{
  "abstract": "Kidney transplant recipients are vulnerable to developing severe coronavirus disease 2019 (COVID-19) infection. Although mRNA vaccines have significantly improved outcomes, seropositivity rates remain variable in immunosuppressed patients. This study aimed to evaluate the antibody response to COVID-19 mRNA vaccines, identify factors affecting immunogenicity, and examine the association between antibody titers and subsequent SARS-CoV-2 infection and COVID-19-related hospitalization among kidney transplant recipients. We retrospectively studied 372 adult kidney transplant recipients who received two doses of COVID-19 mRNA vaccine after transplantation and had anti-SARS‑CoV‑2 spike protein receptor-binding domain antibodies measured ≥ 14 days after the second dose and prior to receiving a third dose. We categorized patients based on previous COVID-19 infection, post-vaccination antibody status (seropositive or seronegative), and antibody titers (low or high). Factors associated with poor vaccine response (seronegativity) and with high antibody titers (antibody titer ≥ 121 U/mL) were determined using multivariable regression models. The proportion of patients with subsequent COVID-19 infection was higher in the seronegative group than in the seropositive or previous infection groups (36% vs. 26% vs. 13%, respectively; P = 0.02). Multivariable regression analysis revealed higher odds of poor response to the mRNA vaccine among patients aged > 52 years compared with those aged ≤ 52 years (aOR = 1.94; 95% CI: 1.12–3.36; P = 0.018). Lower odds were observed among male patients (aOR = 0.43; 95% CI: 0.24–0.77; P = 0.004) and those taking azathioprine (aOR = 0.26; 95% CI: 0.07–0.91; P = 0.035). The proportion of patients with subsequent COVID-19 was also higher in the low-antibody group than in the high-antibody group (33% vs. 20%; P = 0.02). Multivariable logistic regression analysis showed lower odds of high SARS-CoV-2 antibody titers among patients aged > 51 years compared with those aged ≤ 51 years (aOR = 0.43; 95% CI: 0.24–0.75; P = 0.003). Higher odds were observed among those of African race (aOR = 2.82; 95% CI: 1.11–7.16; P = 0.03) and South Asian race (aOR = 2.27; 95% CI: 1.08–4.75; P = 0.03) compared with Middle Eastern recipients. Understanding the immunologic response to the SARS-CoV-2 vaccine in kidney transplant recipients is essential for preventing potentially life-threatening infection. Furthermore, identifying transplant recipients with a low vaccine-induced antibody response may help guide the development of individualized immunization strategies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine, Division of Nephrology, Hamad Medical Corporation, Doha, Qatar",
    "Department of Laboratory Medicine and Pathology, Hamad Medical Corporation, Doha, Qatar",
    "Infectious Disease Epidemiology Group, Weill Cornell Medicine–Qatar, Cornell University, Doha, Qatar"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Mohamad M. Alkadi",
      "orcid": "0000-0003-0009-5823"
    },
    {
      "affs": [
        0
      ],
      "name": "Essa A. Abuhelaiqa"
    },
    {
      "affs": [
        0
      ],
      "name": "Rasha M. Abdul Rahman"
    },
    {
      "affs": [
        0
      ],
      "name": "Ali B. Mahgoub"
    },
    {
      "affs": [
        0
      ],
      "name": "Abdullah I. Hamad"
    },
    {
      "affs": [
        1
      ],
      "name": "Peter V. Coyle",
      "orcid": "0000-0002-0819-6103"
    },
    {
      "affs": [
        2
      ],
      "name": "Zahir M. Tag",
      "orcid": "0009-0000-2775-6658"
    },
    {
      "affs": [
        2
      ],
      "name": "Laith J. Abu Raddad"
    },
    {
      "affs": [
        0
      ],
      "name": "Hassan A. Al-Malki"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9b09hx6rcw3td.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0359640",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13734576/",
  "id": "9b09hx6rcw3td",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0359640",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Antibodies"
    ],
    [
      "heading",
      "Antibody Response"
    ],
    [
      "heading",
      "Biochemistry"
    ],
    [
      "heading",
      "Biology and Life Sciences"
    ],
    [
      "heading",
      "Biology and life sciences"
    ],
    [
      "heading",
      "Coronaviruses"
    ],
    [
      "heading",
      "Covid 19"
    ],
    [
      "heading",
      "Diagnostic Medicine"
    ],
    [
      "heading",
      "Immune Physiology"
    ],
    [
      "heading",
      "Immune Response"
    ],
    [
      "heading",
      "Immune System Proteins"
    ],
    [
      "heading",
      "Immunoassays"
    ],
    [
      "heading",
      "Immunologic Techniques"
    ],
    [
      "heading",
      "Immunology"
    ],
    [
      "heading",
      "Infectious Disease Control"
    ],
    [
      "heading",
      "Infectious Diseases"
    ],
    [
      "heading",
      "Medical Conditions"
    ],
    [
      "heading",
      "Medical microbiology"
    ],
    [
      "heading",
      "Medicine and Health Sciences"
    ],
    [
      "heading",
      "Medicine and health sciences"
    ],
    [
      "heading",
      "Microbial pathogens"
    ],
    [
      "heading",
      "Microbiology"
    ],
    [
      "heading",
      "Organ Transplantation"
    ],
    [
      "heading",
      "Organisms"
    ],
    [
      "heading",
      "Pathogens"
    ],
    [
      "heading",
      "Pathology and laboratory medicine"
    ],
    [
      "heading",
      "Physiology"
    ],
    [
      "heading",
      "Proteins"
    ],
    [
      "heading",
      "RNA viruses"
    ],
    [
      "heading",
      "Renal Transplantation"
    ],
    [
      "heading",
      "Research Article"
    ],
    [
      "heading",
      "Research and Analysis Methods"
    ],
    [
      "heading",
      "SARS CoV 2"
    ],
    [
      "heading",
      "SARS coronavirus"
    ],
    [
      "heading",
      "Surgical and Invasive Medical Procedures"
    ],
    [
      "heading",
      "Transplantation"
    ],
    [
      "heading",
      "Urinary System Procedures"
    ],
    [
      "heading",
      "Vaccines"
    ],
    [
      "heading",
      "Viral Diseases"
    ],
    [
      "heading",
      "Viral pathogens"
    ],
    [
      "heading",
      "Virus Testing"
    ],
    [
      "heading",
      "Viruses"
    ],
    [
      "plos",
      "/Biology and life sciences/Biochemistry/Proteins/Immune system proteins/Antibodies"
    ],
    [
      "plos",
      "/Biology and life sciences/Immunology/Immune response/Antibody response"
    ],
    [
      "plos",
      "/Biology and life sciences/Immunology/Immune system proteins/Antibodies"
    ],
    [
      "plos",
      "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Coronaviruses/SARS coronavirus/SARS CoV 2"
    ],
    [
      "plos",
      "/Biology and life sciences/Organisms/Viruses/RNA viruses/Coronaviruses/SARS coronavirus/SARS CoV 2"
    ],
    [
      "plos",
      "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Coronaviruses/SARS coronavirus/SARS CoV 2"
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    [
      "plos",
      "/Biology and life sciences/Physiology/Immune physiology/Antibodies"
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    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Infectious disease control/Vaccines"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Viral diseases/COVID 19"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Coronaviruses/SARS coronavirus/SARS CoV 2"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Transplantation/Organ transplantation/Renal transplantation"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Urinary system procedures/Renal transplantation"
    ],
    [
      "plos",
      "/Research and analysis methods/Immunologic techniques/Immunoassays"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": "PMC13734576",
  "pmid": "42981357",
  "published": "2026-11-04",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/9b09hx6rcw3td.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T12:20:11Z",
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  "subjects": [
    {
      "field": "biochemistry",
      "origin": "heading:Biochemistry",
      "subfield": "general"
    },
    {
      "field": "biology",
      "origin": "plos:immunology",
      "subfield": "immunology"
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    {
      "field": "biology",
      "origin": "heading:Microbiology",
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    {
      "field": "medicine",
      "origin": "plos:surgical and invasive medical procedures",
      "subfield": "surgery"
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  "title": "Assessment of coronavirus disease 2019 mRNA vaccine response in kidney transplant recipients",
  "title_text": "Assessment of coronavirus disease 2019 mRNA vaccine response in kidney transplant recipients",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:24:01Z",
  "url": "https://research.draconitic.com/paper/9b09hx6rcw3td",
  "venue": "PLOS One",
  "versions": []
}