tetano
Editor, Senior Moderator
Infect Dis Ther
. 2021 Dec 3.
doi: 10.1007/s40121-021-00574-9. Online ahead of print.
Short-Term Immunogenicity Profiles and Predictors for Suboptimal Immune Responses in Patients with End-Stage Kidney Disease Immunized with Inactivated SARS-CoV-2 Vaccine
Sarinya Boongird[SUP] 1 [/SUP], Piyatida Chuengsaman[SUP] 2 [/SUP], Chavachol Setthaudom[SUP] 3 [/SUP], Arkom Nongnuch[SUP] 1 [/SUP], Montira Assanatham[SUP] 1 [/SUP], Salinnart Phanprasert[SUP] 1 [/SUP], Rungthiwa Kitpermkiat[SUP] 1 [/SUP], Sasisopin Kiertiburanakul[SUP] 4 [/SUP], Kumthorn Malathum[SUP] 4 [/SUP], Angsana Phuphuakrat[SUP] 4 [/SUP], Andrew Davenport[SUP] 5 [/SUP], Jackrapong Bruminhent[SUP] 6 [/SUP]
Affiliations
Abstract
Introduction: Patients with end-stage kidney disease (ESKD) are at risk of severe coronavirus disease and mortality. Immunogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) inactivated whole-virus vaccine in patients with ESKD has never been explored.
Methods: We conducted a prospective cohort study of 60 patients with ESKD and 30 healthy controls. All participants received two doses of an inactivated whole-virus SARS-CoV-2 vaccine (Sinovac Biotech Ltd) 4 weeks apart. SARS-CoV-2-specific humoral and cell-mediated immune responses were investigated and referenced with healthy controls.
Results: After two doses, an anti-receptor-binding domain immunoglobulin G of 50 AU/ml or greater was present in 53 of 60 patients (88%) in the ESKD group and all participants (100%) in the control group (P = 0.05). The percentage of patients with ESKD and controls with neutralizing antibodies of 35% threshold or greater was 58% and 88%, respectively (P = 0.01). Furthermore, the proportion of patients with ESKD and S1-specific T cell response was comparable with controls (82% vs. 77%, P = 0.45). Old age, high ferritin level, and low absolute lymphocyte count were independently associated with poor humoral immune responses.
Conclusions: Patients with ESKD could develop similar SARS-CoV-2-specific cell-mediated immune responses compared to healthy controls, although suboptimal humoral immune responses were observed following two doses of SARS-CoV-2 vaccination. Therefore, patients with ESKD and the abovementioned factors are at risk of generating inadequate humoral immune responses, and a vaccine strategy to elicit greater immunogenicity among these relatively immunocompromised patients is warranted. (Thai Clinical Trials Registry, TCTR20210226002).
Keywords: COVID-19; Dialysis; Inactivated vaccine; Neutralizing antibody; Receptor-binding domain.
. 2021 Dec 3.
doi: 10.1007/s40121-021-00574-9. Online ahead of print.
Short-Term Immunogenicity Profiles and Predictors for Suboptimal Immune Responses in Patients with End-Stage Kidney Disease Immunized with Inactivated SARS-CoV-2 Vaccine
Sarinya Boongird[SUP] 1 [/SUP], Piyatida Chuengsaman[SUP] 2 [/SUP], Chavachol Setthaudom[SUP] 3 [/SUP], Arkom Nongnuch[SUP] 1 [/SUP], Montira Assanatham[SUP] 1 [/SUP], Salinnart Phanprasert[SUP] 1 [/SUP], Rungthiwa Kitpermkiat[SUP] 1 [/SUP], Sasisopin Kiertiburanakul[SUP] 4 [/SUP], Kumthorn Malathum[SUP] 4 [/SUP], Angsana Phuphuakrat[SUP] 4 [/SUP], Andrew Davenport[SUP] 5 [/SUP], Jackrapong Bruminhent[SUP] 6 [/SUP]
Affiliations
- PMID: 34859359
- DOI: 10.1007/s40121-021-00574-9
Abstract
Introduction: Patients with end-stage kidney disease (ESKD) are at risk of severe coronavirus disease and mortality. Immunogenicity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) inactivated whole-virus vaccine in patients with ESKD has never been explored.
Methods: We conducted a prospective cohort study of 60 patients with ESKD and 30 healthy controls. All participants received two doses of an inactivated whole-virus SARS-CoV-2 vaccine (Sinovac Biotech Ltd) 4 weeks apart. SARS-CoV-2-specific humoral and cell-mediated immune responses were investigated and referenced with healthy controls.
Results: After two doses, an anti-receptor-binding domain immunoglobulin G of 50 AU/ml or greater was present in 53 of 60 patients (88%) in the ESKD group and all participants (100%) in the control group (P = 0.05). The percentage of patients with ESKD and controls with neutralizing antibodies of 35% threshold or greater was 58% and 88%, respectively (P = 0.01). Furthermore, the proportion of patients with ESKD and S1-specific T cell response was comparable with controls (82% vs. 77%, P = 0.45). Old age, high ferritin level, and low absolute lymphocyte count were independently associated with poor humoral immune responses.
Conclusions: Patients with ESKD could develop similar SARS-CoV-2-specific cell-mediated immune responses compared to healthy controls, although suboptimal humoral immune responses were observed following two doses of SARS-CoV-2 vaccination. Therefore, patients with ESKD and the abovementioned factors are at risk of generating inadequate humoral immune responses, and a vaccine strategy to elicit greater immunogenicity among these relatively immunocompromised patients is warranted. (Thai Clinical Trials Registry, TCTR20210226002).
Keywords: COVID-19; Dialysis; Inactivated vaccine; Neutralizing antibody; Receptor-binding domain.