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Spike and neutralizing antibodies response to COVID-19 vaccination in haemodialysis patients

BACKGROUND: Humoral response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines needs to be evaluated in the fragile population of patients on maintenance haemodialysis (HD). METHODS: We analysed the antibody response to the spike (S) antigen of SARS-CoV-2 before and after...

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Detalles Bibliográficos
Autores principales: Giot, Matthieu, Fourié, Toscane, Lano, Guillaume, Villarroel, Paola Mariela Saba, de Lamballeri, Xavier, Gully, Marion, Samson, Laurent, Farault, Julien, Bouchouareb, Dammar, Jehel, Océane, Brunet, Philippe, Jourde-Chiche, Noémie, Ninove, Laetitia, Robert, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344612/
https://www.ncbi.nlm.nih.gov/pubmed/34603701
http://dx.doi.org/10.1093/ckj/sfab128
Descripción
Sumario:BACKGROUND: Humoral response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines needs to be evaluated in the fragile population of patients on maintenance haemodialysis (HD). METHODS: We analysed the antibody response to the spike (S) antigen of SARS-CoV-2 before and after each dose of the messenger RNA (mRNA) Comirnaty vaccine (BNT162b2; BioNTech & Pfizer) in patients from a single dialysis centre and detected the presence of neutralizing antibodies (Nabs). RESULTS: Among the 90 vaccinated HD patients (mean age 69 years, 61% male), 19 (21%) had a history of SARS-CoV-2 infection. A seroconversion with anti-S immunoglobulin G antibodies (Sabs) was documented in 20% of patients after the first dose (early responders) and in 77% after the second dose, while 23% were non-responders. Cardiac disease, cirrhosis and gamma globulin levels were independently predictive of the absence of seroconversion. Nabs were detected in 15.4% of early responders after the first dose and in 84.6% of early responders and 57.9% of late responders after the second dose. Sab titres after the second dose were higher in patients with Nab than without Nab {598 [interquartile range (IQR) 246–882]) versus 134 [IQR 61–390]; P < 0.0001}. All patients with a history of SARS-CoV-2 infection developed both Sabs and Nabs and their titres for Sabs and Nabs were higher than in late responders. CONCLUSIONS: Most HD patients develop a substantial humoral response against SARS-CoV2, with Nabs, following the mRNA vaccine. Whether this immunity persists over time and is able to efficiently protect patients from coronavirus disease 2019 remains to be determined.