tetano
Editor, Senior Moderator
Adv Clin Exp Med
. 2022 Apr 19.
doi: 10.17219/acem/147360. Online ahead of print.
Factors predictive of anti-spike antibody titers after COVID-19 vaccination in hemodialysis patients
Mabel Aoun[SUP] 1 2 [/SUP], Reine-Marie Kahwaji[SUP] 3 [/SUP], Ghassan Sleilaty[SUP] 4 [/SUP], Celine Boueri[SUP] 2 [/SUP], Jenny Hawi[SUP] 2 [/SUP], Christelle Bou Khalil[SUP] 5 [/SUP], Valerie Hage[SUP] 1 6 [/SUP]
Affiliations
Abstract
Background: Hemodialysis (HD) patients have a high prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mortality, but they may have a weak response to coronavirus disease 2019 (COVID-19) vaccines.
Objectives: This study aimed to evaluate factors predictive of humoral response in HD patients vaccinated against SARS-CoV-2 infection.
Material and methods: This is a 2-center observational study including HD patients who received the BNT162b2 mRNA vaccine followed by serological measurements 20 days and 4 weeks after the 1st and 2nd dose, respectively. Healthy controls were included. Anti-spike antibody was measured using the chemiluminescent immunoassay (CLIA) method. The quantile regression analysis was performed to assess factors associated with anti-spike antibody titers.
Results: Seventy-two HD patients and 22 healthy controls were included. Mean age of dialysis patients and controls was 72.5 ±11.5 years and 45.7 ±17.4 years, respectively. In the HD group, median levels of anti-spike antibody were 3 (interquartile range (IQR): 0.5-26) UI/mL and 391 (IQR: 55-1642) UI/mL after the 1st and 2nd dose, respectively, with response rates of 62.5% and 96.7%. The median level of the anti-spike antibody after the 1st dose in previously infected patients was 8571 (IQR: 2586-19147) UI/mL. There was a significant correlation between anti-spike antibody levels after the 2nd dose and age and anti-hepatitis B surface (HBs) antibody and serum albumin levels (Spearman's rho: r = -0.289, p < 0.001; r = 0.357, p = 0.027; r = 0.317; p = 0.026, respectively). The regression analysis showed a significant association of previous infection and anti-Hbs antibody level with anti-spike antibody level after the 1st dose of vaccine (p < 0.001). After a 5-month follow-up, 2 vaccinated patients contracted COVID-19.
Conclusions: This study showed a response rate of 96.7% to 2 doses of BNT162b2 mRNA vaccine in HD patients and 100% to a single dose in previously infected patients. The level of anti-spike antibody can be predicted by age, anti-Hbs antibodies, serum albumin, and previous infection. Despite the immunization of patients, preventive measures should be maintained in all dialysis units.
Keywords: COVID-19 vaccine; SARS-CoV-2; anti-spike antibody; hemodialysis; hepatitis B vaccine.
. 2022 Apr 19.
doi: 10.17219/acem/147360. Online ahead of print.
Factors predictive of anti-spike antibody titers after COVID-19 vaccination in hemodialysis patients
Mabel Aoun[SUP] 1 2 [/SUP], Reine-Marie Kahwaji[SUP] 3 [/SUP], Ghassan Sleilaty[SUP] 4 [/SUP], Celine Boueri[SUP] 2 [/SUP], Jenny Hawi[SUP] 2 [/SUP], Christelle Bou Khalil[SUP] 5 [/SUP], Valerie Hage[SUP] 1 6 [/SUP]
Affiliations
- PMID: 35438849
- DOI: 10.17219/acem/147360
Abstract
Background: Hemodialysis (HD) patients have a high prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mortality, but they may have a weak response to coronavirus disease 2019 (COVID-19) vaccines.
Objectives: This study aimed to evaluate factors predictive of humoral response in HD patients vaccinated against SARS-CoV-2 infection.
Material and methods: This is a 2-center observational study including HD patients who received the BNT162b2 mRNA vaccine followed by serological measurements 20 days and 4 weeks after the 1st and 2nd dose, respectively. Healthy controls were included. Anti-spike antibody was measured using the chemiluminescent immunoassay (CLIA) method. The quantile regression analysis was performed to assess factors associated with anti-spike antibody titers.
Results: Seventy-two HD patients and 22 healthy controls were included. Mean age of dialysis patients and controls was 72.5 ±11.5 years and 45.7 ±17.4 years, respectively. In the HD group, median levels of anti-spike antibody were 3 (interquartile range (IQR): 0.5-26) UI/mL and 391 (IQR: 55-1642) UI/mL after the 1st and 2nd dose, respectively, with response rates of 62.5% and 96.7%. The median level of the anti-spike antibody after the 1st dose in previously infected patients was 8571 (IQR: 2586-19147) UI/mL. There was a significant correlation between anti-spike antibody levels after the 2nd dose and age and anti-hepatitis B surface (HBs) antibody and serum albumin levels (Spearman's rho: r = -0.289, p < 0.001; r = 0.357, p = 0.027; r = 0.317; p = 0.026, respectively). The regression analysis showed a significant association of previous infection and anti-Hbs antibody level with anti-spike antibody level after the 1st dose of vaccine (p < 0.001). After a 5-month follow-up, 2 vaccinated patients contracted COVID-19.
Conclusions: This study showed a response rate of 96.7% to 2 doses of BNT162b2 mRNA vaccine in HD patients and 100% to a single dose in previously infected patients. The level of anti-spike antibody can be predicted by age, anti-Hbs antibodies, serum albumin, and previous infection. Despite the immunization of patients, preventive measures should be maintained in all dialysis units.
Keywords: COVID-19 vaccine; SARS-CoV-2; anti-spike antibody; hemodialysis; hepatitis B vaccine.