Abstract: PO0144
Immunogenic Response of Hemodialysis Patients to COVID-19 Vaccine: A Multicenter Study
Session Information
- COVID-19: Vaccines, Diagnosis, and Treatment
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Angel-Korman, Avital, Samson Assuta University Hospital, Ashdod, Israel
- Brosh-Nissimov, Tal, Samson Assuta University Hospital, Ashdod, Israel
- Leiba, Adi, Samson Assuta University Hospital, Ashdod, Israel
Background
The use of the mRNA-based vaccine BNT162b2 against COVID-19 has shown great success preventing SARS-CoV-2 infection in the general population. Limited data exist regarding its effectiveness in patients requiring dialysis. Dialysis patients have reduced immune response following different types of vaccines including Hepatitis B vaccine. We aimed to asses humoral response and the factors associated with it in a large and diverse maintenance hemodialysis (MHD) patient population.
Methods
SARS-CoV-2 Anti-spike, anti-nucleocapsid and neutralizing antibody (Ab) levels of 424 MHD patients from 13 nationally spread dialysis units in Israel were compared with 155 control subjects (dialysis patients’ family members and dialysis units health care workers). Patients’ history, dialysis treatment details and Hepatitis B Ab (HBsAb) levels were obtained from dialysis units medical records.
Results
Our study included 400 MHD patients and 141 controls (58% males, 42% females), excluding 24 MHD and 14 control samples from anti-N positive cases, signifying previous SARS-CoV-2 infection. Anti-S antibodies developed in 89.3% of MHD patients and 99.3% of controls, (p<0.01) after a median time of 82 and 89 days from second vaccine dose for MHD and controls, respectively. Median anti-S titer was significantly lower in MHD patients compared with controls (median 194, IQR 118-242 vs. 69, IQR 33-119; p<0.001) and correlated well with the level of neutralizing Ab titers in the study group as compared to control group (median 16, IQR 8-64 vs. 256, IQR 64-516; p<0.001, respectively). Notably, age was higher in MHD patients than controls (median 72, IQR 63-80 vs. 49, IQR 38-58, p<0.01) which likely contributed to the association with anti-S titers (p<0.01, r=0.44) as well as neutralizing Ab titer levels (p<0.01, r=0.42). Sex, dialysis vintage and etiology of ESRD were not significantly associated with anti-S positivity or titer levels. Interestingly, there was a significant correlation, between anti-S and HBsAb positivity (p<0.01) though campatability was low (r=0.18).
Conclusion
MHD patients have lower seroconversion rate, lower anti-S and neutralizing Ab levels after BNT162b2 vaccination. HBsAb levels may potentially be used as a marker for estimating the level of humoral response following COVID-19 vaccine. To our knowledge this is the largest cohort of MHD patients studied thus far.