Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review

Clinical Microbiology and Infection, Journal Year: 2021, Volume and Issue: 28(2), P. 163 - 177

Published: Nov. 17, 2021

Language: Английский

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Predictors of Humoral Response to mRNA COVID19 Vaccines in Kidney Transplant Recipients: A Longitudinal Study—The COViNEPH Project

Vaccines, Journal Year: 2021, Volume and Issue: 9(10), P. 1165 - 1165

Published: Oct. 12, 2021

The efficacy of SARS-CoV-2 vaccination among kidney transplant recipients (KTR) is low. main goal this study was to analyze factors that may influence the humoral response vaccination.We analyzed titer magnitude IgG antibodies directed against spike (S)-SARS-CoV-2 antigen after second dose mRNA vaccine in 142 infection naïve KTR (83 men, i.e., 58.4%) with a median age (IQR) 54 (41-63), and 36 respective controls without chronic disease. mRNA-1273 or BNT162b2 were applied 26% 74% KTR, respectively.S-specific immune (seroconversion) seen 73 (51.41%) all (100%). Independent predictors no elder age, shorter transplantation vintage, more than two-drug immunosuppressive protocol. In subgroup analyses, seroconversion rate highest MMF/MPS treatment (70%), treated two immunosuppressants (69.2%), corticosteroid (66.7%), younger patients aged <54 years (63.2%), those vaccinated (62.16%). independent higher S-antibody responders immunosuppressants, vaccination.Our confirmed low KTR. major modifiable determinants composition protocol, as well type vaccine. latter could be taken into consideration when initial booster considered

Language: Английский

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Safety and Tolerability of the BNT162b2 mRNA COVID-19 Vaccine in Dialyzed Patients. COViNEPH Project

Medicina, Journal Year: 2021, Volume and Issue: 57(7), P. 732 - 732

Published: July 19, 2021

Background and Objectives: The Pfizer-BioNTech (BNT162b2) COVID-19 mRNA vaccine has demonstrated excellent efficacy safety in phase 3 trials. However, no dialyzed patients were included, therefore data for this patient group is lacking. aim of the study was to assess tolerances vaccinations with BNT162b2 performed chronically patients. Materials Methods: We a prospective cohort including 190 (65% male) at median age 68.0 (55–74) years. 169 (89.0%) treated hemodialysis 21 (11.0%) peritoneal dialysis. control consisted 160 people (61% without chronic kidney disease 63 (range 53–77) Both groups vaccinated 21-day interval between first second dose. Solicited local systemic reactogenicity, unsolicited adverse events antipyretic pain medication use assessed standardized questionnaire. toxicity grading scales derived from FDA Center Biologics Evaluation Research guidelines. Results: 59.8% (dose 1), 61.4% 2) 15.9% 29.4% reported least one reaction respectively within seven days after vaccination. Many solicited reactions observed less frequently than sex matched much pivotal study. They mostly mild moderate, short-lived, more younger individuals women. No related observed. Conclusions: have shown here that BNT162b2, an against SARS-COV-2 safe well-tolerated by results can be useful nephrological community resolve patients’ doubts reduce their hesitancy.

Language: Английский

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Boosting Humoral Immunity from mRNA COVID-19 Vaccines in Kidney Transplant Recipients

Vaccines, Journal Year: 2021, Volume and Issue: 10(1), P. 56 - 56

Published: Dec. 31, 2021

Introduction: The immune response to the primary (two-dose) series of mRNA COVID-19 vaccines in kidney transplant recipients (KTRs) is very weak. We conducted a longitudinal observational study compare humoral third, additional dose between infection-naïve (IN-KTRs) and previously infected KTRs (PI-KTRs). Methods: measured levels anti-spike (anti-s) IgG antibodies before 14–21 days after third and, secondary analysis, we compared antibody BNT162b2 versus mRNA-1273. reactogenicity assessment included solicited local systemic reactions. Results: A total 112 were enrolled, including 83 IN-KTR 29 PI-KTR, among whom seroconversion anti-s two-dose vaccination was achieved 45.78% 100% cases, respectively. After three months, waning titer by 67.4% (IN-KTR) 7.5% (PI-KTR) observed. vaccine, 71.08% (59/83) 96.5% (28/29) PI-KTR samples seroconverted with median 468.0 (195.0–1620.0) BAU/mL 1629.0 (1205–1815) BAU/mL, Of those failed, 46.67% (21/45) patients dose. No serious adverse events reported. In strata analyses, dose, 66% (40/60) vaccinated 82.6% (19/23) mRNA-1273 384.5 (144–837) 1620 (671–2040) Conclusions: use vaccine may be benefit for KTR, especially failed. Vaccines higher longer interval doses vaccination, such as mRNA-1273, seem preparations choice immunocompromised individuals.

Language: Английский

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Immunogenicity and safety of SARS-CoV-2 vaccine in hemodialysis patients: A systematic review and meta-analysis

Frontiers in Public Health, Journal Year: 2022, Volume and Issue: 10

Published: Sept. 23, 2022

Rationale and objective COVID-19 vaccination is the most effective way to prevent COVID-19. For chronic kidney disease patients on long-term dialysis, there a lack of evidence pros cons vaccination. This study was conducted investigate immunogenicity safety vaccines in dialysis. Methods PubMed, MEDLINE, EMBASE, Cochrane Library were systemically searched for cohort, randomized controlled trials (RCTs), cross-sectional studies. Data rate, antibody titer, survival new infection adverse events, type vaccine, patient characteristics such as age, sex, dialysis vintage, immunosuppression prevalence diabetes extracted analyzed using REVMAN 5.4 Stata software. A random effects meta-analysis used perform study. Results We screened 191 records included 38 studies regarding 5,628 participants. The overall 87% (95% CI, 84-89%). vaccine response rate 85.1 hemodialysis (HDPs) (1,201 1,412) 97.4% healthy controls (862 885). serological positivity 82.9% (777 937) infection-naive individuals 98.4% (570 579) with previous infection. Standard Mean Difference (SMD) titers or without 1.14 0.68–1.61). Subgroup analysis showed that an influential factor affecting ( P &lt; 0.0001). Nine reported indices, among which four local events seven system documented. Conclusions Vaccination helped achieve humoral immunity, immune efficiency 87.5%. Dialysis may experience various after vaccination; however, incidence malignant very low, no reports death acute renal failure are available, indicating regimens be necessary. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42022342565 , identifier: CRD42022342565.

Language: Английский

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Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection

Journal of Clinical Medicine, Journal Year: 2022, Volume and Issue: 11(2), P. 285 - 285

Published: Jan. 6, 2022

Introduction: The determinants of COVID-19 mortality are well-characterized in the general population. Less numerous and inconsistent data among maintenance hemodialysis (HD) patients, who population most at risk an unfavorable prognosis. Methods: In this retrospective cohort study we included all adult HD patients from Pomeranian Voivodeship, Poland, with laboratory-confirmed SARS-CoV-2 infection hospitalized between 6 October 2020 28 February 2021, both those survived, also died. Demographic, clinical, treatment, laboratory on admission, were extracted electronic medical records dedicated hospital patients’ dialysis unit, compared survivors non-survivors. We used univariable multivariable logistic regression methods to explore factors associated 3-month all-cause mortality. Results: 133 (53.38% males) aged 73.0 (67–79) years, a median duration 42.0 (17–86) months, study. At diagnosis, majority considered have mild course (34 asymptomatic, another 63 subjects presented symptoms), while 36 (27.07%) had low blood oxygen saturation required supplementation. Three-month was 39.08% including in-hospital case fatality rate 33.08%. Multivariable showed that frailty clinical index 4 or greater (OR 8.36, 95%CI 1.81–38.6; p < 0.01), D-Dimer 1500 ng/mL (6.00, 1.94–18.53; CRP >118 mg/L admission (3.77 1.09–13.01; = 0.04) found be predictive Conclusion: Very high determined mainly by frailty. High D-dimer levels upon further confer risk.

Language: Английский

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Waning Humoral Response after COVID-19 mRNA Vaccination in Maintenance Dialysis Patients and Recovery after a Complementary Third Dose

Vaccines, Journal Year: 2022, Volume and Issue: 10(3), P. 433 - 433

Published: March 11, 2022

The aim of this study was to analyze the waning anti-spike (S) antibodies after mRNA vaccination against COVID-19 in maintenance dialysis patients, and assess safety effectiveness complementary third dose. This a prospective, longitudinal which we analyzed kinetics up six months two-dose (first protocol) infection-naïve patients (IN-Ds), previously infected (PI-Ds) subjects without chronic kidney disease (the controls), as well their humoral response dose same vaccine (second protocol). respective reduction antibody titer 3 6 by 82.9% 93.03% IN-Ds (n = 109), 73.4% 93.36% PI-Ds 32) 75.5% 88.8% controls 20) demonstrated. Consequently, protective above 141 BAU/mL found only 47.7% 23.8% months, respectively. After dose, significant increase observed all groups, with increases factor ×51.6 IN-Ds, ×30.1 ×8.4 PI-Ds. median differed significantly between highest PI-Ds: PI-Ds, 9090 (3300−15,000) BAU/mL; controls, 6945 (2130−11,800); 3715 (1470−7325) (p < 0.001). In conclusion, similar degrees patients. over half had very low titer, almost twenty percent them no at all. good, raising higher level than those general population who have received primary scheme. results support administration for soon possible.

Language: Английский

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COVID-19 vaccination reduces mortality in patients on maintenance hemodialysis

Frontiers in Medicine, Journal Year: 2022, Volume and Issue: 9

Published: Sept. 8, 2022

Patients with chronic kidney disease on maintenance hemodialysis (HD) have a very high risk of death in the course COVID-19. The aim study was to assess effectiveness COVID-19 vaccination reduce incidence and fatality rate HD patients. A retrospective registry-based cohort performed all adult patients Pomeranian Voivodeship. Vaccinations were carried out from January April 2021 mRNA vaccines, either BNT162b2 or mRNA-1273 two-dose schedule. In first analysis (2nd pandemic wave), 1,160 unvaccinated included (59.7% males, 25.7% diabetic). second (4th 1,131 (59.4% male, 30.7% diabetic) individuals included, 1,042 (92.13%) fully vaccinated. Three hundred fifteen (27.2%) positive during 2nd wave, 6.9% (78/1,131) 4th wave. Within vaccinated 60 positive, 5.8 vs. 20.2% respectively. ratio (IRR) 0.21 wave-vaccinated wave-unvaccinated) indicating 79% reduction. IRR between wave 0.28 favor 72% 93 died as result (fatality rate: 29.5%). 6.7% (p = 0.004), while within accounted for 11.1%. Significant clinical demonstrated multicenter

Language: Английский

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Immunogenicity of COVID‐19 mRNA vaccines in hemodialysis patients: Systematic review and meta‐analysis

Health Science Reports, Journal Year: 2022, Volume and Issue: 5(6)

Published: Oct. 3, 2022

Abstract Background and Aims Vaccine response is a concern in hemodialysis patients. Given that patients were not included clinical trials, we aimed to synthesize the available evidence on immunogenicity of coronavirus disease 2019 (COVID‐19) mRNA vaccines Methods We searched Scopus, PubMed, Sciencedirect, finally google scholar databases for studies COVID‐19 mRNA‐vaccines up December 1, 2021. Eligible articles measured antibodies against severe acute respiratory syndrome 2 (SARS‐CoV‐2) spike or Receptor‐Binding Domain Antibody (S/RBD) postimmunization with vaccines. The vaccine was evaluated using seroconversion rates between 21 30 days after first immunization 14 36 post second dose. including participants without history before vaccination. Healthy controls health‐care workers served as control groups. After selecting eligible articles, data extracted from articles. used random effects model estimate pooled rate administration. assessed heterogeneity I statistical index. Result selected 39 citations comprising 806 cases 336 dose 6314 927 analysis. vaccines, 36% (95% confidence interval [CI]: 0.24–0.47) 68% CI: 0.45–0.91) group, respectively. While 86% 0.81–0.91) 100% 1.00–1.00) Conclusion Although immune SARS‐CoV‐2 very promising, dialysis lower than healthy controls. Periodically assessment antibody levels at short intervals recommended.

Language: Английский

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Angiotensin Converting Enzyme Inhibitors May Increase While Active Vitamin D May Decrease the Risk of Severe Pneumonia in SARS-CoV-2 Infected Patients with Chronic Kidney Disease on Maintenance Hemodialysis

Viruses, Journal Year: 2022, Volume and Issue: 14(3), P. 451 - 451

Published: Feb. 22, 2022

The group most at risk of death due to COVID-19 are patients on maintenance hemodialysis (HD). study aims describe the clinical course early phase SARS-CoV-2 infection and find predictors development severe pneumonia in this population. This is a case series HD nonvaccinated with stratified into mild according chest computed tomography (CT) total severity score (TSS) admission. Epidemiological, demographic, clinical, laboratory data were obtained from hospital records. 85 mean age 69.74 (13.19) years dialysis vintage 38 (14-84) months included. On admission, 29.14% had no symptoms, 70.59% reported fatigue followed by fever-44.71%, shortness breath-40.0%, cough-30.59%. 20% finger oxygen saturation less than 90%. In 28.81% patients, pulmonary parenchyma was involved least 25%. factors associated include fever, low arterial partial pressure oxygen, increased C-reactive protein ferritin serum levels, blood count lymphocytes as well chronic treatment angiotensin converting enzyme inhibitors; while active vitamin D pneumonia. conclusion, even though nearly one-third completely asymptomatic, remaining usually only single large percentage them extensive inflammatory changes diagnosis infection. We identified potential pneumonia, which might help individualize pharmacological improve outcomes.

Language: Английский

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