Evidence map›Paper›PMID 34904856›Full record

ArticleAnnals of internal medicine2022

SARS-CoV-2 Vaccine Antibody Response and Breakthrough Infection in Patients Receiving Dialysis.

Shuchi Anand, Maria E Montez-Rath, Jialin Han, Pablo Garcia, LinaCel Cadden, Patti Hunsader, Curt Morgan, Russell Kerschmann, Paul Beyer, Mary Dittrich and 3 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed, 1 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

51 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Shuchi AnandDepartment of Medicine (Nephrology), Stanford University, Palo Alto, California (S.A., M.E.M., J.H., P.G.).ORCID 0000-0002-9892-8477
Maria E Montez-RathDepartment of Medicine (Nephrology), Stanford University, Palo Alto, California (S.A., M.E.M., J.H., P.G.).ORCID 0000-0001-5154-2182
Jialin HanDepartment of Medicine (Nephrology), Stanford University, Palo Alto, California (S.A., M.E.M., J.H., P.G.).ORCID 0000-0001-5731-8974
Pablo GarciaDepartment of Medicine (Nephrology), Stanford University, Palo Alto, California (S.A., M.E.M., J.H., P.G.).ORCID 0000-0002-8482-8192
LinaCel CaddenAscend Clinical Laboratory, Redwood City, California (L.C., P.H., C.M., R.K., P.B.).
Patti HunsaderAscend Clinical Laboratory, Redwood City, California (L.C., P.H., C.M., R.K., P.B.).ORCID 0000-0002-1842-7446
Curt MorganAscend Clinical Laboratory, Redwood City, California (L.C., P.H., C.M., R.K., P.B.).
Russell KerschmannAscend Clinical Laboratory, Redwood City, California (L.C., P.H., C.M., R.K., P.B.).
Paul BeyerAscend Clinical Laboratory, Redwood City, California (L.C., P.H., C.M., R.K., P.B.).ORCID 0000-0002-2810-670X
Mary DittrichU.S. Renal Care, Plano, Texas (M.D.).ORCID 0000-0002-3671-9629
Geoffrey A BlockU.S. Renal Care, Golden, Colorado (G.A.B.).ORCID 0000-0002-4646-7074
Glenn M ChertowDepartments of Medicine (Nephrology) and Epidemiology and Population Health, Stanford University, Stanford, California (G.M.C.).
Julie ParsonnetDepartments of Medicine (Infectious Diseases and Geographic Medicine) and Epidemiology and Population Health, Stanford University, Stanford, California (J.P.).ORCID 0000-0001-7342-5366

Funding

Chronic kidney disease of unknown etiology: applying a multidisciplinary approach to investigate the world's most common tubulointerstitial kidney diseaseR01DK127138 · NIDDK · STANFORD UNIVERSITY · PI MONTEZ RATH, MARIA · 2021 to 2025
$2.7M
SARS-COV-2 Screening in Dialysis Facilities: Building an Optimal Strategy to Protect High Risk PopulationsU01AI169477 · NIAID · STANFORD UNIVERSITY · PI ANAND, SHUCHI, CHERTOW, GLENN MATTHEW · 2022 to 2023
$2.3M
NIAID NIH HHS U01 AI169477NIDDK NIH HHS R01 DK127138
6 · The paper itself

Abstract

backgroundWhether breakthrough SARS-CoV-2 infections after vaccination are related to the level of postvaccine circulating antibody is unclear.

objectiveTo determine longitudinal antibody-based response and risk for breakthrough infection after SARS-CoV-2 vaccination.

designProspective study.

settingNationwide sample from dialysis facilities. PATIENTS: 4791 patients receiving dialysis. MEASUREMENTS: Remainder plasma from a laboratory processing routine monthly tests was used to measure qualitative and semiquantitative antibodies to the receptor-binding domain (RBD) of SARS-CoV-2. To evaluate whether peak or prebreakthrough RBD values were associated with breakthrough infection, a nested case-control analysis matched each breakthrough case patient to 5 control patients by age, sex, and vaccination month and adjusted for diabetes status and region of residence.

resultsOf the 4791 patients followed with monthly RBD assays, 2563 were vaccinated as of 14 September 2021. Among the vaccinated patients, the estimated proportion with an undetectable RBD response increased from 6.6% (95% CI, 5.5% to 7.8%) 14 to 30 days after vaccination to 20.2% (CI, 17.0% to 23.3%) 5 to 6 months after vaccination. Estimated median index values decreased from 91.9 (CI, 78.6 to 105.2) 14 to 30 days after vaccination to 8.4 (CI, 7.6 to 9.3) 5 to 6 months after vaccination. Breakthrough infections occurred in 56 patients, with samples collected a median of 21 days before breakthrough infection. Compared with prebreakthrough index RBD values of 23 or higher (equivalent to ≥506 binding antibody units per milliliter), prebreakthrough RBD values less than 10 and values from 10 to less than 23 were associated with higher odds for breakthrough infection (rate ratios, 11.6 [CI, 3.4 to 39.5] and 6.0 [CI, 1.5 to 23.6], respectively). LIMITATIONS: Single measure of vaccine response; ascertainment of COVID-19 diagnosis from electronic health records.

conclusionThe antibody response to SARS-CoV-2 vaccination wanes rapidly in persons receiving dialysis. In this population, the circulating antibody response is associated with risk for breakthrough infection. PRIMARY FUNDING SOURCE: Ascend Clinical Laboratory.

Identifiers

PMID34904856
PMCPMC8722718

What OpenQuestion holds

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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.