Korean J Transplant.  2023 Nov;37(Suppl 1):S150. 10.4285/ATW2023.F-7353.

Impact of solid organ transplantation on the effectiveness of COVID-19 vaccination in hospitalized patients with COVID-19: a propensity score-matched cohort study

• Kim YJ
• Lim JH
• Jung HY
• Choi JY
• Cho JH
• Park SH
• Kim YL

• KMID: 2551770
• DOI: http://doi.org/10.4285/ATW2023.F-7353

Abstract

Background
The effectiveness of coronavirus disease 2019 (COVID-19) vaccination in solid organ transplant recipients (SOTRs) remains a subject of investigation. Solid organ transplantation requires immunosuppressive therapy to prevent organ rejection, which may potentially affect the efficacy of COVID-19 vaccination in SOTRs. This study aimed to evaluate the impact of solid organ transplantation on the effectiveness of COVID-19 vaccination in hospitalized patients with COVID-19.
Methods
We retrospectively collected the data of 7,327 patients hospitalized with COVID-19. To address potential confounding factors, such as age, sex, and COVID-19 diagnosis date between SOTRs and non-SOTRs, we employed a 1:2 propensity score-matching method. We compared the overall and within-group clinical outcomes and course of hospitalization between the two groups based on the appropriateness of the vaccination.
Results
Among the 83 SOTRs, 48 (57.8%) received appropriate vaccination, and of the 160 non-SOTRs, 79 (49.4%) received appropriate vaccination (P=0.211). SOTRs had a significantly higher risk of high-flow nasal cannula use, mechanical ventilation, acute kidney injury, and composite of COVID-19 severity outcomes than non-SOTRs. Among SOTRs, no significant differences were observed in the clinical outcomes or course between the appropriately and inappropriately vaccinated groups. Among non-SOTRs, the appropriately vaccinated group exhibited better clinical outcomes and course than the inappropriately vaccinated group.
Conclusions
Hospitalized SOTRs with COVID-19 had a worse prognosis than non-SOTRs. Furthermore, unlike in non-SOTRs, the effectiveness of vaccination in SOTRs was low, indicating that vaccination may not prevent severe COVID-19 progression in this population.