Spike and neutralizing antibodies response to COVID-19 vaccination in haemodialysis patients.
BNT162 vaccine
COVID-19
SARS-CoV-2
haemodialysis
renal dialysis
vaccine
Journal
Clinical kidney journal
ISSN: 2048-8505
Titre abrégé: Clin Kidney J
Pays: England
ID NLM: 101579321
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
10
05
2021
entrez:
4
10
2021
pubmed:
5
10
2021
medline:
5
10
2021
Statut:
epublish
Résumé
Humoral response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines needs to be evaluated in the fragile population of patients on maintenance haemodialysis (HD). We analysed the antibody response to the spike (S) antigen of SARS-CoV-2 before and after each dose of the messenger RNA (mRNA) Comirnaty vaccine (BNT162b2; BioNTech & Pfizer) in patients from a single dialysis centre and detected the presence of neutralizing antibodies (Nabs). Among the 90 vaccinated HD patients (mean age 69 years, 61% male), 19 (21%) had a history of SARS-CoV-2 infection. A seroconversion with anti-S immunoglobulin G antibodies (Sabs) was documented in 20% of patients after the first dose (early responders) and in 77% after the second dose, while 23% were non-responders. Cardiac disease, cirrhosis and gamma globulin levels were independently predictive of the absence of seroconversion. Nabs were detected in 15.4% of early responders after the first dose and in 84.6% of early responders and 57.9% of late responders after the second dose. Sab titres after the second dose were higher in patients with Nab than without Nab {598 [interquartile range (IQR) 246-882]) versus 134 [IQR 61-390]; P < 0.0001}. All patients with a history of SARS-CoV-2 infection developed both Sabs and Nabs and their titres for Sabs and Nabs were higher than in late responders. Most HD patients develop a substantial humoral response against SARS-CoV2, with Nabs, following the mRNA vaccine. Whether this immunity persists over time and is able to efficiently protect patients from coronavirus disease 2019 remains to be determined.
Sections du résumé
BACKGROUND
BACKGROUND
Humoral response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines needs to be evaluated in the fragile population of patients on maintenance haemodialysis (HD).
METHODS
METHODS
We analysed the antibody response to the spike (S) antigen of SARS-CoV-2 before and after each dose of the messenger RNA (mRNA) Comirnaty vaccine (BNT162b2; BioNTech & Pfizer) in patients from a single dialysis centre and detected the presence of neutralizing antibodies (Nabs).
RESULTS
RESULTS
Among the 90 vaccinated HD patients (mean age 69 years, 61% male), 19 (21%) had a history of SARS-CoV-2 infection. A seroconversion with anti-S immunoglobulin G antibodies (Sabs) was documented in 20% of patients after the first dose (early responders) and in 77% after the second dose, while 23% were non-responders. Cardiac disease, cirrhosis and gamma globulin levels were independently predictive of the absence of seroconversion. Nabs were detected in 15.4% of early responders after the first dose and in 84.6% of early responders and 57.9% of late responders after the second dose. Sab titres after the second dose were higher in patients with Nab than without Nab {598 [interquartile range (IQR) 246-882]) versus 134 [IQR 61-390]; P < 0.0001}. All patients with a history of SARS-CoV-2 infection developed both Sabs and Nabs and their titres for Sabs and Nabs were higher than in late responders.
CONCLUSIONS
CONCLUSIONS
Most HD patients develop a substantial humoral response against SARS-CoV2, with Nabs, following the mRNA vaccine. Whether this immunity persists over time and is able to efficiently protect patients from coronavirus disease 2019 remains to be determined.
Identifiants
pubmed: 34603701
doi: 10.1093/ckj/sfab128
pii: sfab128
pmc: PMC8344612
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2239-2245Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of ERA-EDTA.
Références
Kidney Int. 2021 Jun;99(6):1494-1496
pubmed: 33887320
Clin Kidney J. 2020 Oct 21;13(5):878-888
pubmed: 33354330
J Am Soc Nephrol. 2020 Sep;31(9):1969-1975
pubmed: 32732391
Kidney Int. 2020 Dec;98(6):1540-1548
pubmed: 32979369
Clin J Am Soc Nephrol. 2021 Jul;16(7):1037-1042
pubmed: 33824157
Antiviral Res. 2020 Sep;181:104880
pubmed: 32679056
Nephrol Dial Transplant. 2021 Jan 1;36(1):87-94
pubmed: 33340043
Kidney Int. 2021 Jun;99(6):1492-1494
pubmed: 33887316
JAMA. 2021 May 4;325(17):1784-1786
pubmed: 33720292
Virol J. 2018 Dec 27;15(1):192
pubmed: 30587193
Med Sci Monit. 2013 Nov 18;19:1013-8
pubmed: 24241247
Clin Kidney J. 2021 Apr 01;14(6):1701-1703
pubmed: 34429940
Kidney Int. 2021 Apr;99(4):791-793
pubmed: 33582109
J Nephrol. 2020 Apr;33(2):343-354
pubmed: 31701375
Kidney Int. 2021 Jun;99(6):1496-1498
pubmed: 33887318
N Engl J Med. 2021 Jul 1;385(1):90-92
pubmed: 33852796
Lancet. 2021 Apr 10;397(10282):1347-1348
pubmed: 33770519
Kidney Int. 2021 Jun;99(6):1490-1492
pubmed: 33887317
Kidney Int. 2021 Jun;99(6):1489-1490
pubmed: 33887319
Nephrol Dial Transplant. 2020 Nov 1;35(11):1973-1983
pubmed: 33151337