Vaccination against SARS-CoV-2 in Haemodialysis Patients: Spike's Ab Response and the Influence of BMI and Age

Int J Environ Res Public Health. 2022 Aug 15;19(16):10091. doi: 10.3390/ijerph191610091.

Abstract

Patients with chronic kidney disease (CKD-5D) in dialysis have been associated with higher rates of SARS-CoV-2 infection. Objective: To identify the CKD-5D patients’ immune system behavior regarding the Pfizer-BioNTech (BNT162b2 mRNA) vaccine (Comirnaty©). This was a multicenter study carried out in 38 dialysis units in NephroCare Portugal. Eligible patients from two cohorts—one composed of completely vaccinated patients with Comirnaty© (vaccinated group) against a second cohort of patients who recovered from SARS-CoV-2 infection (control group)—were selected through representative sampling for each cohort. Humoral response was assessed at 3 (t0) and 6 months (t1) after complete vaccination and, in the control group, 6 months after COVID-19 recovery. In the vaccinated group, at t0, the median anti-Spike IgG level was 1120 AU/mL and, at t1, all participants’ antibody level decreased to a median of 455 AU/mL. In the control group, the median serum SARS-CoV-2 antibodies level was 1836 AU/mL. In the vaccinated group, at t0, patients < 70 years presented a significantly (p = 0.002) higher level of anti-Spike IgG titres. In contrast, older patients from the control group presented a significantly (p = 0.038) higher IgG. No correlation was found between age and anti-Spike IgG antibodies level in any of the studied groups. Patients with a higher body mass index showed a greater immune response in both the vaccinated and control group, although without significance. We concluded that, in the vaccinated group, elderly patients developed a lower immune response than younger patients and the levels of anti-Spike IgG antibodies declined faster between t0 and t1, while in the control group, the oldest and overweight patients developed the best humoral response.

Keywords: COVID-19; SARS-CoV-2; antibody; dialysis; immunity; vaccine.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antibodies, Viral
  • BNT162 Vaccine
  • Body Mass Index
  • COVID-19* / prevention & control
  • Humans
  • Immunoglobulin G
  • Renal Dialysis
  • Renal Insufficiency, Chronic*
  • SARS-CoV-2
  • Vaccination

Substances

  • Antibodies, Viral
  • Immunoglobulin G
  • BNT162 Vaccine

Grants and funding

This clinical study benefited from Fresenius Medical Care. The funding had no role in study design, data collection and analysis, or decision to publish.