tetano
Editor, Senior Moderator
Clin Kidney J
. 2021 Jul 6;14(10):2239-2245.
doi: 10.1093/ckj/sfab128. eCollection 2021 Oct.
Spike and neutralizing antibodies response to COVID-19 vaccination in haemodialysis patients
Matthieu Giot[SUP] 1 [/SUP], Toscane Fourié[SUP] 2 [/SUP], Guillaume Lano[SUP] 1 3 [/SUP], Paola Mariela Saba Villarroel[SUP] 2 [/SUP], Xavier de Lamballeri[SUP] 2 [/SUP], Marion Gully[SUP] 1 [/SUP], Laurent Samson[SUP] 1 [/SUP], Julien Farault[SUP] 1 [/SUP], Dammar Bouchouareb[SUP] 1 [/SUP], Océane Jehel[SUP] 1 [/SUP], Philippe Brunet[SUP] 1 3 [/SUP], Noémie Jourde-Chiche[SUP] 1 3 [/SUP], Laetitia Ninove[SUP] 2 [/SUP], Thomas Robert[SUP] 1 4 [/SUP]
Affiliations
Abstract
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: 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: 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: 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.
Keywords: BNT162 vaccine; COVID-19; SARS-CoV-2; haemodialysis; renal dialysis; vaccine.
. 2021 Jul 6;14(10):2239-2245.
doi: 10.1093/ckj/sfab128. eCollection 2021 Oct.
Spike and neutralizing antibodies response to COVID-19 vaccination in haemodialysis patients
Matthieu Giot[SUP] 1 [/SUP], Toscane Fourié[SUP] 2 [/SUP], Guillaume Lano[SUP] 1 3 [/SUP], Paola Mariela Saba Villarroel[SUP] 2 [/SUP], Xavier de Lamballeri[SUP] 2 [/SUP], Marion Gully[SUP] 1 [/SUP], Laurent Samson[SUP] 1 [/SUP], Julien Farault[SUP] 1 [/SUP], Dammar Bouchouareb[SUP] 1 [/SUP], Océane Jehel[SUP] 1 [/SUP], Philippe Brunet[SUP] 1 3 [/SUP], Noémie Jourde-Chiche[SUP] 1 3 [/SUP], Laetitia Ninove[SUP] 2 [/SUP], Thomas Robert[SUP] 1 4 [/SUP]
Affiliations
- PMID: 34603701
- PMCID: PMC8344612
- DOI: 10.1093/ckj/sfab128
Abstract
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: 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: 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: 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.
Keywords: BNT162 vaccine; COVID-19; SARS-CoV-2; haemodialysis; renal dialysis; vaccine.