key: cord-0995575-deb84nxz authors: Paal, Michael; Arend, Florian M; Lau, Tobias; Hasmann, Sandra; Soreth-Rieke, Daniela; Sorodoc-Otto, Johanna; Beuthien, Wilke; Krappe, Julia; Toepfer, Marcell; von Gersdorff, Gero; Thaller, Norbert; Rau, Simon; Northoff, Bernd; Teupser, Daniel; Bruegel, Mathias; Fischereder, Michael; Schönermarck, Ulf title: Antibody response to mRNA SARS-CoV-2 vaccines in hemodialysis patients date: 2021-07-06 journal: Clin Kidney J DOI: 10.1093/ckj/sfab127 sha: 5acf9d2ab22852481bc09852d7b81bd236bf5469 doc_id: 995575 cord_uid: deb84nxz BACKGROUND: Some studies have shown an attenuated immune response in hemodialysis patients after vaccination. The present study examines the humoral response after mRNA vaccination against SARS-CoV-2 in a large population of hemodialysis patients from different outpatient dialysis centers. METHODS: We retrospectively assessed antibodies against SARS-CoV-2 spike protein and nucleocapsid protein (chemiluminescence immunoassays, Roche diagnostics) three to six weeks after the second mRNA vaccine dose in 179 maintenance hemodialysis and 70 non-dialysis patients (control cohort). Differences in Anti-SARS CoV-2 spike protein titers were statistically analysed with respect to patient-relevant factors, including age, gender, previous COVID-19 infection, systemic immunosuppressive therapy and time on dialysis. RESULTS: We found a favorable, but profoundly lower SARS-CoV-2 spike protein antibody response in comparison to a non-dialysis cohort (median 253.5 vs. 1756 U/ml, p < 0.001). In multivariate analysis previous COVID-19 infection (p < 0.001) and female gender were associated with a significantly higher vaccine response (p 0.006) in hemodialysis patients, while there was a significant inverse correlation with increasing patient age and systemic immunosuppression (p < 0.001). There was no statistically significant correlation between the antibody titer and time on dialysis. Immune response in hemodialysis patients with a previous COVID-19 infection led to substantially higher antibody titers that were equal to those of vaccinated non-dialysis individuals with previous infection. CONCLUSION: We strongly argue in favor of regular antibody testing after COVID-19 vaccination in hemodialysis patients. Further studies should elucidate the utility of booster vaccinations to foster a stronger and persistent antibody response. muenchen.de 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 53 INTRODUCTION 54 Dialysis patients represent a particularly vulnerable population during the COVID-19 55 pandemic. Given that most patients receive in-center dialysis, they are not able to self-56 isolate and are regularly exposed to potential contagious individuals, e.g. health care 57 workers, or other patients. This results in a higher seroprevalence rate in this cohort 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 150 On multivariate analysis, female gender and previous COVID-19 infection were 151 associated with a significantly higher vaccine response, while there was a significant 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 15 296 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 308 HD, hemodialysis patients. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 18 309 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 Antibody response to first BNT162b2 277 dose in previously SARS-CoV-2-infected individuals SARS-CoV-2 Antibody Response in 280 Persons with Past Natural Infection Persistence of SARS-CoV-2 283 antibodies in kidney transplant recipients Impaired Humoral and Cellular 286 Immunity after SARS-CoV2 BNT162b2 (Tozinameran) Prime-Boost 287 Vaccination in Kidney Transplant Recipients. medRxiv Seropositive Persons after a Single Dose of SARS-CoV-2 mRNA Vaccine Robust T Cell Immunity in 294 Convalescent Individuals with Asymptomatic or Mild COVID-19