Longevity of Humoral Response Six Months Following BNT162b2 Vaccine in Dialysis Patients

Frontiers in Medicine

article

Timna Agur¹  Naomi Ben-Dor¹  Michal Herman-Edelstein¹  Tali Steinmetz¹  Shelly Lichtenberg¹  Shira Schneider¹  Dafna Yahav²  Benaya Rozen-Zvi¹  Boris Zingerman¹ 

[1] Department of Nephrology and Hypertension, Rabin Medical Center;Sackler Faculty of Medicine, Tel Aviv University;Infectious Diseases Unit, Rabin Medical Center

关键词: COVID-19;    SARS-COV-2;    hemodialysis;    BNT162b2;    anti-spike antibody;   

DOI  :  10.3389/fmed.2022.781888

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background End-stage kidney disease substantially increases the risk of severe COVID-19. However, despite early robust immunogenicity of the mRNA-SARS-CoV-2 vaccination in patients with hemodialysis, the longevity of humoral response in this high-risk population is still unknown. Methods A prospective cohort study aimed to evaluate the longevity of serologic response in patients with hemodialysis, compared with a control group, 6 months following the second dose of the BNT162b2 vaccine. We assessed antibody response by quantitative measurement of IgG antibodies against the receptor-binding domain of the Spike protein (anti-S1-RBD IgG). Study outcomes were defined as a seropositivity rate and log-transformed anti-S1-RBD IgG levels at 6 months, and the change in antibody levels between 3 and 6 months. Findings The cohort included 104 patients with hemodialysis and 84 controls. At a median time of 184 days (IQR, 183–188) following the second dose of the vaccine, 83/104 (79.8%) patients with hemodialysis maintained seropositivity for the anti-S1-RBD IgG level compared to 83/84 (98.8%) in the control group ( p < 0.001). The log-transformed antibody level was significantly lower in the hemodialysis group (2.23 ± 0.39 log AU/ml vs. 2.69 ± 0.65 log AU/ml, respectively, p < 0.001). Older age and hypoalbuminemia were the only variables that were found to be associated with reduced log-transformed antibody levels in univariate and multivariate analysis. There was no interaction between dialysis status and an antibody-level decline rate ( p = 0.972). Conclusion Among patients with hemodialysis, a seropositivity rate and anti-S1-RBD antibody titers were substantially reduced compared with a control group, at 6 months following the second dose of the BNT162b2 vaccine. These findings support the prioritization of patients with hemodialysis for a third “booster” dose.

【 授权许可】

CC BY