Vacinas contra SARS-CoV-2 e seus Efeitos Frente à Mortalidade em Pacientes Transplantados: Uma Revisão Sistemática com Metanálise

Autores

Palavras-chave:

SARS-CoV-2, COVID-19, Vacinas, Transplantados, Eficácia, Mortalidade

Resumo

Objetivos: Com o avançar da pandemia e o melhor conhecimento da doença do coronavírus 2019 (COVID-19), novas maneiras de enfrentar essa enfermidade vieram à tona. Assim, propomos esta revisão sistemática para entender melhor a ação das vacinas no combate à mortalidade causada por esse vírus, em especial nos pacientes transplantados. Métodos: Nesta revisão sistemática com metanálise, os revisores analisaram 389 artigos elegíveis de acordo com os critérios utilizados e selecionaram cegamente os estudos que traziam dados sobre pacientes transplantados e mortalidade, resultando no total de 15 trabalhos inseridos no estudo. Os resultados da triagem foram adicionados a uma planilha e seus dados compilados. Resultados: Dos 15 artigos incluídos, foi possível observar uma queda significativa nos índices de mortalidade geral dos pacientes vacinados, exceto nos estudos que utilizaram o imunizante de vírus inativado. Além disso, a mortalidade dos pacientes infectados mesmo após a vacinação manteve-se próxima à do grupo dos não vacinados, assim como a necessidade de ventilação mecânica. Conclusão: A imunização dos pacientes transplantados é capaz de reduzir significativamente os índices de mortalidade dessa parcela da população. No entanto, por terem uma taxa de soroconversão reduzida, diferentes maneiras de atingir uma resposta imune adequada devem ser consideradas.

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Referências

Kates OS, Heldman MR. COVID-19 in solid organ transplant recipients: a review of the current literature. Curr Treat Options Infect Dis 2021; 13(3): 67-82. https://doi.org/10.1007/s40506-021-00249-6

Imam Z, Odish F, Gill I, O’Connor D, Armstrong J, Vanood A, et al. Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID-19 patients in Michigan, United States. J Int Med 2020; 288(4): 469-76. https://doi.org/10.1111/joim.13119

Heldman MR, Kates OS, Safa K, Kotton CN, Multani A, Georgia SJ, et al. Delayed mortality among solid organ transplant recipients hospitalized for COVID-19. Clin Infect Dis 2022; 74(4): e947-54. https://doi.org/10.1093/cid/ciab060

Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA covid-19 vaccine. N Engl J Med; 383(27): 2603-15. https://doi.org/10.1056/nejmoa2034577

Baden LR, Sahly HM El, Essink B, Kotloff K, Frey S, Novak R, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med 2021; 384(5): 403-16. https://doi.org/10.1056/nejmoa2035389

Hall VG, Ferreira VH, Ierullo M, Ku T, Marinelli T, Majchrzak-Kita B, et al. Humoral and cellular immune response and safety of two-dose SARS-CoV-2 mRNA-1273 vaccine in solid organ transplant recipients. Am J Transplant 2021; 21(12): 3980-9. https://doi.org/10.1111/ajt.16766

Cucchiari D, Egri N, Bodro M, Herrera S, Risco-Zevallos J del, Casals-Urquiza J, et al. Cellular and humoral response after mRNA-1273 SARS-CoV-2 vaccine in kidney transplant recipients. Am J Transplant 2021; 21(8): 2727-39. https://doi.org/10.1111/ajt.16701

Demir E, Dheir H, Safak S, Artan AS, Sipahi S, Turkmen A. Differences in clinical outcomes of COVID-19 among vaccinated and unvaccinated kidney transplant recipients. Vaccine 2022; 40(24): 3313-9. https://doi.org/10.1016/j.vaccine.2022.04.066

Chavarot N, Morel A, Leruez-Ville M, Vilain E, Divard G, Burger C, et al. Weak antibody response to three doses of mRNA vaccine in kidney transplant recipients treated with belatacept. Am J Transplant 2021;21(12):4043-51. https://doi.org/10.1111/ajt.16814

Bell S, Campbell J, Lambourg E, Watters C, O’Neil M, Almond A, et al. The impact of vaccination on incidence and outcomes of SARS-CoV-2 Infection in patients with kidney failure in Scotland. J Am Soc Nephrol 2022; 33(4): 677-86. https://doi.org/10.1681/asn.2022010046

Hippisley-Cox J, Coupland CAc, Mehta N, Keogh RH, Diaz-Ordaz K, Khunti K, et al. Risk prediction of covid-19 related death and hospital admission in adults after covid-19 vaccination: national prospective cohort study 2021; 374: n2244. https://doi.org/10.1136/bmj.n2244

Callaghan CJ, Mumford L, Curtis RMK, Williams SV, Whitaker H, Andrews N, et al. Real-world effectiveness of the Pfizer-BioNTech BNT162b2 and Oxford-AstraZeneca ChAdOx1-S vaccines against SARS-CoV-2 in solid organ and islet transplant recipients. Transplantation 2022; 106(3): 436-46. https://doi.org/10.1097/tp.0000000000004059

Kuczaj A, Przybyłowski P. Patients after orthotopic heart transplantation with COVID-19: are we fast enough with vaccinations? Transplantation Proc 2022; 54(4): 897-900. https://doi.org/10.1016/j.transproceed.2022.02.022

Hall VG, Al-Alahmadi G, Solera JT, Marinelli T, Cardinal H, Prasad GVR, et al. Outcomes of SARS-CoV-2 infection in unvaccinated compared with vaccinated solid organ transplant recipients: a propensity matched cohort study. Transplantation 2022; 106(8): 1622-8. https://doi.org/10.1097/tp.0000000000004178

Peters LL, Raymer DS, Pal JD, Ambardekar AV. Association of COVID-19 vaccination with risk of COVID-19 infection, hospitalization, and death in heart transplant recipients. JAMA Cardiol 2022; 7(6): 651. https://doi.org/10.1001/jamacardio.2022.0670

Reischig T, Kacer M, Vlas T, Drenko P, Kielberger L, Machova J, et al. Insufficient response to mRNA SARS-CoV-2 vaccine and high incidence of severe COVID-19 in kidney transplant recipients during pandemic. Am J Transplant 2021; 22(3): 801-12. https://doi.org/10.1111/ajt.16902

Medina-Pestana J, Covas DT, Viana LA, Dreige YC, Nakamura MR, Lucena EF, et al. Inactivated whole-virus vaccine triggers low response against SARS-CoV-2 infection among renal transplant patients: prospective phase 4 study results. Transplantation 2022; 106(4): 853-61. https://doi.org/10.1097/tp.0000000000004036

Sutharattanapong N, Thotsiri S, Kantachuvesiri S, Wiwattanathum P. Benefits of inactivated vaccine and viral vector vaccine immunization on COVID-19 infection in kidney transplant recipients. Vaccines 2022; 10(4): 572. https://doi.org/10.3390/vaccines10040572

Mazuecos A, Villanego F, Zarraga S, López V, Oppenheimer F, Llinàs-Mallol L, et al. Breakthrough infections following mRNA SARS-CoV-2 vaccination in kidney transplant recipients. Transplantation 2022; 106(7): 1430-9. https://doi.org/10.1097/tp.0000000000004119

Bollineni S, Mahan LD, Duncan P, Mohanka MR, Lawrence A, Joerns J, et al. Characteristics and outcomes among vaccinated lung transplant patients with breakthrough COVID-19. Transpl Infect Dis 2022; 24(2): 1-8. https://doi.org/10.1111/tid.13784

Aslam S, Liu J, Sigler R, Syed RR, Tu XM, Little SJ, et al. Coronavirus disease 2019 vaccination is protective of clinical disease in solid organ transplant recipients. Transpl Infect Dis 2022; 24(2): 1-6. https://doi.org/10.1111/tid.13788

Saharia KK, Anjan S, Streit J, Beekmann SE, Polgreen PM, Kuehnert M, et al. Clinical characteristics of COVID-19 in solid organ transplant recipients following COVID-19 vaccination: a multicenter case series. Transpl Infect Dis 2022; 24(2): 1-6. https://doi.org/10.1111/tid.13774

Meschiari M, Cozzi-Lepri A, Tonelli R, Bacca E, Menozzi M, Franceschini E, et al. First and second waves among hospitalised patients with COVID-19 with severe pneumonia: a comparison of 28-day mortality over the 1-year pandemic in a tertiary university hospital in Italy. BMJ Open 2022; 12(1): 1-11. https://doi.org/10.1136/bmjopen-2021-054069

Jara A, Undurraga EA, González C, Paredes F, Fontecilla T, Jara G, et al. Effectiveness of an Inactivated SARS-CoV-2 vaccine in Chile. N Engl J Med 2021; 385(10): 875-84. https://doi.org/10.1056/nejmoa2107715

Dheir H, Tocoglu A, Toptan H, Pinar M, Demirci T, Koroglu M, et al. Short and mid-term SARS-CoV-2 antibody response after inactivated COVID-19 vaccine in hemodialysis and kidney transplant patients. J Med Virol 2022; 94(7): 3176-83. https://doi.org/10.1002/jmv.27714

Kamar N, Abravanel F, Marion O, Couat C, Izopet J, Bello A del. Three doses of an mRNA Covid-19 vaccine in solid-organ transplant recipients. N Engl J Med 2021; 385(7): 661-2. https://doi.org/10.1056/nejmc2108861

Publicado

2024-08-30

Como Citar

Rocha, A. L., Milan, E. P., Caminha, R. O. de C., & Paiva, D. F. F. . (2024). Vacinas contra SARS-CoV-2 e seus Efeitos Frente à Mortalidade em Pacientes Transplantados: Uma Revisão Sistemática com Metanálise. Brazilian Journal of Transplantation, 27. Recuperado de https://bjt.emnuvens.com.br/revista/article/view/613

Edição

Seção

Artigo de Revisão