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新冠疫苗在维持性血液透析患者中的有效性

Effectiveness of COVID-19 Vaccines in Patients Under Maintenance Hemodialysis.

作者信息

Mahallawi Waleed H, Ibrahim Nadir A, Mumena Walaa A

机构信息

Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia.

Department of Clinical Nutrition, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia.

出版信息

Risk Manag Healthc Policy. 2021 Dec 30;14:5081-5088. doi: 10.2147/RMHP.S345686. eCollection 2021.

Abstract

BACKGROUND

Several published data on the dialysis population showed that antibody levels decreased after COVID-19 vaccinations in comparison to the overall population. We aimed to illustrate the persistence of humoral response after receiving second dose of the Pfizer or AstraZeneca vaccines in patients under maintenance hemodialysis (HD).

METHODS

A total of 119 adult patients on HD who were recruited from a single hemodialysis center in Madinah, Saudi Arabia. An enzyme-linked immunosorbent assay (ELISA) was utilized to measure the specific antibody response to the spike protein in the serum samples.

RESULTS

Mean age of patients was 48.5 ± 13.5 years, while mean time since starting the renal dialysis was 5.09 ± 5.29 years. Blood samples were collected after 89.2 ± 25.7 days of receiving the second dose of the vaccines. A very high positive correlation between anti-S IgG antibodies in pre- and post-dialysis was found (r= 0.93, < 0.001). Additionally, there was a high positive correlation between anti-S IgG antibody collected at baseline and follow-up blood samples (30 days apart) (r= 0.82, < 0.001). Moreover, patients who received Pfizer had significantly higher mean change in anti-S IgG antibodies compared to patients who received AstraZeneca (0.41 ± 0.94 vs 0.03 ± 0.30, respectively, = 0.026).

CONCLUSION

The majority of the patients included in this study were able to yield an immune response to the vaccine after receiving the two doses. Persistence of IgG antibodies in the majority of the patients on HD in response to COVID-19 vaccines is encouraging in terms of continuing to vaccinate this category of patients in addition to monitoring them.

摘要

背景

多项已发表的关于透析人群的数据表明,与普通人群相比,新冠病毒疫苗接种后抗体水平有所下降。我们旨在阐明维持性血液透析(HD)患者接种辉瑞或阿斯利康疫苗第二剂后体液免疫反应的持久性。

方法

从沙特阿拉伯麦地那的一个血液透析中心招募了119名接受HD的成年患者。采用酶联免疫吸附测定(ELISA)法检测血清样本中针对刺突蛋白的特异性抗体反应。

结果

患者的平均年龄为48.5±13.5岁,开始肾脏透析后的平均时间为5.09±5.29年。在接种疫苗第二剂后89.2±25.7天采集血样。透析前和透析后抗S IgG抗体之间存在非常高的正相关性(r = 0.93,P<0.001)。此外,在基线时和随访血样(间隔30天)采集的抗S IgG抗体之间存在高度正相关性(r = 0.82,P<0.001)。此外,与接受阿斯利康疫苗的患者相比,接受辉瑞疫苗的患者抗S IgG抗体的平均变化显著更高(分别为0.41±0.94和0.03±0.30,P = 0.026)。

结论

本研究中的大多数患者在接种两剂疫苗后能够产生针对疫苗的免疫反应。对于继续为这类患者接种疫苗并对其进行监测而言,大多数HD患者体内针对新冠病毒疫苗的IgG抗体的持久性是令人鼓舞的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0998/8722686/8776597c1e2c/RMHP-14-5081-g0001.jpg

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