Reduced humoral but stable cellular SARS-CoV-2-specific immunity in liver transplant recipients in the first year after COVID-19

• Published in: PloS one 2022-11, Vol.17 (11), p.e0276929-e0276929
• Main Authors: Kirchner, Theresa, Heinrich, Sophia, Bonifacius, Agnes, Engel, Bastian, Ruhl, Louisa, Pink, Isabell, Thomas, Nele, Martens, Joerg, Hoeper, Marius M, Blasczyk, Rainer, Wedemeyer, Heiner, Jaeckel, Elmar, Li, Yang, Falk, Christine S, Eiz-Vesper, Britta, Taubert, Richard
• Format: Article
• Language: English
• Subjects: Analysis; Antibodies; Antigens; Cell-mediated immunity; Corona; Coronaviruses; COVID-19; Enzyme-linked immunosorbent assay; Health aspects; IgG antibody; Immune response; Immunity; Immunoglobulin G; Immunosuppression; Immunosuppressive agents; Immunotherapy; Infections; Liver; Liver transplantation; Liver transplants; Lymphocytes; Lymphocytes T; Membrane proteins; Mortality; Nucleocapsids; Organ transplant recipients; Pandemics; Patient outcomes; Patients; Peptides; Plasma; Proteins; Recruitment; Severe acute respiratory syndrome coronavirus 2; Spike protein; Statistical analysis; Transplantation; Vaccination; Viral diseases; Viruses; γ-Interferon
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0276929

Mortality due to COVID-19 is not increased in immunosuppressed individuals after liver transplantation (OLT) compared to individuals without immunosuppression. Data on long-term protective immunity against SARS-CoV-2 in immunosuppressed convalescents, is limited. We prospectively measured immune responses against SARS-CoV-2 by quantifying antibodies against 4 different antigens (spike protein 1 and 2, receptor binding domain, nucleocapsid) and T cell responses by IFN-γ ELISPOT against 4 antigens (membrane, nucleocapsid, spike protein 1 and 2) in 24 OLT convalescents with immunosuppressive therapy longitudinally in the first year after COVID-19 including a booster vaccination in comparison to a matched cohort of non-immunosuppressed convalescents (non-IS-Con). Pre-pandemic OLT samples were retrieved from our prospective OLT biorepository (n = 16). No relevant T cell reactivity or immunoglobulin G (IgG) against SARS-CoV-2 were detectable in pre-pandemic samples of OLT recipients despite reactivity against endemic corona-viruses. OLT convalescents had a lower prevalence of IgG against nucleocapsid (54% vs. 90%) but not against spike protein domains (98–100% vs. 100%) after vaccination in the second half-year after COVID-19 compared to non-IS-Con. Also, concentrations of anti-nucleocapsid IgG were lower in OLT convalescents than in non-IS-Con. Concentration of IgG against spike protein domains was significantly increased by a booster vaccination in OLT convalescents. But concentration of IgG against two of three spike protein domains remains slightly lower compared to non-IS-Con finally. However, none of these differences was mirrored by the cellular immunity against SARS-CoV-2 that remained stable during the first year after COVID-19 and was not further stimulated by a corona vaccination in OLT convalescents. In conclusion, despite lower concentrations of anti-SARS-CoV-2 IgG in OLT convalescents anti-SARS-CoV-2 cellular immunity was as robust as in non-IS-Con.