RESUMEN
The effect of a third vaccine dose (3D) of homologous mRNA vaccine on blood levels of SARS-CoV-2-receptor binding domain (RBD)-total antibodies was assessed in 40 hemodialysis patients (HD) and 21 kidney transplant recipients (KTR) at a median of 46 days after 3D. Anti-RBD antibodies were detected in 39/40 HD and 19/21 KTR. Overall, 3D boosted anti-RBD antibody levels (median: 58-fold increase). Neutralizing antibodies (NtAb) against the Wuhan-Hu-1, Delta, and Omicron variants were detected in 14, 13, and 11 out of 14 HD patients, and in 5, 5, and 4 out of 8 KTR patients, respectively. The median fold increase in NtAb titers in HD patients was 77, 28, and 5 and 56, 37, and 9 in KTR patients for each respective variant. SARS-CoV-2-S S-IFN-γ-producing CD8+ and CD4+ T-cell responses were detected in the majority of HD (35 and 36/37, respectively) and all KTR (16/16) patients at 3D. Overall, the administration of 3D boosted T-cell levels in both population groups. In conclusion, a homologous mRNA COVID-19 vaccine 3D exerts a booster effect on anti-RBD antibodies, NtAb binding to Wuhan-Hu-1, Delta, and Omicron variants, and SARS-CoV-2-S-IFN-γ-producing T cells in both HD and KTR patients. The magnitude of the effect was more marked in HD than KTR patients.
RESUMEN
Background: Little is known regarding the dynamics of antibody and T-cell responses in chronic kidney disease (CKD) following coronavirus disease 2019 (COVID-19) vaccination. Methods: Prospective observational cohort study including 144 participants on haemodialysis (HD) (n = 52) or peritoneal dialysis (PD) (n = 14), those undergoing kidney transplantation (KT) (n = 30) or those with advanced CKD (ACKD) not on dialysis and healthy controls (n = 18). Anti-Spike (S) antibody and T-cell responses were assessed at 15 days (15D) and 3 months (3M) after complete vaccination schedule. HD, PD and KT patients received mRNA vaccines (mRNA-123 and BNT162b2). Most ACKD patients received BNT162b2 (n = 23), or Ad26.COV.2.S (4). Most controls received BNT162b2 (n = 12), or Ad26.COV.2.S (n = 5). Results: Anti-S antibodies at 15D and 3M were detectable in 95% (48/50)/98% (49/50) of HD patients, 93% (13/14)/100% of PD patients, 67% (17/26)/75% (21/28) of KT patients and 96% (25/26)/100% (24/24) of ACKD patients. Rates for healthy controls were 81% (13/16)/100% (17/17). Previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2-S) infection was documented in four (7.7%) HD patients, two (14.3%) PD patients, two (6.7%) KT patients, one (5.55%) healthy control and in no ACKD patient. Antibody levels decreased at 3M in HD (P = .04), PD (P = .008) and ACKD patients (P = .0009). In KT patients, levels increased (P = .04) between 15D and 3M, although they were low at both time points.T-cell responses were detected in HD patients in 37 (80%) at baseline, 35 (70%) at 15D and 41 (91%) at 3M. In PD patients, T-cell responses appeared in 8 (67%) at baseline, 13 (93%) at 15D and 9 (100%) at 3M. In KT patients, T-cell responses were detected in 12 (41%) at baseline, 22 (84%) at 15D and 25 (96%) at 3M. In ACKD patients, T-cell responses were detected in 13 (46%) at baseline, 20 (80%) at 15D and 17 (89%) at 3M. None of healthy controls showed T-cell response at baseline, 10 (67%) at 15D and 8 (89%) at 3M. Conclusions: Most HD, PD and ACKD patients develop SARS-CoV-2-S antibody responses comparable to that of healthy controls, in contrast to KT recipients. Antibody waning at 3M was faster in HD, PD and ACKD patients. No differences in SARS-CoV-2 T-cell immunity responses were noticed across study groups.
