key: cord-0949722-ljqe3qz1
authors: Rodríguez-Espinosa, Diana; Broseta, José Jesús; Francisco Maduell,; José Luis Bedini,; Vera, Manel
title: Humoral response of mRNA-1273 SARS-CoV-2 vaccine in peritoneal dialysis patients
date: 2021-05-31
journal: Kidney Int
DOI: 10.1016/j.kint.2021.05.018
sha: 67d0f60eda1d474ad8b9041a93430d34252e26a6
doc_id: 949722
cord_uid: ljqe3qz1

nan

To the Editor, End-stage kidney disease patients on peritoneal dialysis are known to have an altered cellular and humoral immunity evidenced by the reduced response they have to several vaccines, such as the hepatitis B or influenza vaccine, albeit their response rate is slightly higher than patients on hemodialysis 1 .

Although peritoneal dialysis patients have a reported lower prevalence of SARS-CoV-2 infection than in-center hemodialysis patients, probably due to their ability to self-isolate appropriately, they still have higher mortality and longer hospital admissions than the general population 2 . Currently, there is a lack of data on this population's response to SARS-CoV-2 vaccines. As mRNA's have data of higher potency in comparison to other types of vaccine, this class has been suggested as the preferred one until more data on their response is available 3 .

We evaluated the humoral response of 34 patients from our peritoneal dialysis unit at the Hospital Clínic of Barcelona. This population was immunized with two doses of the mRNA 1273 vaccine separated by a 28-day interval as specified by the manufacturer. Antibody titers were quantified with Siemens Healthineers Atellica® IM SARS-CoV-2 IgG (sCOVG) assay, which detects IgG antibodies to the receptor-binding domain of the S1 spike antigen of SARS-CoV-2 (anti-S1 IgG), at three moments: before administering the first dose, before administering the second dose, and three weeks after the latter (see Figure) .

Two out of the 34 patients had positive serology at baseline and were thus excluded from the analysis of seroconversion after vaccination. From the remaining 32, 20 (62.5%) generated detectable anti-S1 IgG after only one dose. Whereas 11 (34.38%) responded only after two doses were administered. Demographic characteristics, comorbidities, and laboratory parameters were analyzed, seeking correlation between them and either the humoral response intensity (antiS1-IgG titers) or its velocity (seroconversion after one dose vs. seroconversion after two doses). However, no statistically significant differences were observed between groups (see Table) . Only one patient did not seroconvert after completing vaccination, and though the patient was a 77-year-old diabetic obese male, we did not find any compelling reason for this lack of response. SARS-CoV-2 vaccination is of particular importance in high-risk populations such as patients on peritoneal dialysis. The 97% of response observed, high in comparison to kidney transplant recipients (25%) 4 and similar to hemodialysis patients (90%) 5 , reinforces the idea that this J o u r n a l P r e -p r o o f population should be vaccinated as soon as possible as most of them seroconvert and are therefore likely protected from severe COVID-19.

A comparison of responsiveness to hepatitis B vaccination in patients on hemodialysis and peritoneal dialysis

COVID-19 in peritoneal dialysis patients

COVID-19 vaccines and kidney disease

Post-vaccine anti-SARS-CoV-2 spike protein antibody development in kidney transplants recipients

Experience with SARS-COV-2 BNT162b2 mRNA vaccine in dialysis patients

FIGURE LEGEND

Anti-S1 IgG titer at baseline and after each dose of the mRNA-1273 vaccine

J o u r n a l P r e -p r o o f