Immunogenicity of COVID-19 mRNA vaccines in immunocompromised patients: a systematic review and meta-analysis

European Journal of Medical Research

Mohammad-Mehdi Mehrabi Nejad¹  Abdolkarim Haji Ghadery¹  Hojat Dehghanbanadaki²  Mohammadreza Tabary³  Armin Aryannejad⁴  SeyedAhmad SeyedAlinaghi⁵  Nima Rezaei⁶  Fatemeh Moosaie⁷  Mahya Shabani⁷ 

[1] Department of Radiology, School of Medicine, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran;Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran;Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA;Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran;Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran;Research Center for Immunodeficiencies, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran;Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Qarib St, Keshavarz Blvd, 1419733141, Tehran, Iran;School of Medicine, Tehran University of Medical Sciences, Tehran, Iran;

关键词: COVID-19;    SARS-CoV-2;    Vaccination;    Immunocompromised patient;    Malignancy;    Transplantation;    Autoimmune;    Efficacy;   

DOI  :  10.1186/s40001-022-00648-5

来源: Springer

【 摘 要 】

BackgroundImmunocompromised (IC) patients are at higher risk of severe SARS-CoV-2 infection, morbidity, and mortality compared to the general population. They should be prioritized for primary prevention through vaccination. This study aimed to evaluate the efficacy of COVID-19 mRNA vaccines in IC patients through a systematic review and meta-analysis approach.MethodPubMed-MEDLINE, Scopus, and Web of Science were searched for original articles reporting the immunogenicity of two doses of mRNA COVID-19 vaccines in adult patients with IC condition between June 1, 2020 and September 1, 2021. Meta-analysis was performed using either random or fixed effect according to the heterogeneity of the studies. Subgroup analysis was performed to identify potential sources of heterogeneity.ResultsA total of 26 studies on 3207 IC patients and 1726 healthy individuals were included. The risk of seroconversion in IC patients was 48% lower than those in controls (RR = 0.52 [0.42, 0.65]). IC patients with autoimmune conditions were 54%, and patients with malignancy were 42% more likely to have positive seroconversion than transplant recipients (P < 0.01). Subgroup meta-analysis based on the type of malignancy, revealed significantly higher proportion of positive seroconversion in solid organ compared to hematologic malignancies (RR = 0.88 [0.85, 0.92] vs. 0.61 [0.44, 0.86], P = 0.03). Subgroup meta-analysis based on type of transplantation (kidney vs. others) showed no statistically significant between-group difference of seroconversion (P = 0.55).ConclusionsIC patients, especially transplant recipients, developed lower immunogenicity with two-dose of COVID-19 mRNA vaccines. Among patients with IC, those with autoimmune conditions and solid organ malignancies are mostly benefited from COVID-19 vaccination. Findings from this meta-analysis could aid healthcare policymakers in making decisions regarding the importance of the booster dose or more strict personal protections in the IC patients.

【 授权许可】

CC BY