Werzowa Johannes, Behanova Martina, Handisurya Ammon, Heger Florian, Indra Alexander, Holzer Barbara, Dechat Thomas, Spitzer Silvia, Lederer Sandra, Kraus Daniel A, Zwerina Jochen, Fritsch-Stork Ruth D E
Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1140 Vienna, Austria.
1st Medical Department, Hanusch Hospital, 1140 Vienna, Austria.
J Clin Med. 2023 Jul 28;12(15):4983. doi: 10.3390/jcm12154983.
It is not well established to what extent previous immunizations offer protection against infections with the SARS-CoV-2 Omicron variant in dialysis patients. We aimed to define the relevant humoral response in dialysis patients using a SARS-CoV-2 IgG chemiluminescence microparticle immunoassay (CMIA) compared to the activity of neutralizing antibodies assessed by a virus neutralization test. Next, we aimed to determine differences in humoral and cellular response levels over time among patients infected or not infected by the Omicron variant of SARS-CoV-2. Immunological parameters of cellular and humoral response to SARS-CoV-2 were analyzed at baseline and after 3 (T3), 6 (T6) and 14 months (T14). In this monocentric cohort study, we followed 110 dialysis patients (mean age 68.4 ± 13.7 years, 60.9% male) for a median of 545 days. We determined an anti-SARS-CoV-2 IgG level of 56.7 BAU/mL as an ideal cut-off value with a J-index of 90.7. Patients infected during the Omicron era had significantly lower ( < 0.001) mean antibody levels at T0 (3.5 vs. 111.2 BAU/mL), T3 (269.8 vs. 699.8 BAU/mL) and T6 (260.2 vs. 513.9 BAU/mL) than patients without Omicron infection. Patients who developed higher antibody levels at the time of the basic immunizations were less likely to become infected with SARS-CoV-2 during the Omicron era. There is a need to adjust the cut-off values for anti-SARS-CoV-2 IgG levels in dialysis patients.
既往免疫接种在多大程度上能为透析患者提供针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）奥密克戎变异株感染的保护作用，目前尚无定论。我们旨在通过SARS-CoV-2免疫球蛋白G（IgG）化学发光微粒子免疫分析（CMIA）确定透析患者的相关体液反应，并与通过病毒中和试验评估的中和抗体活性进行比较。接下来，我们旨在确定感染或未感染SARS-CoV-2奥密克戎变异株的患者在不同时间点体液和细胞反应水平的差异。在基线以及3个月（T3）、6个月（T6）和14个月（T14）后，对SARS-CoV-2的细胞和体液反应的免疫学参数进行了分析。在这项单中心队列研究中，我们对110例透析患者（平均年龄68.4±13.7岁，男性占60.9%）进行了为期545天的中位数随访。我们确定抗SARS-CoV-2 IgG水平为56.7 BAU/mL作为理想的临界值，J指数为90.7。在奥密克戎流行时期感染的患者在T0（3.5 vs. 111.2 BAU/mL）、T3（269.8 vs. 699.8 BAU/mL）和T6（260.2 vs. 513.9 BAU/mL）时的平均抗体水平显著低于未感染奥密克戎的患者（<0.001）。在基础免疫接种时产生较高抗体水平的患者在奥密克戎流行时期感染SARS-CoV-2的可能性较小。有必要调整透析患者抗SARS-CoV-2 IgG水平的临界值。
