Division of Nephrology, Al Amiri Hospital, Kuwait City, Kuwait.
Division of Nephrology, Jahra Hospital, Jahra City, Kuwait.
Hemodial Int. 2022 Apr;26(2):216-222. doi: 10.1111/hdi.13005. Epub 2022 Jan 5.
COVID-19 infection is associated with high mortality among hemodialysis patients. Standard vaccine response is generally lower among these patients. The adequate antibody titer response and the outcome of COVID-19 vaccine responders versus non-responders are unknown.
Hemodialysis patients on maintenance hemodialysis who have received two doses of Pfizer BNT162B2 vaccine were studied. Antibody response was tested after 14 days of the second dose. LIAISON SARS-CoV2 S1/S2 IgG test by DiaSorin (Italy) was used to assess antibody response. Patients were followed between 3 and 7 months after vaccination for COVID-19 infection, hospitalization and death related to COVID-19.
A total of 138 patients received two doses of Pfizer BNT162B2 vaccine. One hundred and twenty-seven patients had adequate response to the vaccine with IgG level ≥ 15 AU/ml versus 11 patients had poor response with IgG level ≤ 15 AU/ml. The response was 92% (127/138). Patient with history of prior COVID-19 infection had higher antibody titer mean of 339 ± 113 versus 157 ± 140 for patient with no prior history of COVID-19. Seven patients in both groups had COVID-19 infection post vaccine. Among the responders, five patients had COIVD-19 infection and two were hospitalized. These two patients had lower antibody titer of 23.9 and 75.2 AU/ml. In comparison, three patients who were not hospitalized had higher antibody titer 96.3, 118, and 319 AU/ml, respectively. In the non-responders one patient was hospitalized and one death occurred with rate of infection of 18%.
Seropositive patients with low antibody titer might be associated with worse outcome among responders. The ideal antibody titer level among dialysis patient is not known. Also, prior COVID-19 infection is associated with higher response to vaccine with higher antibody titer. All non-responders did not have prior COVID-19 infection. More research is required to further evaluated protective antibody titer.
COVID-19 感染与血液透析患者的高死亡率相关。这些患者的标准疫苗反应通常较低。COVID-19 疫苗应答者与无应答者的适当抗体滴度反应和结果尚不清楚。
研究了接受两剂辉瑞 BNT162B2 疫苗的维持性血液透析患者。在第二剂后 14 天测试抗体反应。使用 DiaSorin（意大利）的 LIAISON SARS-CoV2 S1/S2 IgG 检测来评估抗体反应。在接种疫苗后 3 至 7 个月内对患者进行 COVID-19 感染、住院和 COVID-19 相关死亡的随访。
共有 138 名患者接受了两剂辉瑞 BNT162B2 疫苗。127 名患者的 IgG 水平≥15 AU/ml，对疫苗有足够的反应，11 名患者的 IgG 水平≤15 AU/ml，反应不佳。应答率为 92%（127/138）。有 COVID-19 既往感染史的患者抗体滴度均值为 339±113，而无 COVID-19 既往感染史的患者抗体滴度均值为 157±140。两组均有 7 名患者在接种疫苗后发生 COVID-19 感染。在应答者中，5 名患者发生 COVID-19 感染，2 名患者住院。这两名患者的抗体滴度较低，分别为 23.9 和 75.2 AU/ml。相比之下，3 名未住院的患者的抗体滴度分别为 96.3、118 和 319 AU/ml。在无应答者中，1 名患者住院，1 名患者死亡，感染率为 18%。
低抗体滴度的血清阳性患者可能与应答者的不良结局有关。透析患者的理想抗体滴度水平尚不清楚。此外，COVID-19 既往感染与更高的抗体滴度和更高的疫苗反应相关。所有无应答者均无 COVID-19 既往感染。需要进一步研究以进一步评估保护性抗体滴度。
