ESPN 54th Annual Meeting

ESPN 2022


 
“ANTIBODY RESPONSE TO SARS-COV2 MRNA VACCINES IN IMMUNOSUPPRESSED CHILDREN: VARIAN-COV STUDY”
JESSICA SERAFINELLI 1 ANTONIO MASTRANGELO 1 WILLIAM MORELLO 1 CHIARA TAMBURELLO 1 MARTINA ROSSANO 2 GIOVANNI FILOCAMO 2 ANTONELLA PETACCIA 2 FRANCESCA MINOIA 2 MASSIMO OGGIONI 3 FERRUCCIO CERIOTTI 3 GIOVANNI MONTINI 1

1- PEDIATRIC NEPHROLOGY, DIALYSIS AND TRANSPLANT UNIT, IRCCS CA GRANDA OSPEDALE MAGGIORE POLICLINICO, MILAN, ITALY
2- PEDIATRIC INTERMEDIATE CARE UNIT, IRCCS CA GRANDA OSPEDALE MAGGIORE POLICLINICO, MILAN, ITALY
3- CLINICAL LABORATORY, IRCCS CA GRANDA OSPEDALE MAGGIORE POLICLINICO, MILAN, ITALY
 
Introduction:

SARS-CoV-2 vaccination provides protection in immunocompetent persons, while antibody response in immunosuppressed children is unclear. We evaluate the humoral immunogenicity of mRNA SARS-CoV-2 vaccines in immunosuppressed nephropathic children.

Material and methods:

Single centre prospective observational study (April 2021-January 2022). Three groups of patients >5 years of age, receiving  2 doses of SARS-CoV-2 mRNA-vaccines, were enrolled: Kidney group (K), children undergoing immunosuppression because of glomerulonephritis, nephrotic syndrome, SLE/vasculitis; Rheumatologic group (R), children immunosuppressed because of juvanile idiopathic arthtitis/uveitis, connectivitis; and Control group (C), non-immunosuppressed children. IgG against receptor-binding domani of the spike protein and nucleocapsid were measured with the Elecsys® assay (Roche), before the vaccination (T0) and 2 weeks after the second dose (T1). Patients testing positive for nucleocapsid-IgG were excluded, because of the previous infection. Clinical, demographic and lab data were collected. The study was approved by the Ethics Committee.

Results:

Excluding patients with a previous infection (presence of nuclecapside-IgG at T0) and those lost to follow-up, we report data for 41 (median age 17,3y, 37% male), 19 (16,5y, 53% male) and 40 (16,7y, 32% male) subjects  from K, R and C group respectively. Ongoing immunosuppression was different for the 2 disease groups: in the K group mainly MMF, steroids, calcineurin inhibitors and anti-CD20, while in the R group MTX±anti-TNF/IL6. 73% of patients of the K group and 100% of both the R and C group developed RBD-IgG. Furthermore, lower titres (median 568 U/ml , IQ 93-2147) were present in the K group, compared to R patients (3675, 1237-10928) and the C group (6427, 3478-9752) (p <0,0001)., while no  statistically differences were present between the R and C groups.

Conclusions:

Immunosuppressed children showed a good response to SARS-CoV-2 mRNA vaccines, although underlying disease and type of immunosuppression affect the grade of response.