Reduced CoronaVac vaccine antibody response in patients with chronic kidney disease

Akpolat, T.

doi:10.1007/s11255-021-03023-1

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…The immune response following COVID-19 vaccine in patients on MHD was generally comparable to healthy population in some studies [10][11][12]. On the other hand, lower immune response was found in others [13].…”

Section: Introductionmentioning

confidence: 52%

Untitled

2022

JCCM

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Background: Patients with end stage renal disease (ESRD) on maintenance hemodialysis (ESRD on MHD) are at high risk of contracting SARS-CoV-2 and developing severe COVID-19 infection. An altered immunologic response to COVID-19 vaccines was reported in this population. This study aimed to assess the level of anti-Spike antibody 2 weeks after 4 doses of COVID-19 vaccine in patients on MHD. Methods:A cross-sectional descriptive study was conducted in August 2022 among patients with ESRD on MHD who received COVID-19 vaccine 4 doses; last dose was 2 weeks ago. Data were collected by using standardized forms and analysis was done.Results: A total of 61 patients with ESRD on maintenance hemodialysis (ESRD on MHD) were included; all patients had raised anti-Spike antibody level; the median anti-Spike antibody level was 3912 U/mL. The mean age was 51.15 ± 12.85 years. The older age group (over 50 years) had higher anti-Spike antibody level than younger age group (less than 50 years), 4175.5 U/mL and 3024.5 U/ mL respectively. Mean BMI (dry weight) was 19.93 ± 2.83 kg/m2. Anti-Spike antibody level was highest in normal BMI group 4117 U/mL; 3180 U/mL in overweight group; and, the lowest 1680 U/mL in underweight group. This study included male 26 (42.6%) and female 35 (57.4%); no difference in anti-Spike antibody level between male (3928 U/mL) and female (3912 U/mL). Nearly 70% of them had history of COVID-19 infection and they had higher anti-Spike antibody level (4400 U/mL) than those without infection (2355 U/mL). Those with diabetes mellitus had significantly higher anti-Spike antibody level (11,935 U/mL) than those without diabetes mellitus (3,155 U/mL). Anti-Spike antibody level in smokers (3149 U/mL) was lower than that of non-smoker (4059 U/ mL). Those who got vaccinated in the morning had higher antibody level (4232 U/mL) than who got in the afternoon (3003 U/mL). Antibody response decreased with falling hemoglobin; mild anemia (4232 U/mL); moderate anemia (3103.5 U/mL); and severe anemia (1680 U/mL). Presence of diabetes mellitus was the only significant predictor for anti-Spike antibody level on univariable analysis.

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Section: Introductionmentioning

confidence: 52%

Untitled

2022

JCCM

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“…The immune response following COVID-19 vaccine in patients on MHD was interesting; it was generally comparable to healthy population in some studies (Sanders et al, 2022) (Park et al, 2022. Nonetheless, lower immune response was found in others (Akpolat, 2022) Reported clinical predictors of antibody positive response toward COVID-19 vaccination were age, previous infection (Aoun et al, 2022), immunosuppressive therapy, body mass index, iron deficiency anemia ) (Preston et al, 2021 and serum albumin level (Aoun et al, 2022). Longer vintage of end-stage kidney disease, and lower pre-vaccination serum albumin were related with response to vaccine in patients on MHD (Anand et al, 2021).…”

Section: Introductionmentioning

confidence: 92%

Effectiveness of 4 doses of COVID-19 vaccine in patients on maintenance hemodialysis in 5th wave of COVID-19 infection in Myanmar: Do we need 5 doses?

Pyar

Myint

Hla

et al. 2022

IJMSCRS

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Background: Patients on maintenance hemodialysis (MHD) are at high risk of contracting SARS-CoV-2 and developing severe COVID-19 infection because they have low innate immunity as well as poor antibody response to COVID-19 vaccine. This study aimed to assess the effectiveness of 4 doses of COVID-19 vaccine in preventing 5th wave of COVID-19 infections in patients on maintenance hemodialysis in Myanmar. Methods: A hospital-based descriptive study was conducted in July 2022 to November 2022 among patients on MHD who received COVID-19 vaccine 4 doses; last dose was 2 weeks ago. Data were collected by using standardized forms and analysis was done. Results: A total of 61 patients on maintenance hemodialysis ( MHD) who had 4 doses of COVID-19 vaccination more than 2 weeks were included. Nasopharyngeal swab PCR was taken twice a week to all patients (if they did not have symptoms) and it was repeated if they had symptoms suggestive of COVID-19 infection or they had history of contact with patients having COVID-19 infection. Their signs and symptoms were analyzed; chest radiograph and blood tests were taken if indicated. Then, the severity of COVID-19 infection was determined according to WHO criteria and they were given treatment according to hospital guideline. They were followed up till 28 days. The base line characteristics were as follows: mean age was 51.15 ± 12.85 years; male to female ratio was 4:6; mean BMI was 19.93 ± 2.83 kg/m2; 16.4%(10/61) had diabetic nephropathy; 9.8%(6/61) had cerebrovascular accident; 24.6%(15/61) had coronary heart disease; and one fifth of them were current smokers. Sixty six percent had past history of COVID-19 infection; duration from last infection was 404 days. Thirty three percent of cases had shortest duration of hemodialysis (6 months) and 23% were over 3 years. Mean duration from last vaccination was 39 days. Thirty six percent (22/61) had confirmed COVID-19 infection and 64% (39/61) of them were not infected till the end of 5th wave. All infected cases were mild form according to WHO criteria; none of them required oxygen therapy. One case having multiple comorbidities (lymphoma, coronary heart disease, hypertension and malignant cachexia) had sudden death due to pulmonary embolism. Conclusions: The protection rate of four doses of COVID-19 vaccine in patients on MHD was not good as 36% of them were infected in the 5th wave of epidemic in Myanmar. However, all the infected cases were mild form and they did not need oxygen therapy showing that booster vaccination prevented morbidity and mortality. Therefore, the protection rate of four doses of COVID-19 vaccine in patients on MHD was nearly 65%; it reduced the severe form of infection and death. Fifth dose of COVID-19 vaccine is necessary along with personnel protective measures.

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