Short-term antibody response after 1 dose of BNT162b2 vaccine in patients receiving hemodialysis

被引：36

作者：

Goupil, Remi ^{[1
]}

Benlarbi, Mehdi ^{[2
]}

Beaubien-Souligny, William

Nadeau-Fredette, Annie-Claire ^{[3
]}

Chatterjee, Debashree ^{[2
]}

Goyette, Guillaume ^{[2
]}

Gunaratnam, Lakshman ^{[4
,5
]}

Lamarche, Caroline ^{[3
]}

Tom, Alexander ^{[6
]}

Finzi, Andres ^{[2
,7
,8
]}

Suri, Rita S. ^{[2
,6
,9
]}

机构：

[1] Hop Sacre Coeur Montreal, Ctr Rech, Montreal, PQ, Canada

[2] Ctr Hosp Univ Montreal CHUM, Ctr Rech, Montreal, PQ, Canada

[3] Hop Maison Neuve Rosemont, Ctr Rech, Montreal, PQ, Canada

[4] Western Univ, Dept Microbiol & Immunol, London, ON, Canada

[5] Western Univ, Dept Med, Div Nephrol, London, ON, Canada

[6] McGill Univ, Hlth Ctr, Res Inst, Montreal, PQ, Canada

[7] Univ Montreal, Dept Microbiol Infectiol & Immunol, Montreal, PQ, Canada

[8] McGill Univ, Dept Microbiol & Immunol, Montreal, PQ, Canada

[9] McGill Univ, Div Nephrol, Dept Med, Montreal, PQ, Canada

来源：

CANADIAN MEDICAL ASSOCIATION JOURNAL | 2021年 / 193卷 / 22期

基金：

加拿大健康研究院;

关键词：

PROTECTION; DIALYSIS;

D O I：

10.1503/cmaj.210673

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND: Patients receiving in-centre hemodialysis are at high risk of exposure to SARS-CoV-2 and death if infected. One dose of the BNT162b2 SARS-CoV-2 vaccine is efficacious in the general population, but responses in patients receiving hemodialysis are uncertain. METHODS: We obtained serial plasma from patients receiving hemodialysis and health care worker controls before and after vaccination with 1 dose of the BNT162b2 mRNA vaccine, as well as convalescent plasma from patients receiving hemodialysis who survived COVID-19. We measured anti-receptor binding domain (RBD) immunoglobulin G (IgG) levels and stratified groups by evidence of previous SARS-CoV-2 infection. RESULTS: Our study included 154 patients receiving hemodialysis (135 without and 19 with previous SARS-CoV-2 infection), 40 controls (20 without and 20 with previous SARS-CoV-2 infection) and convalescent plasma from 16 patients. Among those without previous SARS-CoV-2 infection, anti-RBD IgG was undetectable at 4 weeks in 75 of 131 (57%, 95% confidence interval [CI] 47% to 65%) patients receiving hemodialysis, compared with 1 of 20 (5%, 95% CI 1% to 23%) controls (p < 0.001). No patient with nondetectable levels at 4 weeks developed anti-RBD IgG by 8 weeks. Results were similar in non-immunosuppressed and younger individuals. Three patients receiving hemodialysis developed severe COVID-19 after vaccination. Among those with previous SARS-CoV-2 infection, median anti-RBD IgG levels at 8 weeks in patients receiving hemodialysis were similar to controls at 3 weeks (p = 0.3) and to convalescent plasma (p = 0.8). INTERPRETATION: A single dose of BNT162b2 vaccine failed to elicit a humoral immune response in most patients receiving hemodialysis without previous SARS-CoV-2 infection, even after prolonged observation. In those with previous SARS-CoV-2 infection, the antibody response was delayed. We advise that patients receiving hemodialysis be prioritized for a second BNT162b2 dose at the recommended 3-week interval.

引用

页码：E793 / E800

页数：8

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