Trajectory of Humoral Responses to Two Doses of ChAdOx1 nCoV-19 Vaccination in Patients Receiving Maintenance Hemodialysis

Ling, Tsai-Chieh; Chen, Po‐Lin; Li, Nan-Yao; Ko, Wen–Chien; Sun, Chien Yao; Chao, Jo-Yen; Shieh, Chi‐Chang; Shen, Ching‐Fen; Wu, Jia‐Ling; Huang, Teng-Ching; Chao, Chiao-Hsuan; Wang, Jen Ren; Chang, Yu Tzu

doi:10.1128/spectrum.03445-22

Cited by 4 publications

(7 citation statements)

References 42 publications

(55 reference statements)

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“…At 6 months post 2nd dose, though seropositivity in HDs dropped further to 66.7%, MAB level of patients who remained seropositive had not changed significantly as those with low antibody levels had become seronegative while those with moderate to high antibody appeared able to maintain levels. This is in contrast to other studies where the decay of nAB levels following 2 doses has been shown consistently in both healthy individuals [ 52 , 53 ] and HD patients [ 50 , 54 – 56 ]. These studies varied in terms of the patient demographics (mean age, dialysis vintage, prior infection status etc.)…”

Section: Discussioncontrasting

confidence: 99%

“…HD patients were shown to maintain seropositivity at 98.3% four months after the third dose, though MAB levels reduced [ 16 ]. Importantly, low to moderate levels of Omicron neutralization were seen in patients only after either 3rd dose vaccination or post COVID-19 infection [ 50 , 57 ]. Further, while patients who had COVID-19 (after 2 previous doses) developed nAB levels similar to those who had 3rd dose vaccination (2200 -2500 IU/ml), those who had infection, had a 3.2 fold higher level of Omicron nAB compared to post vaccination individuals [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

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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

Karunathilake,

Kumara,

Karunathilaka

et al. 2024

BMC Nephrol

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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.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Karunathilake,

Kumara,

Karunathilaka

et al. 2024

BMC Nephrol

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“…In December 2022, Beijing, China, witnessed a wave of SARS-CoV-2 infections dominated by the Omicron BF.7 variant. Weakened immune response, prolonged virus clearance, and low vaccination rate render patients undergoing hemodialysis particularly vulnerable [ 1–3 ]. A systematic review and meta-analysis investigating the mortality rate of coronavirus disease 2019 (COVID-19) among hemodialysis patients published in 2022 reported an infection rate of >10%, with a mortality rate of 20%.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and prognosis for coronavirus disease 2019 among 131 hemodialysis patients during the Omicron variant epidemic

Wen

Cai

et al. 2023

Renal Failure

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The present study evaluated the presentations and outcomes of coronavirus disease 2019 (COVID-19) among patients undergoing maintenance hemodialysis (MHD) and the impact of the Omicron BF.7 variant. Adult patients (age ≥ 18 years), who underwent MHD (dialysis vintage ≥ 3 months) at the Hemodialysis Center at Beijing Tsinghua Changgung Hospital between December 2022 and January 2023, were included based on predefined eligibility criteria. Clinical and laboratory characteristics were retrospectively collected. Among 131 patients who underwent MHD (10.7% vaccination rate), 106 (80.9%) tested positive for COVID-19. The prevalence of asymptomatic, mild, moderate, and severe COVID-19 was 8.5%, 58.5%, 17%, and 16%, respectively. Among the 97 patients with symptoms, 23 (23.7%) were hospitalized and six (5.7%) died. Fever was experienced by 74.2% of patients and respiratory symptoms were the most common (81.4%). Residual symptoms persisted in 20.9% of patients one month after the onset of COVID-19. COVID-19-positive hemodialysis patients were more likely to experience weight loss and exhibit reduced albumin levels compared to those without COVID-19 ( p < .05). Compared with the asymptomatic group, patients with symptoms were younger, and exhibited higher interleukin-6 levels and lower post-infection phosphate levels ( p < .05). Age, dialysis vintage, comorbidities, and inflammatory factors were positively associated with disease severity, while baseline albumin and hemoglobulin levels were associated with death ( p < .05). In conclusion, COVID-19 was prevalent among patients undergoing MHD, even during the Omicron variant epidemic. Age, nutritional status, comorbidities, and inflammatory factors were associated with disease severity and prognosis.

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“…Differences in continuous variables between groups were assessed with Mann-Whitney test or Wilcoxon signed-rank test. Even though the sVNT of 30% is arbitrarily set as the cut-off value for adequate neutralizing activity against SARS-CoV-2, a value <30% still represents neutralizing antibody level and correlates with anti-SARS-CoV-2 spike antibody even though it may not be enough to prevent most real life infection [ 28 ]. Therefore, we used the raw data of sVNT for further correlation analysis (Spearman correlation).…”

Section: Methodsmentioning

confidence: 99%

Pre-existing humoral immunity and CD4+ T cell response correlate with cross-reactivity against SARS-CoV-2 Omicron subvariants after heterologous prime-boost vaccination

Shen¹,

Fu²,

Ho³

et al. 2023

Clinical Immunology

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Trajectory of Humoral Responses to Two Doses of ChAdOx1 nCoV-19 Vaccination in Patients Receiving Maintenance Hemodialysis

Cited by 4 publications

References 42 publications

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

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

Risk factors and prognosis for coronavirus disease 2019 among 131 hemodialysis patients during the Omicron variant epidemic

Pre-existing humoral immunity and CD4+ T cell response correlate with cross-reactivity against SARS-CoV-2 Omicron subvariants after heterologous prime-boost vaccination

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