Li Kejia, Xia Yang, Ye Hua, Sun Xian, Shi Bairu, Wu Jiajun
Department of Nephrology, The First People's Hospital of Jiashan, Jiaxing, Zhejiang 314100, P.R. China.
Biomed Rep. 2024 Mar 19;20(5):78. doi: 10.3892/br.2024.1766. eCollection 2024 May.
The coronavirus disease 2019 (COVID-19) vaccination is the most effective way to prevent COVID-19. However, for chronic kidney disease patients on long-term dialysis, there is a lack of evidence regarding the efficacy and safety of the immune response to the vaccine. The present meta-analysis explores the efficacy and safety of COVID-19 vaccine in the immune response of patients with chronic kidney disease (CKD) undergoing dialysis. PubMed, Web of Science, Science Direct, and Cochrane Library databases were systematically searched from January 1, 2020, to December 31, 2022. Data analysis was performed using REVMAN 5.1s and Stata14 software. Baseline data and endpoint events were extracted, mainly including age, sex, dialysis vintage, body mass index (BMI), vaccine type and dose, history of COVID-19 infection, seropositivity rate, antibody titer, pain at injection site, headache and other safety events. The meta-analysis included 33 trials involving 81,348 patients. The immune efficacy of patients with CKD and dialysis was 80% (95 CI, 73-87%). The seropositivity rate of individuals without COVID-19 infection was 76.48% (3,824/5,000), while the seropositivity rate of individuals with COVID-19 infection was 80.82% (1,858/2,299). The standard mean difference of antibody titers in CKD and dialysis patients with or without COVID-19 infection was 27.73 (95% CI, -19.58-75.04). A total of nine studies reported the most common adverse events: Pain at the injection site, accounting for 18% (95 CI, 6-29%), followed by fatigue and headache, accounting for 8 (95 CI, 4-13%) and 6% (95 CI, 2-9%), respectively. COVID-19 vaccine benefitted patients with CKD undergoing dialysis with seropositivity rate ≥80%. Adverse events such as fatigue, headache, and pain at the injection site may occur after COVID-19 vaccination but the incidence is low.
2019冠状病毒病（COVID-19）疫苗接种是预防COVID-19最有效的方法。然而，对于长期接受透析的慢性肾脏病患者，关于疫苗免疫反应的有效性和安全性缺乏证据。本荟萃分析探讨了COVID-19疫苗在接受透析的慢性肾脏病（CKD）患者免疫反应中的有效性和安全性。系统检索了2020年1月1日至2022年12月31日期间的PubMed、Web of Science、Science Direct和Cochrane图书馆数据库。使用REVMAN 5.1s和Stata14软件进行数据分析。提取基线数据和终点事件，主要包括年龄、性别、透析龄、体重指数（BMI）、疫苗类型和剂量、COVID-19感染史、血清阳性率、抗体滴度、注射部位疼痛、头痛及其他安全事件。该荟萃分析纳入了33项试验，涉及81348例患者。CKD透析患者的免疫效力为80%（95%CI，73-87%）。未感染COVID-19个体的血清阳性率为76.48%（3824/5000），而感染COVID-19个体的血清阳性率为80.82%（1858/2299）。有或无COVID-19感染的CKD透析患者抗体滴度的标准平均差为27.73（95%CI，-19.58-75.04）。共有9项研究报告了最常见的不良事件：注射部位疼痛，占18%（95%CI，6-29%），其次是疲劳和头痛，分别占8%（95%CI，4-13%）和6%（95%CI，2-9%）。COVID-19疫苗使血清阳性率≥80%的CKD透析患者受益。COVID-19疫苗接种后可能会出现疲劳、头痛和注射部位疼痛等不良事件，但发生率较低。
