tetano
Editor, Senior Moderator
Microorganisms
. 2021 Dec 21;10(1):4.
doi: 10.3390/microorganisms10010004.
Immune Responses to SARS-CoV-2 Infection and Vaccination in Dialysis Patients and Kidney Transplant Recipients
Patrick Affeldt[SUP] 1 [/SUP], Felix Carlo Koehler[SUP] 1 2 [/SUP], Karl August Brensing[SUP] 3 [/SUP], Vivien Adam[SUP] 1 [/SUP], Julia Burian[SUP] 4 [/SUP], Linus Butt[SUP] 1 2 [/SUP], Martin Gies[SUP] 5 [/SUP], Franziska Grundmann[SUP] 1 [/SUP], Steffen Hinrichs[SUP] 1 [/SUP], Wibke Johannis[SUP] 6 [/SUP], Nils Kalisch[SUP] 1 [/SUP], Matthias Meyer-Delpho[SUP] 7 [/SUP], Simon Oehm[SUP] 1 [/SUP], Eva Platen[SUP] 8 [/SUP], Claudia Schöler[SUP] 5 [/SUP], Eva Heger[SUP] 9 [/SUP], Gertrud Steger[SUP] 9 [/SUP], Dirk Stippel[SUP] 10 [/SUP], Aileen Ziegelhöfer[SUP] 9 [/SUP], Thomas Benzing[SUP] 1 2 [/SUP], Florian Klein[SUP] 9 [/SUP], Christine Kurschat[SUP] 1 2 [/SUP], Roman-Ulrich Müller[SUP] 1 2 [/SUP], Veronica Di Cristanziano[SUP] 9 [/SUP]
Affiliations
Abstract
Dialysis patients and kidney transplant (KTX) recipients suffer from an impaired immune system and show a decreased response to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccination. We performed a retrospective analysis of 1505 serological SARS-CoV-2 measurements obtained from 887 dialysis patients and 86 KTX recipients. The results were separated by patient subgroups (dialysis/KTX) as well as SARS-CoV-2 status. The latter criterion included SARS-CoV-2-naïve patients with or without COVID-19 vaccination and convalescent patients receiving a booster shot. Serologies of 27 vaccinated healthy individuals served as the reference group. Vaccine-induced cellular immune response was quantified by an interferon-γ release assay in 32 KTX recipients. We determined seroconversion rates of 92.6%, 93.4%, and 71.4% in dialysis patients vaccinated with either BNT162b2, mRNA-1273, or AZD1222, respectively. Vaccination-induced anti-SARS-CoV-2 antibody titers were lower in dialysis patients compared to healthy individuals, and vaccination with mRNA-1273 induced higher titers than BNT162b2. The initial seroconversion rate was 39.5% in KTX recipients vaccinated with BNT162b2. A linear regression model identified medication with mycophenolate-mofetil/mycophenolic acid as an independent risk factor for missing seroconversion. Within a cohort of 32 KTX recipients, cellular and humoral immune reactivity to SARS-CoV-2 was detectable in three patients only. Conclusively, vaccine-induced seroconversion rates were similar in dialysis patients compared to healthy individuals but were strongly impaired in KTX recipients. Anti-SARS-CoV-2 IgG titers elicited by double active immunization were significantly lower in both cohorts compared to healthy individuals, and immune responses to vaccination vanished quickly.
Keywords: COVID-19; antibodies; immunosuppression; kidney disease; protection; titer.
. 2021 Dec 21;10(1):4.
doi: 10.3390/microorganisms10010004.
Immune Responses to SARS-CoV-2 Infection and Vaccination in Dialysis Patients and Kidney Transplant Recipients
Patrick Affeldt[SUP] 1 [/SUP], Felix Carlo Koehler[SUP] 1 2 [/SUP], Karl August Brensing[SUP] 3 [/SUP], Vivien Adam[SUP] 1 [/SUP], Julia Burian[SUP] 4 [/SUP], Linus Butt[SUP] 1 2 [/SUP], Martin Gies[SUP] 5 [/SUP], Franziska Grundmann[SUP] 1 [/SUP], Steffen Hinrichs[SUP] 1 [/SUP], Wibke Johannis[SUP] 6 [/SUP], Nils Kalisch[SUP] 1 [/SUP], Matthias Meyer-Delpho[SUP] 7 [/SUP], Simon Oehm[SUP] 1 [/SUP], Eva Platen[SUP] 8 [/SUP], Claudia Schöler[SUP] 5 [/SUP], Eva Heger[SUP] 9 [/SUP], Gertrud Steger[SUP] 9 [/SUP], Dirk Stippel[SUP] 10 [/SUP], Aileen Ziegelhöfer[SUP] 9 [/SUP], Thomas Benzing[SUP] 1 2 [/SUP], Florian Klein[SUP] 9 [/SUP], Christine Kurschat[SUP] 1 2 [/SUP], Roman-Ulrich Müller[SUP] 1 2 [/SUP], Veronica Di Cristanziano[SUP] 9 [/SUP]
Affiliations
- PMID: 35056453
- DOI: 10.3390/microorganisms10010004
Abstract
Dialysis patients and kidney transplant (KTX) recipients suffer from an impaired immune system and show a decreased response to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccination. We performed a retrospective analysis of 1505 serological SARS-CoV-2 measurements obtained from 887 dialysis patients and 86 KTX recipients. The results were separated by patient subgroups (dialysis/KTX) as well as SARS-CoV-2 status. The latter criterion included SARS-CoV-2-naïve patients with or without COVID-19 vaccination and convalescent patients receiving a booster shot. Serologies of 27 vaccinated healthy individuals served as the reference group. Vaccine-induced cellular immune response was quantified by an interferon-γ release assay in 32 KTX recipients. We determined seroconversion rates of 92.6%, 93.4%, and 71.4% in dialysis patients vaccinated with either BNT162b2, mRNA-1273, or AZD1222, respectively. Vaccination-induced anti-SARS-CoV-2 antibody titers were lower in dialysis patients compared to healthy individuals, and vaccination with mRNA-1273 induced higher titers than BNT162b2. The initial seroconversion rate was 39.5% in KTX recipients vaccinated with BNT162b2. A linear regression model identified medication with mycophenolate-mofetil/mycophenolic acid as an independent risk factor for missing seroconversion. Within a cohort of 32 KTX recipients, cellular and humoral immune reactivity to SARS-CoV-2 was detectable in three patients only. Conclusively, vaccine-induced seroconversion rates were similar in dialysis patients compared to healthy individuals but were strongly impaired in KTX recipients. Anti-SARS-CoV-2 IgG titers elicited by double active immunization were significantly lower in both cohorts compared to healthy individuals, and immune responses to vaccination vanished quickly.
Keywords: COVID-19; antibodies; immunosuppression; kidney disease; protection; titer.