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Severe COVID-19 by SARS-CoV-2 Lineage B.1.1.7 in Vaccinated Solid-Organ Transplant Recipients: New Preventive Strategies Needed to Protect Immunocompromised Patients
| Content Provider | MDPI |
|---|---|
| Author | Giulia, Fontò Loconsole, Daniela Stea, Emma Sallustio, Anna Pronzo, Virginia Simone, Simona Centrone, Francesca Accogli, Marisa Gesualdo, Loreto Chironna, Maria |
| Copyright Year | 2021 |
| Description | Background: Solid-organ transplant (SOT) recipients are at a high risk of severe COVID-19, and are priority for vaccination. Here, we describe three cases of severe COVID-19 caused by SARS-CoV-2 B.1.1.7 lineage in vaccinated SOT recipients. Methods: Three SOT patients were hospitalized in the Policlinico Hospital of Bari (southern Italy) and underwent nasopharyngeal swabs for molecular detection of SARS-CoV-2 genes and spike protein mutations by real-time PCR. One sample was subjected to whole-genome sequencing. Results: One patient was a heart transplant recipient and two were kidney transplant recipients. All were hospitalized with severe COVID-19 between March and May 2021. Two patients were fully vaccinated and one had received only one dose of the BNT162b2 mRNA vaccine. All the patients showed a high viral load at diagnosis, and molecular typing revealed the presence of B.1.1.7 lineage SARS-CoV-2. In all three cases, prolonged viral shedding was reported. Conclusions: The three cases pose concern about the role of the B.1.1.7 lineage in severe COVID-19 and about the efficacy of COVID-19 vaccination in immunocompromised patients. Protecting immunocompromised patients from COVID-19 is a challenge. SOT recipients show a suboptimal response to standard vaccination, and thus, an additive booster or a combined vaccination strategy with mRNA, protein/subunit, and vector-based vaccines may be necessary. This population should continue to practice strict COVID-19 precautions post-vaccination, until new strategies for protection are available. |
| Starting Page | 806 |
| e-ISSN | 2076393X |
| DOI | 10.3390/vaccines9080806 |
| Journal | Vaccines |
| Issue Number | 8 |
| Volume Number | 9 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2021-07-21 |
| Access Restriction | Open |
| Subject Keyword | Vaccines Solid-organ Transplant Recipients Sars-cov-2 Infection B.1.1.7 Lineage Covid-19 Vaccine Whole-genome Sequencing |
| Content Type | Text |
| Resource Type | Article |
