Risk of strong antibody decline in dialysis and transplant patients after SARS-CoV-2mRNA vaccination: Six months data from the observational Dia-Vacc study.

Autor:	Stumpf J; Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.; KfH-Nierenzentrum Dresden, Dresden, Germany., Schwöbel J; Dialysezentrum Chemnitz, Chemnitz, Germany., Lindner T; Division of Nephrology, University Hospital Leipzig, Leipzig, Germany., Anders L; Dialysepraxis Leipzig, Leipzig, Germany., Siepmann T; KfH-Nierenzentrum am Klinikum Chemnitz, Krankenhaus Küchwald, Chemnitz, Germany., Karger C; KfH-Nierenzentrum am Klinikum St. Georg, Leipzig, Germany., Hüther J; Nephrocare GmbH Döbeln, Döbeln, Germany., Martin H; Nephrologisches Zentrum Zwickau, Zwickau, Germany., Müller P; PHV Dialysezentrum Dresden-Johannstadt, Dresden, Germany., Faulhaber-Walter R; Nephrologisches Zentrum Freiberg, Freiberg, Germany., Langer T; Dialysezentrum Annaberg, Annaberg-Buchholz, Germany., Schirutschke H; PHV Dialysezentrum Dresden Friedrichstadt, Dresden, Germany., Stehr T; KfH-Nierenzentrum Bautzen, Bautzen, Germany., Meistring F; KfH-Nierenzentrum am Städtischen Klinikum Görlitz, Görlitz, Germany., Pietzonka A; Via medis Nierenzentrum Dresden MVZ GmbH, Dresden, Germany., Anding-Rost K; KfH-Nierenzentrum Bischofswerda, Bischofswerda, Germany., Escher K; KfH-Gesundheitszentrum Aue, Aue-Bad-Schlema, Germany., Pistrosch F; Nephrologisches Zentrum Hoyerswerda, Hoyerswerda, Germany., Schewe J; Dialyse- und Nierenambulanz Sebnitz, Sebnitz, Germany., Seidel H; KfH-Nierenzentrum am Vogtland Krankenhaus Plauen, Plauen, Germany., Barnett K; Dialyse Heidenau, Heidenau, Germany., Pluntke T; KfH-Nierenzentrum Grimma, Grimma, Germany., Cerny S; ELBLAND Dialyse Großenhain, Großenhain, Germany., Paliege A; Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Bast I; Dialysepraxis Leipzig, Leipzig, Germany., Steglich A; Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Gembardt F; Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Kessel F; Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Kröger H; Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Arndt P; Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Sradnick J; Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Frank K; Institut für Transfusionsmedizin Plauen, DRK-Blutspendedienst Nord-Ost Gemeinnützige GmbH, Plauen, Germany., Klimova A; National Center for Tumor Diseases (NCT) Partner Site Dresden, Dresden, Germany., Mauer R; Faculty of Medicine Carl Gustav Carus, Institute for Medical Informatics and Biometry (IMB), Technische Universität, Dresden, Germany., Grählert X; Coordinating Centre for Clinical Trials, Dresden, Germany., Tonn T; Institute for Transfusion Medicine, German Red Cross Blood Donation Service North-East, Dresden, Germany.; Faculty of Medicine Carl Gustav Carus, Transfusion Medicine, Technische Universität, Dresden, Germany., Hugo C; Medizinische Klinik und Poliklinik III, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.; KfH-Nierenzentrum Dresden, Dresden, Germany.
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Europe [Lancet Reg Health Eur] 2022 Apr 11; Vol. 17, pp. 100371. Date of Electronic Publication: 2022 Apr 11 (Print Publication: 2022).
DOI:	10.1016/j.lanepe.2022.100371
Abstrakt:	Background: Vulnerable dialysis and kidney transplant patients show impaired seroconversion rates compared to medical personnel eight weeks after SARS-CoV-2mRNA vaccination. Methods: We evaluated six months follow up data in our observational Dia-Vacc study exploring specific cellular (interferon-γ release assay) or/and humoral immune responses after 2x SARS-CoV-2mRNA vaccination in 1205 participants including medical personnel (125 MP), dialysis patients (970 DP) and kidney transplant recipients (110 KTR) with seroconversion ( de novo IgA or IgG antibody positivity by ELISA) after eight weeks. Findings: Six months after vaccination, seroconversion remained positive in 98% of MP, but 91%/87% of DP/KTR ( p  = 0·005), respectively. Receptor binding domain-IgG (RBD-IgG) antibodies were positive in 98% of MP, but only 68%/57% of DP/KTR ( p  < 0·001), respectively. Compared to MP, DP and KTR were at risk for a strong IgG or RBD-IgG decline ( p  < 0·001). Within the DP but not KTR group male gender, peritoneal dialysis, short time on dialysis, BNT162b2mRNA vaccine, immunosuppressive drug use and diabetes mellitus were independent risk factors for a strong decline of IgG or RBD antibodies. The percentage of cellular immunity decline was similar in all groups. Interpretation: Both vulnerable DP and KTR groups are at risk for a strong decline for IgG and RBD antibodies. In KTR, antibody titres peak at a markedly lower level and accelerated antibody decline is mixed with a delayed/increasing IgG, RBD-IgG, or cellular immune response in a 16% fraction of patients. In both populations, immune monitoring should be used for early timing of additional booster vaccinations. Funding: This study was funded by the Else Kröner Fresenius Stiftung, Bad Homburg v. d. H., grant number Fördervertrag EKFS 2021_EKSE.27. Competing Interests: JS, JSc, TL, LA, TS, CK, JH, HM, PM, RF-W, TLa, HS, TSt, FM, AP, KA-R, KE, FP, JeS, HSe, KB, TP, SC, APa, IB, AS, FG, FK, HK, PA, JSr, KF, AK, RM, XG, and TT have no conflict of interests. (© 2022 The Author(s).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu