18-month longitudinal SARS COV-2 neutralizing antibody dynamics in haemodialysis patients receiving heterologous 3-dose vaccination (AZD-1222- AZD-1222- BNT162b2) in a lower middle income setting.

Autor: Karunathilake RP; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400, Sri Lanka., Kumara RA; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400, Sri Lanka., Karunathilaka A; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400, Sri Lanka., Wazil AWM; Nephrology Unit, National Hospital Kandy, Kandy, 20000, Sri Lanka., Nanayakkara N; Nephrology Unit, National Hospital Kandy, Kandy, 20000, Sri Lanka., Bandara CK; Nephrology Unit, National Hospital Kandy, Kandy, 20000, Sri Lanka., Abeysekera RA; Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400, Sri Lanka.; Center for Education, Research and Training in Kidney Disease (CERTKiD), University of Peradeniya, Peradeniya, 20400, Sri Lanka., Noordeen F; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400, Sri Lanka., Gawarammana IB; Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400, Sri Lanka., Ratnatunga CN; Department of Microbiology, Faculty of Medicine, University of Peradeniya, Peradeniya, 20400, Sri Lanka. champa.ratnatunga@med.pdn.ac.lk.
Jazyk: angličtina
Zdroj: BMC nephrology [BMC Nephrol] 2024 May 22; Vol. 25 (1), pp. 176. Date of Electronic Publication: 2024 May 22.
DOI: 10.1186/s12882-024-03599-7
Abstrakt: Background: Patients with chronic kidney disease on haemodialysis (HD) were given priority COVID-19 vaccination due to increased disease risk. The immune response to COVID-19 vaccination in patients on HD was diminished compared to healthy individuals in 2-dose studies. This study aimed to evaluate seroconversion rate, neutralizing antibody (nAB) levels and longitudinal antibody dynamics to 3-dose heterologous vaccination against COVID-19 in a cohort of HD patients compared to healthy controls and assess patient factors associated with antibody levels.
Methods: This study was a case-control longitudinal evaluation of nAB dynamics in 74 HD patients compared to 37 healthy controls in a low/middle income setting. Corresponding samples were obtained from the two cohorts at time-points (TP) 1-1-month post 2nd dose of AZD1222 vaccine, TP2- 4 months post 2nd dose, TP4- 2 weeks post 3rd dose with BNT162b2 vaccine, TP5-5 months post 3rd dose and TP6-12 months post 3rd dose. Additional data is available at TP0- pre 2nd dose and TP3- 6 months post 2nd dose in HC and HD cohorts respectively. Anti-SARS-CoV-2 nAB were detected using Genscript cPassTM pseudoviral neutralization kit. Demographic and clinical details were obtained using an interviewer administered questionnaire.
Results: Cohorts were gender matched while mean age of the HD cohort was 54.1yrs (vs HCs mean age, 42.6yrs, p < 0.05). Percentage seroconverted and mean/median antibody level (MAB) in the HD cohort vs HCs at each sampling point were, TP1-83.7% vs 100% (p < 0.05), MAB-450 IU/ml vs 1940 IU/ml (p < 0.0001); TP2-71.4% vs 100%, (p < 0.001), MAB- 235 IU/ml vs 453 IU/ml, (p < 0.05); TP4-95.2% vs 100% (p > 0.05), MAB-1029 IU/ml vs 1538 IU/ml (p < 0.0001); TP5-100% vs 100%, MAB-1542 IU/ml vs 1741IU/ml (p > 0.05); TP6-100% vs 100%, MAB-1961 IU/ml vs 2911 IU/ml (p > 0.05). At TP2, patients aged < 60 years (p < 0.001) were associated with maintaining seropositivity compared to patients > 60 years.
Conclusion: Two dose vaccination of haemodialysis patients provided poor nAB levels which improved markedly following 3rd dose vaccination, the effect of which was long- lasting with high nAB levels in both patients and controls detectable at 1 year follow-up.
(© 2024. The Author(s).)
Databáze: MEDLINE
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