Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland.
Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, Gdańsk, Poland
Pol Arch Intern Med. 2021 Sep 30;131(9):797-801. doi: 10.20452/pamw.16069. Epub 2021 Aug 5.
Introduction: There is an urgent need to check the efficacy of SARS-CoV-2 vaccination among hemodialysis patients who are known to have large abnormalities of acquired immunity and a catastrophic risk of death from COVID-19. Objectives: In this cross-sectional study, we aimed to assess the humoral response following vaccination with the BNT162b2 (BioNTech / Pfizer Comirnaty) vaccine. Patients and methods: We analyzed the titer magnitude of the IgG antibodies directed against SARS-CoV-2 spike antigen 14 to 21 days after the second dose of the BNT162b2 vaccine in a group of hemodialysis patients who have not been confirmed with SARS-CoV-2 infection yet, compared with HD patients with a history of COVID-19. A total of 126 hemodialysis patients were stratified based on evidence of a previous infection with SARS-CoV-2 confirmed by the detection of viral RNA or nucleocapsid-specific IgG antibodies. Results: S-antigen immune response with a median (interquartile range) antibody titer of 366 (193–691) AU/ml was seen in 87 of 91 infection-naïve hemodialysis patients (95.6%), and in 68 (74.7%), a strong humoral response was observed with an anti-S antibodies titer greater than 200 AU/ml. Older patients were less likely to develop a response to S-antibodies (P <0.001). The median (interquartile range) S-antigen antibody titer in 35 previously infected hemodialysis patients was over 12-fold higher than in infection-naïve hemodialysis patients: 4620 (1240–7820) AU/ml (P <0.001). There were no significant differences in S-antibody titer between symptomatic and asymptomatic previously infected hemodialysis patients. Conclusions: Our study demonstrated that the majority of hemodialysis patients achieved a high immunization rate after vaccination with BNT162b2. Whether this translates into protecting this population from COVID-19 requires further research.
已知血液透析患者获得性免疫异常大，死于 COVID-19 的风险极高，迫切需要检查他们接种 SARS-CoV-2 疫苗的效果。目的：在这项横断面研究中，我们旨在评估 BNT162b2（BioNTech/Pfizer Comirnaty）疫苗接种后针对 SARS-CoV-2 刺突抗原 1 的体液反应。患者和方法：我们分析了未感染 SARS-CoV-2 的血液透析患者在接种 BNT162b2 疫苗第二剂后 14-21 天针对 SARS-CoV-2 刺突抗原 1 的 IgG 抗体滴度大小，与有 COVID-19 病史的血液透析患者进行了比较。根据检测病毒 RNA 或核衣壳特异性 IgG 抗体证实的 SARS-CoV-2 既往感染证据，对 126 名血液透析患者进行分层。结果：在 91 名无感染史的血液透析患者中（87 例），87 例（95.6%）患者观察到 S-抗原免疫应答，抗体滴度中位数（四分位距）为 366（193-691）AU/ml，68 例（74.7%）患者观察到强烈的体液反应，抗 S 抗体滴度大于 200 AU/ml。年龄较大的患者不太可能对 S-抗体产生反应（P<0.001）。35 例既往感染的血液透析患者的 S-抗原抗体滴度中位数（四分位距）比无感染史的血液透析患者高 12 倍以上：4620（1240-7820）AU/ml（P<0.001）。无症状和有症状的既往感染的血液透析患者之间 S 抗体滴度无显著差异。结论：我们的研究表明，大多数血液透析患者接种 BNT162b2 后达到了高免疫率。这是否转化为保护该人群免受 COVID-19 感染还需要进一步研究。
