Kitamura Mineaki, Takazono Takahiro, Yamamoto Kazuko, Harada Takashi, Funakoshi Satoshi, Mukae Hiroshi, Nishino Tomoya
Nagasaki Renal Center, Nagasaki, Japan.
Department of Nephrology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501 Japan.
Ren Replace Ther. 2022;8(1):8. doi: 10.1186/s41100-022-00397-5. Epub 2022 Mar 16.
Patients on hemodialysis (HD) face a high mortality risk from coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and they are therefore prioritized for vaccination. However, the efficacy of vaccination in this vulnerable population has not been confirmed. Although age is negatively correlated with serum immunoglobulin (Ig) levels, humoral responses to vaccination in elderly patients undergoing HD have not been investigated. To address this issue, we evaluated the anti-SARS-CoV-2 spike protein antibodies in nursing home residents on HD after BNT162b2 vaccine administration.
Patients on HD from a nursing home and care workers (controls) receiving two doses of the BNT162b2 vaccine between April and May 2021 were enrolled in this study. Those with a prior history of COVID-19 were excluded. Anti-spike protein antibodies were measured with the Elecsys (Roche) immunoassay system.
The study included 26 nursing home residents (41% male; median age, 86 years) and 184 care workers (28% male; median age, 45 years). The median HD vintage was 51 months. After two doses of BNT162b2, 73% of the nursing home residents and 99.5% of the control group developed sufficient anti-spike protein antibodies (> 29 U/mL) to neutralize SARS-CoV-2. Three weeks after the second dose, median IgG titers of the residents and care workers were 83 [interquartile range (IQR) 17-511] and 1365 (IQR 847-2245) U/mL, respectively ( < 0.001).
The humoral response to BNT162b2 among elderly HD patients was relatively low; therefore, the optimal vaccination strategy for this population should be studied further to avoid COVID-19 outbreaks in healthcare facilities.
The online version contains supplementary material available at 10.1186/s41100-022-00397-5.
接受血液透析（HD）的患者面临由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）导致的高死亡风险，因此他们被优先接种疫苗。然而，疫苗在这一脆弱人群中的疗效尚未得到证实。虽然年龄与血清免疫球蛋白（Ig）水平呈负相关，但尚未对接受HD的老年患者接种疫苗后的体液反应进行研究。为解决这一问题，我们评估了BNT162b2疫苗接种后养老院中接受HD的居民体内抗SARS-CoV-2刺突蛋白抗体情况。
本研究纳入了2021年4月至5月期间来自一家养老院的接受HD的患者以及接受两剂BNT162b2疫苗的护理人员（对照组）。排除有COVID-19既往史的患者。使用罗氏公司的电化学发光免疫分析系统检测抗刺突蛋白抗体。
该研究纳入了26名养老院居民（男性占41%；中位年龄86岁）和184名护理人员（男性占28%；中位年龄45岁）。HD的中位病程为51个月。接种两剂BNT162b2后，73%的养老院居民和99.5%的对照组人员产生了足以中和SARS-CoV-2的抗刺突蛋白抗体（>29 U/mL）。第二剂接种三周后，居民和护理人员的中位IgG滴度分别为83 [四分位间距（IQR）17 - 511] 和1365（IQR 847 - 2245）U/mL（<0.001）。
老年HD患者对BNT162b2的体液反应相对较低；因此，应进一步研究针对该人群的最佳疫苗接种策略，以避免医疗机构内发生COVID-19疫情。
在线版本包含可在10.1186/s41100 - 022 - 00397 - 5获取的补充材料。
