methods to protect this highly vulnerable patient group. Prevention plays a key role; other measures are essential in the mitigation and spread of COVID-19 in HD centers. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infection and Vaccines for Patients with Renal Diseases)
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6 pages, 225 KiB  
Article
How Vaccinations Changed the Outcome of COVID-19 Infections in Kidney Transplant Patients: Single-Center Experience
by Mariarosaria Campise, Carlo Maria Alfieri, Matteo Benedetti, Alessandro Perna, Roberta Miglio, Paolo Molinari, Angela Cervesato, Silvia Giuliani, Maria Teresa Gandolfo, Anna Regalia, Donata Cresseri, Laura Alagna, Andrea Gori and Giuseppe Castellano
Vaccines 2022, 10(7), 990; https://doi.org/10.3390/vaccines10070990 - 22 Jun 2022
Cited by 1 | Viewed by 2155
Abstract
Kidney transplant recipients are a vulnerable population at risk of a life-threatening COVID-19 infection with an incidence of death four-times higher than in the general population. The availability of mRNA COVID-19 vaccines has dramatically changed the fate of this infection also within this [...] Read more.
Kidney transplant recipients are a vulnerable population at risk of a life-threatening COVID-19 infection with an incidence of death four-times higher than in the general population. The availability of mRNA COVID-19 vaccines has dramatically changed the fate of this infection also within this fragile population. Transplanted patients have an impaired immunological response also to mRNA vaccines. In March 2021, however, we started a vaccination campaign. These preliminary results show that both the incidence of death and of hospitalization dropped from 13% to 2.4% and from 45% to 12.5% compared to the previous outbreaks reported by our group. In univariate analysis, two variables were associated with an increased risk of hospitalization: older age and dyspnea (p = 0.023, p < 0.0001, respectively). In multivariate analysis, dyspnea (p < 0.0001) and mycophenolate therapy (p = 0.003) were independently associated with the risk of hospitalization. The association was even stronger when the two variables were combined (p < 0.0001). Vaccinations did not reduce the incidence of COVID-19 infections among our transplanted patients, but provided certain protection that was associated with a significantly better outcome for this infection. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infection and Vaccines for Patients with Renal Diseases)

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8 pages, 1095 KiB  
Brief Report
Comparison of Post-Vaccination Response (Humoral and Cellular) to BNT162b2 in Clinical Cases, Kidney and Pancreas Transplant Recipient with Immunocompetent Subjects over Almost Two Years of Parallel Monitoring
by Jaroslaw Walory, Iza Ksiazek, Karolina Wegrzynska and Anna Baraniak
Vaccines 2024, 12(8), 844; https://doi.org/10.3390/vaccines12080844 - 26 Jul 2024
Viewed by 1057
Abstract
Background: Vaccination is one of the most effective medical interventions to prevent infectious diseases. The introduction of vaccines against coronavirus acute respiratory syndrome 2 (SARS-CoV-2) was aimed at preventing severe illness and death due to coronavirus disease 2019 (COVID-19). Solid organ transplant recipients [...] Read more.
Background: Vaccination is one of the most effective medical interventions to prevent infectious diseases. The introduction of vaccines against coronavirus acute respiratory syndrome 2 (SARS-CoV-2) was aimed at preventing severe illness and death due to coronavirus disease 2019 (COVID-19). Solid organ transplant recipients (SOTRs) are at high risk of infection with SARS-CoV-2 and serious effects associated with COVID-19, mainly due to the use of immunosuppressive therapies, which further cause suboptimal response to COVID-19 vaccination. Aim of the study: We aimed to compare post-vaccination response to BNT162b2 in kidney–pancreas transplant recipient, specifically in immunocompetent individuals, over two years of simultaneous monitoring. Methods: To determine the humoral response, the levels of the IgG and IgA anti-S1 antibodies were measured. To assess the cellular response to SARS-CoV-2, the released IFN-γ-S1 was determinate. Results and Conclusion: After primary vaccination, compared to immunocompetent subjects, SOTR showed lower seroconversion for both antibody classes. Only the additional dose produced antibodies at the level reached by the control group after the baseline vaccination. During the monitored period, SOTR did not achieve a positive cellular response in contrast to immunocompetent individuals, so in order to obtain longer protection, including immune memory, the adoption of booster doses of the vaccine should be considered. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infection and Vaccines for Patients with Renal Diseases)
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15 pages, 1595 KiB  
Brief Report
Antibody Response after 3-Dose Booster against SARS-CoV-2 mRNA Vaccine in Kidney Transplant Recipients
by Domenico Tripodi, Roberto Dominici, Davide Sacco, Gennaro Santorelli, Rodolfo Rivera, Sandro Acquaviva, Marino Marchisio, Paolo Brambilla, Graziana Battini and Valerio Leoni
Vaccines 2024, 12(3), 264; https://doi.org/10.3390/vaccines12030264 - 1 Mar 2024
Cited by 2 | Viewed by 1735
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a high rate of mortality in kidney transplant recipients (KTRs). Current vaccine strategies for KTRs seem to be unable to provide effective protection against coronavirus disease 2019 (COVID-19), and the occurrence of severe [...] Read more.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a high rate of mortality in kidney transplant recipients (KTRs). Current vaccine strategies for KTRs seem to be unable to provide effective protection against coronavirus disease 2019 (COVID-19), and the occurrence of severe disease in some vaccinated KTRs suggested a lack of immunity. We initially analyzed the antibody response in a group of 32 kidney transplant recipients (KTRs) followed at the nephrology and dialysis unit of the Hospital Pio XI of Desio, ASST-Brianza, Italy. Thus, we studied the differences in antibody levels between subjects who contracted SARS-CoV-2 after the booster (8 individuals) and those who did not contract it (24 individuals). Furthermore, we verified if the antibody response was in any way associated with creatinine and eGFR levels. We observed a significant increase in the antibody response pre-booster compared to post-booster using both a Roche assay and DIAPRO assay. In the latter, through immunotyping, we highlight that the major contribution to this increase is specifically due to IgG S1 IgM S2. We observed a significant increase in IgA S1 and IgA NCP (p = 0.045, 0.02) in the subjects who contracted SARS-CoV-2. We did not find significant associations for the p-value corrected for false discovery rate (FDR) between the antibody response to all assays and creatinine levels. This observation allows us to confirm that patients require additional vaccine boosters due to their immunocompromised status and therapy in order to protect them from infections related to viral variants. This is in line with the data reported in the literature, and it could be worthwhile to deeply explore these phenomena to better understand the role of IgA S1 and IgA NCP antibodies in SARS-CoV-2 infection. Full article
(This article belongs to the Special Issue SARS-CoV-2 Infection and Vaccines for Patients with Renal Diseases)
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