Torres Rubén, Toro Luis, Sanhueza María Eugenia, Lorca Eduardo, Ortiz Mireya, Pefaur Jacqueline, Clavero Rene, Machuca Eduardo, Gonzalez Fernando, Herrera Patricia, Mocarquer Alfredo, Frias Alondra, Roessler Eric, Muñoz Carolina, Nuñez Miguel, Aravena Cesar, Quintana Enrique, Lemus Juan, Lillo Mario, Reynolds Enrique, Morales Alvaro, Pais Edgard, Fiabane Andrea, Parra-Lucares Alfredo, Garrido Cristian, Mendez-Valdes Gabriel, Villa Eduardo, Mansilla Rodrigo, Sotomayor Germana, Gonzalez Marcela, Miranda Cecilia, Briones Eduardo, Gomez Esteban, Mezzano Sergio, Bernales Waldo, Rocca Ximena, Espinoza Oscar, Zuñiga Eric, Aragon Henry, Badilla Marta, Valenzuela Marcela, Escobar Luis, Zamora Daniela, Flores Ivan, Tapia Beatriz, Borquez Tamara, Herrera Patricio
Fuerza de Trabajo anti COVID-19, Sociedad Chilena de Nefrología, Chile.
Division of Nephrology, Department of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile.
Kidney Int Rep. 2022 Oct;7(10):2176-2185. doi: 10.1016/j.ekir.2022.07.007. Epub 2022 Jul 16.
The COVID-19 pandemic is a global public health problem. Patients with end-stage renal disease on hemodialysis are at a higher risk of infection and mortality than the general population. Worldwide, a vaccination campaign has been developed that has been shown to reduce severe infections and deaths in the general population. However, there are currently limited data on the clinical efficacy of vaccinations in the hemodialysis population.
A national multicenter observational cohort was performed in Chile to evaluate the clinical efficacy of anti-SARS-CoV-2 vaccination in end-stage renal disease patients on chronic hemodialysis from February 2021 to August 2021. In addition, the BNT162b2 (Pfizer-BioNTech) and CoronaVac (Sinovac) vaccines were evaluated. The efficacy of vaccination in preventing SARS-CoV-2 infection, hospitalizations, and deaths associated with COVID-19 was determined.
A total of 12,301 patients were evaluated; 10,615 (86.3%) received a complete vaccination (2 doses), 490 (4.0%) received incomplete vaccination, and 1196 (9.7%) were not vaccinated. During follow-up, 1362 (11.0%) patients developed COVID-19, and 150 died (case fatality rate: 11.0%). The efficacy of the complete vaccination in preventing infection was 18.1% (95% confidence interval [CI]:11.8-23.8%), and prevention of death was 66.0% (95% CI:60.6-70.7%). When comparing both vaccines, BNT162b2 and CoronaVac were effective in reducing infection and deaths associated with COVID-19. Nevertheless, the BNT162b2 vaccine had higher efficacy in preventing infection (42.6% vs. 15.0%) and deaths (90.4% vs. 64.8%) compared to CoronaVac.
The results of our study suggest that vaccination against SARS-CoV-2 in patients on chronic hemodialysis was effective in preventing infection and death associated with COVID-19.
新冠疫情是一个全球公共卫生问题。接受血液透析的终末期肾病患者比普通人群感染和死亡风险更高。在全球范围内，已开展了一项疫苗接种运动，该运动已被证明可减少普通人群中的严重感染和死亡。然而，目前关于血液透析人群疫苗接种临床疗效的数据有限。
在智利进行了一项全国多中心观察性队列研究，以评估2021年2月至2021年8月期间慢性血液透析的终末期肾病患者中抗SARS-CoV-2疫苗接种的临床疗效。此外，还评估了BNT162b2（辉瑞-生物科技公司）和科兴新冠疫苗。确定了疫苗接种在预防SARS-CoV-2感染、住院和与新冠相关的死亡方面的疗效。
共评估了12301名患者；10615名（86.3%）接受了全程接种（2剂），490名（4.0%）接受了不完全接种，1196名（9.7%）未接种。在随访期间，1362名（11.0%）患者感染了新冠，150人死亡（病死率：11.0%）。全程接种预防感染的疗效为18.1%（95%置信区间[CI]：11.8-23.8%），预防死亡的疗效为66.0%（95%CI：60.6-70.7%）。比较两种疫苗时，BNT162b2和科兴新冠疫苗在减少与新冠相关的感染和死亡方面均有效。然而，与科兴新冠疫苗相比，BNT162b2疫苗在预防感染（42.6%对15.0%）和死亡（90.4%对64.8%）方面具有更高的疗效。
我们的研究结果表明，慢性血液透析患者接种抗SARS-CoV-2疫苗可有效预防与新冠相关的感染和死亡。
