Humoral Response after SARS-CoV-2 mRNA Vaccination in a Cohort of Hemodialysis Patients and Kidney Transplant Recipients.
Age Factors
Aged
Antibodies, Viral
/ biosynthesis
BNT162 Vaccine
COVID-19
/ complications
COVID-19 Vaccines
/ administration & dosage
Case-Control Studies
Cohort Studies
Female
Hepatitis B Vaccines
/ pharmacology
Humans
Immunocompromised Host
Immunosuppressive Agents
/ adverse effects
Kidney Failure, Chronic
/ complications
Kidney Transplantation
Male
Middle Aged
Pandemics
Renal Dialysis
Retrospective Studies
SARS-CoV-2
/ immunology
Spike Glycoprotein, Coronavirus
/ immunology
Time Factors
Transplant Recipients
COVID-19
hemodialyzed
humoral response
kidney transplant recipients
kinetic
vaccine
Journal
Journal of the American Society of Nephrology : JASN
ISSN: 1533-3450
Titre abrégé: J Am Soc Nephrol
Pays: United States
ID NLM: 9013836
Informations de publication
Date de publication:
09 2021
09 2021
Historique:
received:
11
04
2021
accepted:
14
05
2021
pubmed:
18
6
2021
medline:
18
9
2021
entrez:
17
6
2021
Statut:
ppublish
Résumé
Kidney transplant recipients and patients receiving hemodialysis are immunocompromised populations that are prioritized for COVID-19 vaccination but were excluded from clinical trials of SARS-CoV-2 mRNA vaccines. Antibody titers and rates of seroconversion after vaccination are lower among patients with CKD and those taking immunosuppressants compared with controls. Data are lacking regarding their humoral response to vaccination to prevent COVID-19. This investigation of early serological response after COVID-19 vaccination with the Pfizer/BioNTech (BNT162b2) mRNA vaccine included 78 patients undergoing hemodialysis, 74 kidney transplant recipients, and seven healthy controls. We recorded data from the medical file for various clinical parameters, including response to hepatitis B vaccination, and measured antibody titers against SARS-CoV-2 at 0, 14, 28, 36, and 58 days after the first injection. In controls, we detected antibodies at a positive level (>13 arbitrary units per ml; AU/ml) at day 14 postinjection, which increased progressively to peak at day 36 (1082 AU/ml; interquartile range [IQR], 735.0-1662.0). Patients undergoing hemodialysis had lower titers that peaked at day 58 (276 AU/ml; IQR, 83.4-526.0). We detected a positive antibody level in only three transplant recipients at day 36. In patients on hemodialysis, those aged <75 years had a higher antibody response versus those aged >75 years, and serum albumin and Kt/V were positively correlated with serological response ( Our results suggest that the postvaccination humoral response is strongly inhibited by immunosuppressant therapy in kidney transplant recipients, and is reduced by the uremic condition in patients undergoing hemodialysis.
Sections du résumé
BACKGROUND
Kidney transplant recipients and patients receiving hemodialysis are immunocompromised populations that are prioritized for COVID-19 vaccination but were excluded from clinical trials of SARS-CoV-2 mRNA vaccines. Antibody titers and rates of seroconversion after vaccination are lower among patients with CKD and those taking immunosuppressants compared with controls. Data are lacking regarding their humoral response to vaccination to prevent COVID-19.
METHODS
This investigation of early serological response after COVID-19 vaccination with the Pfizer/BioNTech (BNT162b2) mRNA vaccine included 78 patients undergoing hemodialysis, 74 kidney transplant recipients, and seven healthy controls. We recorded data from the medical file for various clinical parameters, including response to hepatitis B vaccination, and measured antibody titers against SARS-CoV-2 at 0, 14, 28, 36, and 58 days after the first injection.
RESULTS
In controls, we detected antibodies at a positive level (>13 arbitrary units per ml; AU/ml) at day 14 postinjection, which increased progressively to peak at day 36 (1082 AU/ml; interquartile range [IQR], 735.0-1662.0). Patients undergoing hemodialysis had lower titers that peaked at day 58 (276 AU/ml; IQR, 83.4-526.0). We detected a positive antibody level in only three transplant recipients at day 36. In patients on hemodialysis, those aged <75 years had a higher antibody response versus those aged >75 years, and serum albumin and Kt/V were positively correlated with serological response (
CONCLUSIONS
Our results suggest that the postvaccination humoral response is strongly inhibited by immunosuppressant therapy in kidney transplant recipients, and is reduced by the uremic condition in patients undergoing hemodialysis.
Identifiants
pubmed: 34135083
pii: 00001751-202109000-00013
doi: 10.1681/ASN.2021040490
pmc: PMC8729854
doi:
Substances chimiques
Antibodies, Viral
0
COVID-19 Vaccines
0
Hepatitis B Vaccines
0
Immunosuppressive Agents
0
Spike Glycoprotein, Coronavirus
0
spike protein, SARS-CoV-2
0
BNT162 Vaccine
N38TVC63NU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2153-2158Informations de copyright
Copyright © 2021 by the American Society of Nephrology.
Références
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