Evidence map›Paper›PMID 34031181›Full record

ArticleClinical journal of the American Society of Nephrology : CJASN2021

Early Humoral Responses of Hemodialysis Patients after COVID-19 Vaccination with BNT162b2.

Claudius Speer, Daniel Göth, Louise Benning, Mirabel Buylaert, Matthias Schaier, Julia Grenz, Christian Nusshag, Florian Kälble, Martin Kreysing, Paula Reichel and 8 more

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Article in Clinical journal of the American Society of Nephrology : CJASN, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  4. Immunological and clinical efficacy of COVID-19 vaccines in immunocompromised populations: a systematic review.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors.

Claudius SpeerDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Daniel GöthDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Louise BenningDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Mirabel BuylaertDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Matthias SchaierDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Julia GrenzDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Christian NusshagDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Florian KälbleDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Martin KreysingDepartment of Gastroenterology and Hepatology, University of Heidelberg, Heidelberg, Germany.
Paula ReichelDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Maximilian TöllnerDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Asa HidmarkDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Gerald PonathDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Paul SchnitzlerDepartment of Infectious Diseases, Virology, University of Heidelberg, Heidelberg, Germany.
Martin ZeierDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Caner SüsalDepartment of Transplantation Immunology, University of Heidelberg, Heidelberg, Germany.
Christian MorathDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.
Katrin KleinDepartment of Nephrology, University of Heidelberg, Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesPatients receiving hemodialysis are at high risk for both severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe coronavirus disease 2019. A lifesaving vaccine is available, but sensitivity to vaccines is generally lower in patients on dialysis. Little is yet known about antibody responses after coronavirus disease 2019 (COVID-19) vaccination in this vulnerable group. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: In this prospective single-center study, we included 22 patients on dialysis and 46 healthy controls from Heidelberg University Hospital between December 2020 and February 2021. We measured anti-S1 IgG with a threshold index for detection greater than one, neutralizing antibodies with a threshold for viral neutralization of ≥30%, and antibodies against different SARS-CoV2 fragments 17-22 days after the first dose and 18-22 days after the second dose of the mRNA vaccine BNT162b2.

resultsAfter the first vaccine dose, four of 22 (18%) patients on dialysis compared with 43 of 46 (93%) healthy controls developed positive anti-S1 IgG, with a median anti-S1 IgG index of 0.2 (interquartile range, 0.1-0.7) compared with nine (interquartile range, 4-16), respectively. SARS-CoV2 neutralizing antibodies exceeded the threshold for neutralization in four of 22 (18%) patients on dialysis compared with 43 of 46 (93%) healthy controls, with a median percent inhibition of 11 (interquartile range, 3-24) compared with 65 (interquartile range, 49-75), respectively. After the second dose, 14 of 17 (82%) patients on dialysis developed neutralizing antibodies exceeding the threshold for viral neutralization and antibodies against the receptor binding S1 domain of the spike protein, compared with 46 of 46 (100%) healthy controls, respectively. The median percent inhibition was 51 (interquartile range, 32-86) compared with 98 (interquartile range, 97-98) in healthy controls.

conclusionsPatients receiving long-term hemodialysis show a reduced antibody response to the first and second doses of the mRNA vaccine BNT162b2. The majority (82%) develop neutralizing antibodies after the second dose but at lower levels than healthy controls.

Indexed as

Renal DialysisVaccinationAdultAgedAged, 80 and overAge FactorsAntibodies, ViralBNT162 VaccineCOVID-19COVID-19 VaccinesFemaleHumansImmunoglobulin GMaleMiddle AgedSARS-CoV-2Antibodies, ViralBNT162 VaccineCOVID-19 VaccinesImmunoglobulin GCOVID-19dialysishemodialysishumoral responseSARS-CoV-2vaccination

Identifiers

PMID34031181
PMCPMC8425619

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.