SARS-CoV-2 Antibody responses in solid organ transplant recipients.

Zervou, Fainareti N; Ali, Nicole M; Neumann, Henry J; Madan, Rebecca Pellett; Mehta, Sapna A

Antibody responses among immunocompromised solid organ transplant recipients (SOT) infected with SARS-CoV-2 may be diminished compared to the general population and have not been fully characterized. We conducted a cohort study at our transplant center to investigate the rate of seroconversion for SARS-CoV-2 IgG antibodies among SOT recipients who were diagnosed with COVID-19 and underwent serum SARS-CoV-2 IgG ELISA testing. The 61 patients who were included in the final analysis underwent initial SARS-CoV-2 IgG testing at a median of 62 days (IQR 55.0-75.0) from symptom onset. 51 of 61 patients (83.6%) had positive SARS-CoV-2 IgG results, whereas 10 (16.4%) had negative IgG results. 6 (60%) out of 10 seronegative patients underwent serial IgG testing and remained seronegative up to 17 weeks post-diagnosis. Use of belatacept in maintenance immunosuppression was significantly associated with negative IgG antibodies to SARS-CoV-2 both in univariate and multivariate analyses (OR 0.04; p = 0.01). In conclusion, the majority of organ transplant recipients with COVID-19 in our study developed SARS-CoV-2 antibodies. Further longitudinal studies of the durability and immunologic role of these IgG responses and the factors associated with lack of seroconversion are needed. This article is protected by copyright. All rights reserved.