BACKGROUND AND OBJECTIVES: Patients receiving hemodialysis are at high risk for both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe coronavirus disease 2019. A lifesaving vaccine is available, but sensitivity to vaccines is generally lower in patients on dialysis. Little is yet known about antibody responses after coronavirus disease 2019 (COVID-19) vaccination in this vulnerable group. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: In this prospective single-center study, we included 22 patients on dialysis and 46 healthy controls from Heidelberg University Hospital between December 2020 and February 2021. We measured anti-S1 IgG with a threshold index for detection greater than one, neutralizing antibodies with a threshold for viral neutralization of ≥30%, and antibodies against different SARS-CoV2 fragments 17-22 days after the first dose and 18-22 days after the second dose of the mRNA vaccine BNT162b2. RESULTS: After the first vaccine dose, four of 22 (18%) patients on dialysis compared with 43 of 46 (93%) healthy controls developed positive anti-S1 IgG, with a median anti-S1 IgG index of 0.2 (interquartile range, 0.1-0.7) compared with nine (interquartile range, 4-16), respectively. SARS-CoV2 neutralizing antibodies exceeded the threshold for neutralization in four of 22 (18%) patients on dialysis compared with 43 of 46 (93%) healthy controls, with a median percent inhibition of 11 (interquartile range, 3-24) compared with 65 (interquartile range, 49-75), respectively. After the second dose, 14 of 17 (82%) patients on dialysis developed neutralizing antibodies exceeding the threshold for viral neutralization and antibodies against the receptor binding S1 domain of the spike protein, compared with 46 of 46 (100%) healthy controls, respectively. The median percent inhibition was 51 (interquartile range, 32-86) compared with 98 (interquartile range, 97-98) in healthy controls. CONCLUSIONS: Patients receiving long-term hemodialysis show a reduced antibody response to the first and second doses of the mRNA vaccine BNT162b2. The majority (82%) develop neutralizing antibodies after the second dose but at lower levels than healthy controls.
BACKGROUND AND OBJECTIVES: Patients receiving hemodialysis are at high risk for both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe coronavirus disease 2019. A lifesaving vaccine is available, but sensitivity to vaccines is generally lower in patients on dialysis. Little is yet known about antibody responses after coronavirus disease 2019 (COVID-19) vaccination in this vulnerable group. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: In this prospective single-center study, we included 22 patients on dialysis and 46 healthy controls from Heidelberg University Hospital between December 2020 and February 2021. We measured anti-S1 IgG with a threshold index for detection greater than one, neutralizing antibodies with a threshold for viral neutralization of ≥30%, and antibodies against different SARS-CoV2 fragments 17-22 days after the first dose and 18-22 days after the second dose of the mRNA vaccine BNT162b2. RESULTS: After the first vaccine dose, four of 22 (18%) patients on dialysis compared with 43 of 46 (93%) healthy controls developed positive anti-S1 IgG, with a median anti-S1 IgG index of 0.2 (interquartile range, 0.1-0.7) compared with nine (interquartile range, 4-16), respectively. SARS-CoV2 neutralizing antibodies exceeded the threshold for neutralization in four of 22 (18%) patients on dialysis compared with 43 of 46 (93%) healthy controls, with a median percent inhibition of 11 (interquartile range, 3-24) compared with 65 (interquartile range, 49-75), respectively. After the second dose, 14 of 17 (82%) patients on dialysis developed neutralizing antibodies exceeding the threshold for viral neutralization and antibodies against the receptor binding S1 domain of the spike protein, compared with 46 of 46 (100%) healthy controls, respectively. The median percent inhibition was 51 (interquartile range, 32-86) compared with 98 (interquartile range, 97-98) in healthy controls. CONCLUSIONS: Patients receiving long-term hemodialysis show a reduced antibody response to the first and second doses of the mRNA vaccine BNT162b2. The majority (82%) develop neutralizing antibodies after the second dose but at lower levels than healthy controls.
Authors: Louise Benning; Christian Morath; Marie Bartenschlager; Christian Nusshag; Florian Kälble; Mirabel Buylaert; Matthias Schaier; Jörg Beimler; Katrin Klein; Julia Grenz; Paula Reichel; Asa Hidmark; Gerald Ponath; Maximilian Töllner; Marvin Reineke; Susanne Rieger; Burkhard Tönshoff; Paul Schnitzler; Martin Zeier; Caner Süsal; Ralf Bartenschlager; Claudius Speer Journal: Clin J Am Soc Nephrol Date: 2021-12-22 Impact factor: 8.237
Authors: Jeffrey Silberzweig; J Ganesh Bhat; Mary O Dittrich; Raghu Durvasula; Jeff Giullian; Jeffrey L Hymes; Doug Johnson; Brigitte Schiller; Richard Spech; Leslie Spry; Geoffrey Scott Walker; Suzanne Watnick; Jerry Yee; Barry I Freedman Journal: J Am Soc Nephrol Date: 2022-06-02 Impact factor: 14.978
Authors: André Weigert; Marie-Louise Bergman; Lígia A Gonçalves; Iolanda Godinho; Nádia Duarte; Rita Abrantes; Patrícia Borges; Ana Brennand; Vanessa Malheiro; Paula Matoso; Onome Akpogheneta; Lindsay Kosack; Pedro Cruz; Estela Nogueira; Magda Pereira; Ana Ferreira; Marco Marques; Telmo Nunes; João Faro-Viana; Jocelyne Demengeot; Carlos Penha-Gonçalves Journal: Front Med (Lausanne) Date: 2021-12-24
Authors: Edward J Carr; Andreas Kronbichler; Matthew Graham-Brown; Graham Abra; Christos Argyropoulos; Lorraine Harper; Edgar V Lerma; Rita S Suri; Joel Topf; Michelle Willicombe; Swapnil Hiremath Journal: Kidney Int Rep Date: 2021-07-06
Authors: Eva Schrezenmeier; Leon Bergfeld; David Hillus; Joerg-Detlev Lippert; Ulrike Weber; Pinkus Tober-Lau; Irmgard Landgraf; Tatjana Schwarz; Kai Kappert; Ana-Luisa Stefanski; Arne Sattler; Katja Kotsch; Thomas Dörner; Leif Erik Sander; Klemens Budde; Fabian Halleck; Florian Kurth; Victor Max Corman; Mira Choi Journal: Front Immunol Date: 2021-06-30 Impact factor: 7.561
Authors: José Jesús Broseta; Diana Rodríguez-Espinosa; Néstor Rodríguez; María Del Mar Mosquera; María Ángeles Marcos; Natalia Egri; Mariona Pascal; Erica Soruco; José Luis Bedini; Beatriu Bayés; Francisco Maduell Journal: Am J Kidney Dis Date: 2021-06-24 Impact factor: 8.860