Factors predictive of anti-spike antibody titers after COVID-19 vaccination in hemodialysis patients.

Autor:	Aoun M; Department of Nephrology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.; Department of Nephrology, Saint-George Hospital Ajaltoun, Lebanon., Kahwaji RM; Department of Internal Medicine, Holy Spirit University Kaslik, Lebanon., Sleilaty G; Department of Biostatistics and Clinical Research Center, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon., Boueri C; Department of Nephrology, Saint-George Hospital Ajaltoun, Lebanon., Hawi J; Department of Nephrology, Saint-George Hospital Ajaltoun, Lebanon., Khalil CB; Laboratory Department, Saint-George Hospital Ajaltoun, Lebanon., Hage V; Department of Nephrology, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.; Department of Nephrology, Centre Hospitalier de Bhannes, Lebanon.
Jazyk:	angličtina
Zdroj:	Advances in clinical and experimental medicine : official organ Wroclaw Medical University [Adv Clin Exp Med] 2022 Aug; Vol. 31 (8), pp. 855-861.
DOI:	10.17219/acem/147360
Abstrakt:	Background: Hemodialysis (HD) patients have a high prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mortality, but they may have a weak response to coronavirus disease 2019 (COVID-19) vaccines. Objectives: This study aimed to evaluate factors predictive of humoral response in HD patients vaccinated against SARS-CoV-2 infection. Material and Methods: This is a 2-center observational study including HD patients who received the BNT162b2 mRNA vaccine followed by serological measurements 20 days and 4 weeks after the 1st and 2nd dose, respectively. Healthy controls were included. Anti-spike antibody was measured using the chemiluminescent immunoassay (CLIA) method. The quantile regression analysis was performed to assess factors associated with anti-spike antibody titers. Results: Seventy-two HD patients and 22 healthy controls were included. Mean age of dialysis patients and controls was 72.5 ±11.5 years and 45.7 ±17.4 years, respectively. In the HD group, median levels of anti-spike antibody were 3 (interquartile range (IQR): 0.5-26) UI/mL and 391 (IQR: 55-1642) UI/mL after the 1st and 2nd dose, respectively, with response rates of 62.5% and 96.7%. The median level of the anti-spike antibody after the 1st dose in previously infected patients was 8571 (IQR: 2586-19147) UI/mL. There was a significant correlation between anti-spike antibody levels after the 2nd dose and age and anti-hepatitis B surface (HBs) antibody and serum albumin levels (Spearman's rho: r = -0.289, p < 0.001; r = 0.357, p = 0.027; r = 0.317; p = 0.026, respectively). The regression analysis showed a significant association of previous infection and anti-Hbs antibody level with anti-spike antibody level after the 1st dose of vaccine (p < 0.001). After a 5-month follow-up, 2 vaccinated patients contracted COVID-19. Conclusions: This study showed a response rate of 96.7% to 2 doses of BNT162b2 mRNA vaccine in HD patients and 100% to a single dose in previously infected patients. The level of anti-spike antibody can be predicted by age, anti-Hbs antibodies, serum albumin, and previous infection. Despite the immunization of patients, preventive measures should be maintained in all dialysis units.
Databáze:	MEDLINE
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