Neutralization Assessments Reveal High Cardiothoracic Ratio and Old Age as Independent Predictors of Low Neutralizing Antibody Titers in Hemodialysis Patients Receiving a Single Dose of COVID-19 Vaccine

Abstract

Background: Data are lacking regarding predictors of quantification of neutralizing antibodies (nAbs) based on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 50% neutralization titer (NT50) after a single dose of COVID-19 vaccine in hemodialysis (HD) patients. Methods: This prospective single-center study enrolled 200 HD patients and 82 healthy subjects to estimate antibodies against the SARS-CoV-2 viral spike protein 1 and receptor-binding domain after a first dose of a COVID-19 vaccine (ChAdOx1 or mRNA-1273), measured by enzyme-linked immunosorbent assay and applied spline-based generalized additive model regression analysis to predict NT50 converted to international units. Results: After the first dose of ChAdOx1, multiple linear regression showed that age (p = 0.011) and cardiothoracic ratio (p = 0.002) were negatively associated with NT50. Older age (OR = 0.958, p = 0.052) and higher cardiothoracic ratio (OR < 0.001, p = 0.037) could predict negative humoral response (NT50 < 35.13 IU/mL). NT50 was lower in HD patients compared with healthy controls receiving ChAdOx1 (10.68 vs. 43.01 IU/m, p < 0.001) or mRNA-1273 (36.39 vs. 262.2 IU/mL, p < 0.001). ChAdOx1 elicited lower GMTs than mRNA-1273 in the HD cohort (10.68 vs. 36.39 IU/mL, p < 0.001) and in healthy controls (43.01 vs. 262.22 IU/mL, p < 0.001). Conclusion: High cardiothoracic ratio and old age could independently predict a decline in nAb titers in an HD cohort vaccinated with a single dose of ChAdOx1.

Titers and breadth of neutralizing antibodies against SARS-CoV-2 variants after heterologous booster vaccination in health care workers primed with two doses of ChAdOx1 nCov-19: A single-blinded, randomized clinical trial

“…SARS-CoV-2 nucleocapsid IgG were measured for confirmation of previous infection by Roche Elecsys Anti-SARS-CoV-2 [17] . The MeDiPro SARS-CoV-2 Antibody ELISA kit, based on the binding affinity of S1 and RBD domains to antibodies, was designed to indirectly quantify SARS-CoV-2 neutralizing antibodies in the serum [18] . Values <12 IU/mL were considered negative results.…”

“…Values <12 IU/mL were considered negative results. Similar to other quantitative serological tests using different technologies, the MeDiPro SARS-CoV-2 Antibody ELISA assay was able to detect the trend in terms of humoral response magnitude and of variants of concern (VOCs) neutralizing ability levels [ 18 , 19 ]. The kit was approved by Taiwan FDA (No.…”

Humoral immune response to an mRNA-1273 booster after chAdOx1-nCoV-19-priming among patients undergoing hemodialysis

“…Linear regression models were used to evaluate the relationship between the baseline characteristics and the outcomes of interest. Models were adjusted for patient characteristics, which were selected on the basis of clinical relevance and the results from prior studies and included age, sex, body mass index (BMI), diabetes, CAD, the use of immunosuppressants, serum albumin levels, and the lymphocyte count [ 4 - 6 ]. Two-tailed P < 0.05 were considered to indicate statistical significance.…”

Titers and capacity of neutralizing antibodies against SARS-CoV-2 variants after heterologous booster vaccination in health care workers primed with two doses of ChAdOx1 nCov-19: a single-blinded, randomized clinical trial

“…SARS-CoV-2 nucleocapsid IgG were measured for confirmation of previous infection with the use of Roche Elecsys Anti-SARS-COV-2 [16]. The MeDiPro SARS-CoV-2 Antibody ELISA kit, based on the binding affinity of S1 and RBD domains to antibodies, was designed to indirectly quantify SARS-CoV-2 neutralizing antibodies in the serum [17]. Values <12 IU/mL were considered negative.…”