KMID : 1102220220410030342
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Kidney Research and Clinical Practice 2022 Volume.41 No. 3 p.342 ~ p.350
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Humoral response to viral vector COVID-19 vaccine in hemodialysis patients
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Raja Niranjan
Rajagopalan Arul Arunachalam Jegan Prasath Arun Durai Rakesh Rajendran Manorajan
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Abstract
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Background: The coronavirus disease 2019 (COVID-19) vaccine is not readily available in many countries where dosing interval is spaced more than ideal. Patients with chronic kidney disease, especially those on maintenance hemodialysis, have a tendency for a reduced immune response. This study was undertaken to demonstrate the distinct humoral immune response to the viral vector COVID-19 vaccine in patients with kidney failure receiving maintenance hemodialysis.
Methods: The study was carried out with two cohorts: 1) patients receiving maintenance hemodialysis and 2) healthcare workers from the same dialysis center as controls, each group with 72 subjects. Participants received a dose of Covishield ChAdOx1 nCoV-19 coronavirus vaccine. The humoral immunological response was determined using electrochemiluminescence immunoassay which quantitatively measures antibodies to the severe acute respiratory syndrome coronavirus 2 spike protein receptor-binding domain.
Results: All study subjects in the control group developed a humoral response (antibody titer of ¡Ã0.8 U/mL), while only 64 of 72 in the dialysis group (88.9%) were responders. Age (¥ñ = -0.234, p = 0.04) and sodium level (¥ñ = 0.237, p = 0.04) correlated with low antibody titer in bivariate analysis. In multivariate analysis, only age (odds ratio, 1.10; 95% confidence interval, 1.01-1.22; p = 0.045)was associated with nonresponders.
Conclusion: Our study demonstrated a weak antibody response of hemodialysis patients to the viral vector COVID-19 vaccine. Older age was associated with nonresponders. Evaluation of both humoral and cellular immunity after the second vaccine dose and serial antibody titers can help determine the need for booster shots.
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KEYWORD
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Antibody formation, Secondary immunization, Chronic kidney failure, COVID-19, Hemodialysis
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