Immune Response to Third and Fourth COVID-19 Vaccination in Hemodialysis Patients and Kidney Transplant Recipients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Patients, and Ethical Statement
2.2. Serological Assays Detecting Anti-SARS-CoV-2 Antibodies
2.3. Live Virus Assay to Determine Serum Neutralizing Activity against SARS-CoV-2 Wild Type (WT) and Omicron Variant BA.1
2.4. Determination of T Cell Response to SARS-CoV-2
2.5. Statistics
3. Results
3.1. SARS-CoV-2 Anti-RBD IgG Titers in Hemodialysis Patients after Third and Fourth Vaccination
3.2. Comparison of Anti-Spike IgG Titers Quantified with Different Commercial Serological Assays
3.3. Determination of IgG Titers as a Surrogate Marker of the Neutralizing Activity against SARS-CoV-2 after the Fourth Vaccination in Hemodialysis Patients
3.4. Anti-RBD-IgG Titers with Potential Neutralizing Activity against WT in Dialysis Patients
3.5. Anti-RBD-IgG Titers with Potential Neutralizing Activity against Omicron Variant BA.1 in Dialysis Patients
3.6. Humoral and Cellular Immune Responses after SARS-CoV-2 Vaccination in Kidney Transplant (KTX) Recipients
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Hemodialysis (HD) Patients after Third Vaccination | All HD Patients N = 309 (100%) | 3xBNT162b2 N = 179 (48.8%) | 3xmRNA1273 N = 130 (35.4%) | |
Age in years, median (IQR) | 68 (23.75) | 68 (24) | 66 (23,5) | |
Sex, N (%) | ||||
Female | 119 (38.5) | 72 (40.2) | 47 (36.2) | |
Male | 190 (61.5) | 107 (59.8) | 83 (63.8) | |
Years on hemodialysis, median (IQR) | 4 (5) | 4 (5) | 5 (5) | |
Infection with SARS-CoV-2 before booster-immunization, N | 6 | 5 | 1 | |
Days between second and third vaccine dose (IQR) | 188 (18) | 175 (19) | 189 (19) | |
Hemodialysis (HD) Patients after Fourth Vaccination | All HD Patients N = 182 | 4x BNT162b2 N = 32 (17.6%) | 4x mRNA-1273 N = 118 (64.8%) | 4x cross mRNA N = 32 (17.6%) |
Age in years, median (IQR) | 66 (23.5) | 65 (18.3) | 65 (17.3) | 66 (19) |
Sex, N (%) | ||||
Female | 68 (37.4) | 14 (43.8) | 41 (34.7) | 13 (40.6) |
Male | 114 (62.6) | 18 (56.3) | 77 (65.3) | 19 (59.4) |
Years on hemodialysis, median (IQR) | 4 (7) | 4 (7) | 4 (7) | 5 (6) |
Infection with SARS-CoV-2 before booster-immunization, N (%) | 6 | 5 | 1 | 0 |
Days between second and fourth vaccine dose (IQR) | 308 (25) | 316.5 (18) | 296 (21) | 315.5 (4.5) |
Vaccination Status | SARS-CoV-2 Anti-RBD IgG, Median (IQR) |
---|---|
Three doses (N = 309) | 2882.7 (3093.0) |
Four doses (all vaccines, N = 182) | 6923.5 (8661.2) |
Four doses BNT162b2 (N = 32) | 2741.7 (5327.7) |
Four doses mRNA-1273 (N = 118) | 8078.5 (7579.5) |
Four cross mRNA doses (N = 32) | 9789.3 (8876.3) |
Anti-RBD IgG Wild-Type Cut-Off (≥296 BAU/mL) | N, (%) |
After third dose | |
<296 BAU/mL | 37 (12.0) |
≥296 BAU/mL | 272 (88.0) |
Total | 309 (100.0) |
After fourth dose | |
<296 BAU/mL | 9 (5.0) |
≥296 BAU/mL | 173 (95.0) |
Total | 182 (100.0) |
Anti-RBD IgG omicron cut-off (≥4159 BAU/mL) | N, (%) |
After third dose | |
<4159 BAU/mL | 214 (69.2) |
≥4159 BAU/mL | 95 (30.8) |
Total | 309 (100.0) |
After fourth dose | |
<4159 BAU/mL | 65 (35.7) |
≥4159 BAU/mL | 117 (64.3) |
Total | 182 (100.0) |
Kidney Transplant Recipients (KTX) | N = 36 |
---|---|
Age in years, median (IQR) | 55 (20) |
Sex, N (%) | |
Female | 14 (38.9) |
Male | 22 (61.1) |
Years transplanted, median (IQR) | 2 (4) |
Underlying kidney disease | |
ADPKD | 14 (38.9) |
Diabetic nephropathy | 1 (2.8) |
Glomerulonephritis | 10 (27.8) |
Hypertensive nephropathy | 2 (5.6) |
Other genetic nephropathy | 2 (5.6) |
Unknown | 7 (19.4) |
Donation procedure | |
Living donation | 26 (72.2) |
Living donation, ABO incompatible | 5 (13.9) |
Deceased donation | 10 (27.8) |
Immunosuppressive therapy | |
Tacrolimus, MMF/MPA, Prednisolone | 28 (77.8) |
Tacrolimus, Prednisolone | 5 (13.9) |
Tacrolimus, MMF/MPA | 2 (5.6) |
Tacrolimus, Azathioprine, Prednisolone | 1 (2.8) |
Basic immunization | |
AZD1222 | 3 (8.3) |
BNT162b2 | 26 (72.2) |
mRNA-1273 | 7 (19.4) |
Booster immunization | |
AZD1222 | 2 (5.6) |
BNT162b2 | 29 (80.6) |
Ad26.COV2.S | 1 (2.8) |
mRNA-1273 | 4 (11.1) |
Cellular Immune Response after Second Vaccine Dose | n= | |||
---|---|---|---|---|
Negative | Positive | |||
Anti-RBD IgG after second vaccine dose | negative | 28 | 1 | 29 |
positive | 3 | 0 | 3 | |
n= | 31 | 1 | 32 | |
Cellular immune response after third vaccine dose | n= | |||
negative | positive | |||
Anti-RBD IgG after third vaccine dose | negative | 18 | 1 | 19 |
positive | 9 | 1 | 10 | |
n= | 27 | 2 | 29 |
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Affeldt, P.; Koehler, F.C.; Brensing, K.A.; Gies, M.; Platen, E.; Adam, V.; Butt, L.; Grundmann, F.; Heger, E.; Hinrichs, S.; et al. Immune Response to Third and Fourth COVID-19 Vaccination in Hemodialysis Patients and Kidney Transplant Recipients. Viruses 2022, 14, 2646. https://doi.org/10.3390/v14122646
Affeldt P, Koehler FC, Brensing KA, Gies M, Platen E, Adam V, Butt L, Grundmann F, Heger E, Hinrichs S, et al. Immune Response to Third and Fourth COVID-19 Vaccination in Hemodialysis Patients and Kidney Transplant Recipients. Viruses. 2022; 14(12):2646. https://doi.org/10.3390/v14122646
Chicago/Turabian StyleAffeldt, Patrick, Felix Carlo Koehler, Karl August Brensing, Martin Gies, Eva Platen, Vivien Adam, Linus Butt, Franziska Grundmann, Eva Heger, Steffen Hinrichs, and et al. 2022. "Immune Response to Third and Fourth COVID-19 Vaccination in Hemodialysis Patients and Kidney Transplant Recipients" Viruses 14, no. 12: 2646. https://doi.org/10.3390/v14122646
APA StyleAffeldt, P., Koehler, F. C., Brensing, K. A., Gies, M., Platen, E., Adam, V., Butt, L., Grundmann, F., Heger, E., Hinrichs, S., Kalisch, N., Oehm, S., Steger, G., Wirtz, M., Benzing, T., Stippel, D., Klein, F., Kurschat, C., Müller, R.-U., & Di Cristanziano, V. (2022). Immune Response to Third and Fourth COVID-19 Vaccination in Hemodialysis Patients and Kidney Transplant Recipients. Viruses, 14(12), 2646. https://doi.org/10.3390/v14122646