Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Abstract

BACKGROUND AND AIMS

Vaccination against coronavirus disease 2019 (COVID-19) can reduce disease incidence and severity. Dialysis patients demonstrate a delayed immunologic response to vaccines. We determined factors affecting the immunologic response to COVID-19 vaccines in hemodialysis patients.

METHOD

All patients within a Swedish hemodialysis network, vaccinated with two doses of COVID-19 vaccine 2–8 weeks before inclusion, were eligible for this cross-sectional study. Severe adult respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein antibody levels were determined by the EliA SARS-CoV-2-Sp1 IgG test (Thermo Fisher Scientific, Phadia AB) and related to clinical and demographic parameters. Eighty-nine patients were included.

RESULTS

Patients were vaccinated with two doses of Comirnaty (BNT162b2, 73%) or Spikevax (mRNA-1273, 23.6%). Three patients received combinations of different vaccines. Response rate (antibody titres >7 U/mL) was 89.9%, while 39.3% developed high antibody titres (>204 U/mL), 47 (43–50) days after the second dose. A previous COVID-19 infection associated with higher antibody titres [median (25th–75th percentile) 1558.5 (814.5–3763.8) U/mL versus 87 (26–268) U/mL; P = 0.002], while the time between vaccine doses did not differ between groups (P = 0.7). Increasing SARS-CoV-2 antibody titres were independently associated with increasing time between vaccine doses, decreasing serum calcium levels and previous COVID-19 (Table 1).

CONCLUSION

In conclusion, a longer interval between COVID-19 mRNA vaccine doses, lower calcium and a previous COVID-19 infection were independently associated with a stronger immunologic vaccination response in hemodialysis patients. While the response rate was good, only a minority developed high antibody titres 47 (43–50) days after the second vaccine dose.

Table 1.
Open in new tab

Multiple regression of predictors of SARS-CoV-2 spike IgG response to COVID-19 vaccines

Regression coefficient
(95% CI)P
(Constant)0.015 (–0.507 to 0.537)0.95
Type of vaccine–0.194 (–0.566 to 0.179)0.30
Sodium (1 SD)–0.154 (–0.309 to 0.001)0.051
Calcium (1 SD)–0.233 (–0.4 to –0.067)0.007
Treatment time (1 SD)–0.05 (–0.234 to 0.133)0.586
Bodymass index (1 SD)0.104 (–0.086 to 0.294)0.279
IDBWG (1 SD)0.118 (–0.042 to 0.278)0.145
Kt/V (1 SD)0.009 (–0.159 to 0.177)0.915
Vaccine interval (1 SD)0.241 (0.039 to 0.443)0.02
Interval first dose to sample (1 SD)0.027 (–0.142 to 0.197)0.750
Previous COVID-191.078 (0.56 to 1.596)<0.001
Regression coefficient
(95% CI)P
(Constant)0.015 (–0.507 to 0.537)0.95
Type of vaccine–0.194 (–0.566 to 0.179)0.30
Sodium (1 SD)–0.154 (–0.309 to 0.001)0.051
Calcium (1 SD)–0.233 (–0.4 to –0.067)0.007
Treatment time (1 SD)–0.05 (–0.234 to 0.133)0.586
Bodymass index (1 SD)0.104 (–0.086 to 0.294)0.279
IDBWG (1 SD)0.118 (–0.042 to 0.278)0.145
Kt/V (1 SD)0.009 (–0.159 to 0.177)0.915
Vaccine interval (1 SD)0.241 (0.039 to 0.443)0.02
Interval first dose to sample (1 SD)0.027 (–0.142 to 0.197)0.750
Previous COVID-191.078 (0.56 to 1.596)<0.001
Table 1.
Open in new tab

Multiple regression of predictors of SARS-CoV-2 spike IgG response to COVID-19 vaccines

Regression coefficient
(95% CI)P
(Constant)0.015 (–0.507 to 0.537)0.95
Type of vaccine–0.194 (–0.566 to 0.179)0.30
Sodium (1 SD)–0.154 (–0.309 to 0.001)0.051
Calcium (1 SD)–0.233 (–0.4 to –0.067)0.007
Treatment time (1 SD)–0.05 (–0.234 to 0.133)0.586
Bodymass index (1 SD)0.104 (–0.086 to 0.294)0.279
IDBWG (1 SD)0.118 (–0.042 to 0.278)0.145
Kt/V (1 SD)0.009 (–0.159 to 0.177)0.915
Vaccine interval (1 SD)0.241 (0.039 to 0.443)0.02
Interval first dose to sample (1 SD)0.027 (–0.142 to 0.197)0.750
Previous COVID-191.078 (0.56 to 1.596)<0.001
Regression coefficient
(95% CI)P
(Constant)0.015 (–0.507 to 0.537)0.95
Type of vaccine–0.194 (–0.566 to 0.179)0.30
Sodium (1 SD)–0.154 (–0.309 to 0.001)0.051
Calcium (1 SD)–0.233 (–0.4 to –0.067)0.007
Treatment time (1 SD)–0.05 (–0.234 to 0.133)0.586
Bodymass index (1 SD)0.104 (–0.086 to 0.294)0.279
IDBWG (1 SD)0.118 (–0.042 to 0.278)0.145
Kt/V (1 SD)0.009 (–0.159 to 0.177)0.915
Vaccine interval (1 SD)0.241 (0.039 to 0.443)0.02
Interval first dose to sample (1 SD)0.027 (–0.142 to 0.197)0.750
Previous COVID-191.078 (0.56 to 1.596)<0.001
PDF
This content is only available as a PDF.
© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://dbpia.nl.go.kr/journals/pages/open_access/funder_policies/chorus/standard_publication_model)
Topic:
Issue Section:
COVID-19 and Oxygen
Download all slides

Comments

0 Comments
Comments (0)
Submit a comment
You have entered an invalid code
Thank you for submitting a comment on this article. Your comment will be reviewed and published at the journal's discretion. Please check for further notifications by email.