Department of Nephrology, Ajou University School of Medicine, Suwon, Republic of Korea.
Malgundam Internal Medicine Clinic, Suwon, Republic of Korea.
Medicine (Baltimore). 2023 Sep 29;102(39):e35484. doi: 10.1097/MD.0000000000035484.
Vaccination is important for patients undergoing hemodialysis (HD) to prevent coronavirus disease 2019 (COVID-19) infection since they are more vulnerable. However, they exhibit a weak response to vaccines, underscoring the importance of understanding whether antibodies are sufficiently produced and their durability post-COVID-19 vaccination. This prospective observational study assessed the antibody response of Korean patients undergoing HD for 1 year. We compared the antibody responses of patients undergoing HD to the COVID-19 vaccine with those of healthy volunteers from 2021 to 2022. The patient and control groups received 2 doses of ChAdOx1 nCoV-19 and mRNA-1273, respectively. Immunoglobulin G (IgG) and neutralizing antibody levels were measured weeks or months apart after 2 doses for 1 year using enzyme-linked immunosorbent and fluorescence-based competitive severe acute respiratory syndrome coronavirus 2 neutralizing assays, respectively. We analyzed the third dose's effect on the patient group by categorizing the group into patients who received the third dose and those who did not since it was initiated midway through the study. In the control group, we enrolled participants who had completed 3 doses of mRNA-1273 since almost all participants received the third dose. Thirty-two patients undergoing HD and 15 healthy participants who received 2 doses of ChAdOx1 nCoV-19 and 3 of mRNA-1273, respectively, were enrolled. Although antibody production was weaker in the patient group than in the control group (P < .001), patients showed an increase in IgG levels (0.408 ± 0.517 optical density (OD) pre-vaccination, 2.175 ± 1.241 OD in patients with 2 doses, and 2.134 ± 1.157 OD in patients with 3 doses 1 year after the second dose) and neutralizing antibodies (23 ± 8% pre-vaccination, 87 ± 23% in patients with 2 doses, and 89 ± 18% in patients with 3 doses 1 year after the second dose) post-vaccination (P < .001). In the patient group, 19 patients received a third dose (BNT162b2 or mRNA-1273); however, it did not increase the antibody levels (P = 1.000). Furthermore, the antibodies produced by the vaccination did not wane until 1 year. Two doses of vaccination resulted in a significant antibody response in patients undergoing HD, and antibody levels did not wane until 1 year.
接种疫苗对于接受血液透析（HD）的患者预防 2019 年冠状病毒病（COVID-19）感染非常重要，因为他们更容易受到感染。然而，他们对疫苗的反应较弱，这突显了了解 COVID-19 疫苗接种后抗体是否充分产生及其持久性的重要性。本前瞻性观察研究评估了接受 HD 治疗 1 年的韩国患者的抗体反应。我们比较了接受 HD 治疗的患者与 2021 年至 2022 年接受 COVID-19 疫苗的健康志愿者的抗体反应。患者和对照组分别接受了 2 剂 ChAdOx1 nCoV-19 和 mRNA-1273。使用酶联免疫吸附和基于荧光的竞争性严重急性呼吸综合征冠状病毒 2 中和测定法，在接种 2 剂疫苗后数周或数月测量 1 年的 IgG 和中和抗体水平。由于该研究进行到一半时开始接种第三剂，我们通过将患者组分为接种第三剂和未接种第三剂的患者来分析第三剂对患者组的影响。在对照组中，我们招募了已经完成 3 剂 mRNA-1273 接种的参与者，因为几乎所有参与者都接种了第三剂。共纳入 32 名接受 HD 治疗的患者和 15 名健康参与者，他们分别接受了 2 剂 ChAdOx1 nCoV-19 和 3 剂 mRNA-1273。尽管患者组的抗体产生弱于对照组（P<0.001），但患者的 IgG 水平升高（接种前为 0.408±0.517 光密度（OD），接种 2 剂后为 2.175±1.241 OD，接种 2 剂后 1 年为 2.134±1.157 OD）和中和抗体（接种前为 23±8%，接种 2 剂后为 87±23%，接种 2 剂后 1 年为 89±18%）（P<0.001）。在患者组中，有 19 名患者接受了第三剂（BNT162b2 或 mRNA-1273）；然而，这并没有增加抗体水平（P=1.000）。此外，接种疫苗产生的抗体直到 1 年才消失。两剂疫苗接种可使接受 HD 治疗的患者产生显著的抗体反应，且抗体水平直到 1 年后才下降。
