Response to three doses of the Pfizer/BioNTech BNT162b2 COVID-19 vaccine: a retrospective study of a cohort of haemodialysis patients in France.
Response to three doses of the Pfizer/BioNTech BNT162b2 COVID-19 vaccine: a retrospective study of a cohort of haemodialysis patients in France.
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DOI：
10.1186/s12882-022-02751-5
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发表时间：
2022-05-18
期刊：
影响因子：
2.3
通讯作者：
中科院分区：
文献类型：
--
作者：
血液透析患者与2019冠状病毒病（COVID-19）相关的死亡率很高。我们试图描述血液透析患者的血清学状态，接受了多达三剂BNT 162 b2 mRNA疫苗，并确定与体液反应差的相关因素。我们对法国昂蒂布透析中心的患者进行了一项回顾性观察研究。每例患者每月采集一份或两份静脉血样本，测定抗加标（S1）免疫球蛋白G（IgG）。我们纳入了142名患者，其中124名在整个研究期间保持COVID-19阴性。在这些COVID-19阴性患者中，体液免疫应答率（定义为抗S1 IgG滴度≥1.2 U/ml）在两次注射后为82.9%，在三次注射后为95.8%，中位[四分位距]滴度从两次注射的7.09 [2.21; 19.94] U/ml显著增加至93.26 [34.25; 176.06] U/ml。在接受两次注射的患者中，应答者的平均体重指数和血清白蛋白水平显著高于非应答者（分别为26.5 kg/m2 vs. 23.2 kg/m2，p = 0.0392; 41.9 g/l vs. 39.0 g/l，p = 0.0042）。对于研究结束时的整个研究人群，COVID-19病史、至少两剂疫苗以及在法国国家肾移植等待名单上是与抗S1 IgG滴度独立相关的唯一因素。透析患者接种两剂BNT 162 b2疫苗可能无法充分预防SARS-CoV-2，因此应接受第三剂（加强剂）。本临床实践回顾性研究不具有干预性，因此未注册。
The mortality rate associated with coronavirus disease 2019 (COVID-19) is high among haemodialyzed patients. We sought to describe the serological status of haemodialysis patients having received up to three doses of BNT162b2 mRNA vaccine, and to identify factors associated with a poor humoral response. We performed a retrospective, observational study of patients attending a dialysis centre in Antibes, France. One or two of each patient’s monthly venous blood samples were assayed for anti–spike (S1) immunoglobulin G (IgG). We included 142 patients, of whom 124 remained COVID-19-negative throughout the study. Among these COVID-19-negative patients, the humoral immune response rate (defined as an anti-S1 IgG titre ≥1.2 U/ml) was 82.9% after two injections and 95.8% after three injections, and the median [interquartile range] titre increased significantly from 7.09 [2.21; 19.94] U/ml with two injections to 93.26 [34.25; 176.06] U/ml with three. Among patients with two injections, the mean body mass index and serum albumin levels were significantly higher in responders than in non-responders (26.5 kg/m2 vs. 23.2 kg/m2, p = 0.0392; and 41.9 g/l vs. 39.0 g/l, p = 0.0042, respectively). For the study population as a whole at the end of the study, a history of COVID-19, at least two vaccine doses, and being on the French national waiting list for kidney transplantation were the only factors independently associated with the anti-S1 IgG titre. Dialysis patients vaccinated with two doses of BNT162b2 might not be sufficiently protected against SARS-CoV-2 and so should receive a third (booster) dose. The present retrospective study of clinical practice was not interventional and so was not registered.
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