Figure 2 - uploaded by Kin Israel Notarte
Content may be subject to copyright.
Methodological quality of those studies investigating humoral response in patients receiving hemodialysis after mRNA COVID-19 vaccine.
Source publication
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has infected over 600 million individuals and caused nearly 7 million deaths worldwide (10 January 2023). Patients with renal disease undergoing hemodialysis are among those most adversely affected, with an increased predisposit...
Contexts in source publication
Context 1
... cohort studies were of high methodological quality (7/9 stars), six studies were of medium methodological quality (6/9 stars), and one was of low methodological quality (4/9 stars). No study matched the comparative group by age/gender or controlled for other factors (e.g., other comorbidities), thus none fulfilled these methodological criteria (Figure 2). No disagreement between authors was found. ...
Context 2
... cohort studies were of high methodological quality (7/9 stars), six studies were of medium methodological quality (6/9 stars), and one was of low methodological quality (4/9 stars). No study matched the comparative group by age/gender or controlled for other factors (e.g., other comorbidities), thus none fulfilled these methodological criteria ( Figure 2). No disagreement between authors was found. ...
Citations
... 25 The seroconversion rate in the HV group was 94.7%, with a median (IQR) anti-S protein titer of 400 AU/mL (348-400), which was significantly higher than that in the KTV group (p < .001). [26][27][28] Our study is unique in comparing the seroconversion rate and anti-S protein titers across four different groups, including hemodialysis patients. We also were the first to show the robust humoral immune response of BNT 162b2 vaccine in hemodialysis patients. ...
Introduction
Since the start of the COVID‐19 pandemic, data published on the immunogenicity of the SARS‐CoV‐2 BNT 162B2 vaccine in pediatric patients receiving renal replacement therapy are scant. Our primary objective is to study this population's humoral immune response to the COVID‐19 vaccine.
Methods
Pediatric kidney transplant recipients (PKTRs) and hemodialysis recipients (HR) at our center who received two doses of the SARS‐CoV‐2 BNT 162B2 vaccine were included. Transplant and HR who had PCR‐positive COVID‐19 infections during the study, regardless of their vaccine status, were also included. SARS‐CoV‐2 anti‐spike protein (S1/S2) IgG was measured after the second dose of the vaccine and after any PCR‐positive COVID‐19 infection as routine clinical practice. Data on demographics, induction, maintenance immunosuppressants, type of transplant, and posttransplant or dialysis duration were included.
Results
Of the 61 patients included, 19 were dialysis recipients who received two doses of vaccine without subsequent infection (HV), and 42 were kidney transplant recipients. All dialysis patients and 33 (78.6%) transplant recipients received two doses of the SARS‐CoV‐2 BNT 162b2 vaccine. A total of 33.3% (11/33) of the transplant recipients who received vaccination developed COVID‐19 infection (KTH) at a median time of 13 days after the second dose of vaccine. Nine transplant patients had pure COVID‐19 infection without vaccination (KTI). The seroconversion rate in the HV group was 94.7% (18/19) compared to 50% (11/22) in the kidney transplant vaccine recipients who did not develop subsequent COVID‐19 infection (KTV) ( p < .001). The median S1/S2 IgG titers for the HV group were 400 AU/mL versus 15 AU/mL in the KTV group ( p < .0001). There was no significant difference in the duration of the test from the second dose of the vaccine between HV and KTV (55 vs. 33.5 days, p = .095). The KTH had higher titers than KTV group (370 vs. 15 p < .0001). The median duration of the test after vaccination in the vaccine group and those with hybrid immunity was similar (35 vs. 33.5 days, p = .2).There were no clear predictors for seroconversion in the PKTRs. Natural infection alone was as good as the vaccine in eliciting humoral immune response.
Conclusion
The humoral immune response to two doses of the SARS‐CoV‐2 BNT 162B2 vaccine in PKTRs without subsequent COVID‐19 infection is suboptimal compared to that in hemodialysis recipients and in PKTRs with hybrid immunity from both infection and vaccination.
