Immunogenicity and safety of SARS-CoV-2 vaccine in hemodialysis patients: A systematic review and meta-analysis

Peiyao, Ren; Yu, Mengjie; Xiaogang, Shen; Wenfang, He; Danna, Zheng; Yuqun, Zeng; Juan, José; He, Qing

doi:10.3389/fpubh.2022.951096

Cited by 12 publications

(10 citation statements)

References 57 publications

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“…The effectiveness of different vaccines against SARS-CoV-2 in patients receiving maintenance dialysis have been extensively studied previously, typically including BNT162b2 (P zer), mRNA-1273 (Moderna), ChAdOx1 nCoV-19 (AstraZeneca), and Ad26.COV2.S (Janssen) vaccines. Initial overall immunogenicity rate in dialysis patients reaches 87-89%, which is slightly lower than that of the general population [11,12]. However, vaccine-induced seroresponse seems to be waning over time across all vaccine types [13].…”

Section: Discussionmentioning

confidence: 92%

Long-term humoral and cellular responses elicited by Gam-COVID-Vac (Sputnik V) vaccine in hemodialysis patients versus non-renal subjects: a prospective cohort study

Parshina,

Zulkarnaev,

Tolkach

et al. 2023

Preprint

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Background we aimed to assess long-term immunogenicity of the recombinant adenovirus 26 and 5 vector-based COVID-19 vaccine Gam-COVID-Vac (Sputnik V, developed by N.F. Gamaleya National Research Centre, Russia) in patients receiving maintenance hemodialysis compared to healthy subjects. Methods a prospective cohort study included patients treated with maintenance hemodialysis (n = 23) and healthy volunteers (n = 28). The levels of anti-severe acute respiratory syndrome coronavirus-2 specific IgG as well as specific T-cell responses were quantified in all participants at two time points: 1 and 6 months after complete vaccination. All participates were adults, had been vaccinated twice with Gam-COVID-Vac and had no prior history of confirmed COVID-19. Results In both groups, IgG levels decreased from month 1 to 6, however, antibodies did not decline more rapidly in the hemodialysis group (analysis of variance p = 0.7214 for the “time × group” interaction, non-adjusted model). At the end of the study, 48% of non-hemodialysis and 67% of hemodialysis participants showed T-cell positivity. T-spot counts dropped over time in non-hemodialysis controls, but not in hemodialysis subjects (p = 0.008 and p = 0.18, respectively). Conclusions Patients receiving hemodialysis maintain significant long-term humoral response after Gam-COVID-Vac vaccination, which is comparable to that in subjects with normal kidney function. Cellular response turned up to be more sustained over time in hemodialysis group.

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Section: Discussionmentioning

confidence: 92%

Long-term humoral and cellular responses elicited by Gam-COVID-Vac (Sputnik V) vaccine in hemodialysis patients versus non-renal subjects: a prospective cohort study

Parshina,

Zulkarnaev,

Tolkach

et al. 2023

Preprint

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“…In a previous study conducted in the ORCHESTRA cohort, we demonstrated that, at 9 months, antibody levels showed a decreasing trend over time without analyzing whether this was dependent on previous diseases or multimorbidity [ 18 ]. Several studies have investigated the humoral response to the SARS-CoV-2 vaccine in patients suffering from cancer, kidney failure, and immunosuppression, showing a lower immune response in these subjects [ 19 , 20 , 21 ]. Similar results were reported among subjects who underwent kidney transplant or who were affected by multiple sclerosis [ 19 , 20 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have investigated the humoral response to the SARS-CoV-2 vaccine in patients suffering from cancer, kidney failure, and immunosuppression, showing a lower immune response in these subjects [ 19 , 20 , 21 ]. Similar results were reported among subjects who underwent kidney transplant or who were affected by multiple sclerosis [ 19 , 20 , 21 , 22 ]. It is worth noting that there are likely many other factors that can influence the immune response to the virus and the vaccines, and more research is needed to fully understand this complex topic.…”

Section: Introductionmentioning

confidence: 99%

Multimorbidity and Serological Response to SARS-CoV-2 Nine Months after 1st Vaccine Dose: European Cohort of Healthcare Workers—Orchestra Project

et al. 2023

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Understanding antibody persistence concerning multimorbidity is crucial for vaccination policies. Our goal is to assess the link between multimorbidity and serological response to SARS-CoV-2 nine months post-first vaccine. We analyzed Healthcare Workers (HCWs) from three cohorts from Italy, and one each from Germany, Romania, Slovakia, and Spain. Seven groups of chronic diseases were analyzed. We included 2941 HCWs (78.5% female, 73.4% ≥ 40 years old). Multimorbidity was present in 6.9% of HCWs. The prevalence of each chronic condition ranged between 1.9% (cancer) to 10.3% (allergies). Two regression models were fitted, one considering the chronic conditions groups and the other considering whether HCWs had diseases from ≥2 groups. Multimorbidity was present in 6.9% of HCWs, and higher 9-months post-vaccine anti-S levels were significantly associated with having received three doses of the vaccine (RR = 2.45, CI = 1.92–3.13) and with having a prior COVID-19 infection (RR = 2.30, CI = 2.15–2.46). Conversely, lower levels were associated with higher age (RR = 0.94, CI = 0.91–0.96), more time since the last vaccine dose (RR = 0.95, CI = 0.94–0.96), and multimorbidity (RR = 0.89, CI = 0.80–1.00). Hypertension is significantly associated with lower anti-S levels (RR = 0.87, CI = 0.80–0.95). The serological response to vaccines is more inadequate in individuals with multimorbidity.

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“…Although the prospect of sterile immunity has diminished considering novel variants, vaccinations are an effective measure against severe and fatal COVID-19 ( 13 ). There is now a large body of evidence displaying that SARS-CoV-2 vaccination elicits a dampened, but still measurable serological response in individuals on HD, who were excluded from initial trials ( 14 ). However, frequent booster shots may be necessary in this population to combat waning immunity and non-responders ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Reduced COVID-19 morbidity and mortality in hemodialysis patients across the various Omicron sublineages—A retrospective analysis

Schuller,

Ginthör,

Paller

et al. 2023

Front. Public Health

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IntroductionHemodialysis (HD) patients are a COVID-19 high risk population due to comorbidities and impaired immune response. Vaccines, advent of effective treatment and the emergence of novel variants have fundamentally changed the pandemic. We aimed to assess temporal changes of COVID-19 in HD patients of our catchment area, and risk factors for severe and fatal course.Methods and materialsWe retrospectively collected data from 274 patients admitted to the Medical University Graz, Austria for HD between 1st of May 2020 and 31st of August 2022. We analyzed clinical and demographic data between different COVID-19 waves and assessed factors associated with hospitalization, ICU admission and mortality by logistic regression. To further evaluate the dialysis at-risk population, we collected demographic and vaccination data between August 2021 and August 2022.ResultsTime of infection and SARS-CoV-2 sequencing data allowed for distinction of five separate waves of infection with different impact on the dialysis population: While in the initial four waves frequencies of hospitalization, necessity of critical care and mortality were around 60%, 10% and 20%, respectively. These events became rare during the large fifth wave, when Omicron had become the dominant variant. Although only 16.9% had to be hospitalized, this resulted in 29 hospital admissions, due to the high prevalence of COVID-19 during the Omicron era. Furthermore, we observed similar clinical outcomes with BA.4/5 as with BA.1/BA.2 Omicron sublineages. The proportion of previously infected increased simultaneously with the number of vaccination doses in our dialysis population. Vaccination at time of positivity and infection with an Omicron variant conferred protection against hospitalization and mortality in univariate analysis, but only infection with an Omicron variant remained a robust predictor for these outcomes in multivariable analysis.DiscussionWhile a fourth of our at-risk population became infected during the Omicron wave, mortality was almost non-existent. Several concomitant factors have contributed to the decrease of COVID-19 severity in HD patients. This trend appears to be continued with BA.4/5, which was equally mild as BA.1 and BA.2 in our well vaccinated dialysis population.

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Immunogenicity and safety of SARS-CoV-2 vaccine in hemodialysis patients: A systematic review and meta-analysis

Cited by 12 publications

References 57 publications

Long-term humoral and cellular responses elicited by Gam-COVID-Vac (Sputnik V) vaccine in hemodialysis patients versus non-renal subjects: a prospective cohort study

Long-term humoral and cellular responses elicited by Gam-COVID-Vac (Sputnik V) vaccine in hemodialysis patients versus non-renal subjects: a prospective cohort study

Multimorbidity and Serological Response to SARS-CoV-2 Nine Months after 1st Vaccine Dose: European Cohort of Healthcare Workers—Orchestra Project

Reduced COVID-19 morbidity and mortality in hemodialysis patients across the various Omicron sublineages—A retrospective analysis

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