tetano
Editor, Senior Moderator
Clin Kidney J
. 2021 Jul 6;14(10):2234-2238.
doi: 10.1093/ckj/sfab127. eCollection 2021 Oct.
Antibody response to mRNA SARS-CoV-2 vaccines in haemodialysis patients
Michael Paal[SUP] 1 [/SUP], Florian M Arend[SUP] 1 [/SUP], Tobias Lau[SUP] 2 [/SUP], Sandra Hasmann[SUP] 3 [/SUP], Daniela Soreth-Rieke[SUP] 4 [/SUP], Johanna Sorodoc-Otto[SUP] 5 [/SUP], Wilke Beuthien[SUP] 5 [/SUP], Julia Krappe[SUP] 3 [/SUP], Marcell Toepfer[SUP] 6 [/SUP], Gero von Gersdorff[SUP] 7 [/SUP], Norbert Thaller[SUP] 4 [/SUP], Simon Rau[SUP] 2 [/SUP], Bernd Northoff[SUP] 1 [/SUP], Daniel Teupser[SUP] 1 [/SUP], Mathias Bruegel[SUP] 1 [/SUP], Michael Fischereder[SUP] 3 [/SUP], Ulf Schönermarck[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Some studies have shown an attenuated immune response in haemodialysis patients after vaccination. The present study examines the humoral response after mRNA vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a large population of haemodialysis patients from different outpatient dialysis centres.
Methods: We retrospectively assessed antibodies against SARS-CoV-2 spike protein and nucleocapsid protein (chemiluminescence immunoassays, Roche diagnostics) 3-6 weeks after the second mRNA vaccine dose in 179 maintenance haemodialysis and 70 non-dialysis patients (control cohort). Differences in anti-SARS-CoV-2 spike protein titers were statistically analysed with respect to patient-relevant factors, including age, gender, previous coronavirus disease 2019 (COVID-19) infection, systemic immunosuppressive therapy and time on dialysis.
Results: We found a favourable, but profoundly lower SARS-CoV-2 spike protein antibody response in comparison with a non-dialysis cohort (median 253.5 versus 1756 U/mL, P < 0.001). In multivariate analysis, previous COVID-19 infection (P < 0.001) and female gender were associated with a significantly higher vaccine response (P = 0.006) in haemodialysis patients, while there was a significant inverse correlation with increasing patient age and systemic immunosuppression (P < 0.001). There was no statistically significant correlation between the antibody titer and time on dialysis. Immune response in haemodialysis patients with a previous COVID-19 infection led to substantially higher antibody titers that were equal to those of vaccinated non-dialysis individuals with previous infection.
Conclusion: We strongly argue in favour of regular antibody testing after COVID-19 vaccination in haemodialysis patients. Further studies should elucidate the utility of booster vaccinations to foster a stronger and persistent antibody response.
Keywords: SARS-CoV-2; antibody response; haemodialysis; immunosuppression; vaccination.
. 2021 Jul 6;14(10):2234-2238.
doi: 10.1093/ckj/sfab127. eCollection 2021 Oct.
Antibody response to mRNA SARS-CoV-2 vaccines in haemodialysis patients
Michael Paal[SUP] 1 [/SUP], Florian M Arend[SUP] 1 [/SUP], Tobias Lau[SUP] 2 [/SUP], Sandra Hasmann[SUP] 3 [/SUP], Daniela Soreth-Rieke[SUP] 4 [/SUP], Johanna Sorodoc-Otto[SUP] 5 [/SUP], Wilke Beuthien[SUP] 5 [/SUP], Julia Krappe[SUP] 3 [/SUP], Marcell Toepfer[SUP] 6 [/SUP], Gero von Gersdorff[SUP] 7 [/SUP], Norbert Thaller[SUP] 4 [/SUP], Simon Rau[SUP] 2 [/SUP], Bernd Northoff[SUP] 1 [/SUP], Daniel Teupser[SUP] 1 [/SUP], Mathias Bruegel[SUP] 1 [/SUP], Michael Fischereder[SUP] 3 [/SUP], Ulf Schönermarck[SUP] 3 [/SUP]
Affiliations
- PMID: 34603700
- PMCID: PMC8394831
- DOI: 10.1093/ckj/sfab127
Abstract
Background: Some studies have shown an attenuated immune response in haemodialysis patients after vaccination. The present study examines the humoral response after mRNA vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a large population of haemodialysis patients from different outpatient dialysis centres.
Methods: We retrospectively assessed antibodies against SARS-CoV-2 spike protein and nucleocapsid protein (chemiluminescence immunoassays, Roche diagnostics) 3-6 weeks after the second mRNA vaccine dose in 179 maintenance haemodialysis and 70 non-dialysis patients (control cohort). Differences in anti-SARS-CoV-2 spike protein titers were statistically analysed with respect to patient-relevant factors, including age, gender, previous coronavirus disease 2019 (COVID-19) infection, systemic immunosuppressive therapy and time on dialysis.
Results: We found a favourable, but profoundly lower SARS-CoV-2 spike protein antibody response in comparison with a non-dialysis cohort (median 253.5 versus 1756 U/mL, P < 0.001). In multivariate analysis, previous COVID-19 infection (P < 0.001) and female gender were associated with a significantly higher vaccine response (P = 0.006) in haemodialysis patients, while there was a significant inverse correlation with increasing patient age and systemic immunosuppression (P < 0.001). There was no statistically significant correlation between the antibody titer and time on dialysis. Immune response in haemodialysis patients with a previous COVID-19 infection led to substantially higher antibody titers that were equal to those of vaccinated non-dialysis individuals with previous infection.
Conclusion: We strongly argue in favour of regular antibody testing after COVID-19 vaccination in haemodialysis patients. Further studies should elucidate the utility of booster vaccinations to foster a stronger and persistent antibody response.
Keywords: SARS-CoV-2; antibody response; haemodialysis; immunosuppression; vaccination.