Jacobson-Naftali Merav, Azoulay Odile, Frishman Sigal, Godny Lihi, Zingerman Boris, Rozen-Zvi Benaya, Agur Timna
Nephrology & Hypertension Department, Rabin Medical Center, Petaḥ Tikva 4941492, Israel.
Nutrition Unit, Nephrology & Hypertension Department, Rabin Medical Center, Petaḥ Tikva 4941492, Israel.
Vaccines (Basel). 2023 Jun 24;11(7):1141. doi: 10.3390/vaccines11071141.
Hemodialysis patients are highly susceptible to poor nutritional status. Our objective was to investigate whether poor nutritional status during mRNA-SARS-CoV-2 vaccination is correlated with impaired vaccine responses. This retrospective study was conducted in two hospital-based dialysis units. The nutritional status of hemodialysis patients was assessed, using a malnutrition inflammation score (MIS) at the time of their first BNT162b2 vaccine dose. One month after the second vaccine dose, we performed a quantitative assessment of antibodies against the spike protein (anti-S1 IgG). A total of 115 hemodialysis patients, with an average age of 72 were enrolled in the study. Among them, 39 (33.9%) were female, and 67 (58.2%) had diabetes mellitus. In 43/115 (37.4%) patients, moderate to severe malnutrition (MIS > 5) was detected. Comparatively, malnourished patients showed a lower log-transformed mean level of anti-S1 IgG compared to those with normal nutrition (2.91 ± 0.83 vs. 3.25 ± 0.72, respectively, = 0.024). In a multivariable analysis that adjusted for age, sex, and KT/V, the nutritional status assessed by an MIS remained inversely associated with an anti-S1 IgG response [B; -0.066 (-0.117 to -0.015)]. In conclusion, moderate to severe malnutrition in hemodialysis patients is associated with reduced humoral responses to BNT162b2 vaccination.
血液透析患者极易出现营养状况不佳的情况。我们的目的是调查mRNA-SARS-CoV-2疫苗接种期间营养状况不佳是否与疫苗反应受损相关。这项回顾性研究在两个医院的透析科室进行。在首次接种BNT162b2疫苗时，使用营养不良炎症评分（MIS）对血液透析患者的营养状况进行评估。在第二次接种疫苗一个月后，我们对针对刺突蛋白的抗体（抗S1 IgG）进行了定量评估。共有115名平均年龄为72岁的血液透析患者纳入研究。其中，39名（33.9%）为女性，67名（58.2%）患有糖尿病。在43/115（37.4%）名患者中，检测到中度至重度营养不良（MIS>5）。相比之下，营养不良患者的抗S1 IgG对数转换平均水平低于营养正常的患者（分别为2.91±0.83和3.25±0.72，P = 0.024）。在一项对年龄、性别和KT/V进行校正的多变量分析中，通过MIS评估的营养状况仍然与抗S1 IgG反应呈负相关[B；-0.066（-0.117至-0.015）]。总之，血液透析患者的中度至重度营养不良与BNT162b2疫苗接种后的体液反应降低有关。
