Observational studyJornal brasileiro de nefrologia
Kinetics of cellular immune response to SARS-CoV-2 vaccine boosters in dialysis and kidney transplant patients without infection.
Observational study in Jornal brasileiro de nefrologia. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
introductionDialysis patients and kidney transplant recipients (KTRs) present impaired immune response to COVID-19 vaccines. Although vaccination remains the primary strategy to reduce mortality, data on the cellular immune response kinetics in these populations are limited. This study evaluated the kinetics of vaccine-induced cellular immunity to SARS-CoV-2 in dialysis and KTRs without prior infection.
methodsThis is a post-hoc analysis of a prospective, observational, single-center study comparing the cellular immunity kinetics induced by SARS-CoV-2 vaccination in adult patients undergoing kidney transplant (n = 77) and patients on dialysis (n = 92). Those who had COVID-19 were excluded. Blood samples were collected at screening and at 1, 3, 6, and 12 months to assess SARS-CoV-2-specific T-cell responses using a commercial Interferon-gamma release assay (IGRA, QuantiFERON SARS-CoV-2 RUO), with results classified as positive, negative, or indeterminate. Comparisons were performed using chi-square and Mann-Whitney tests.
resultsPositive IGRA results were infrequent in transplant and dialysis patients over time (Screening: 8.1% vs. 23.2%; M1: 14.1% vs. 16.5%; M3: 10% vs. 7.1%; M6: 1.5% vs. 2.5%; M12: 15.2% vs. 13.4%), but indeterminate results were common (Screening: 82.4% vs. 17.8%; M1: 71.8% vs. 42.4%; M3: 62.9% vs. 47.1%; M6: 69.1% vs. 58.8%; M12: 30.3% vs. 19.4%), particularly among KTRs, although they received more vaccine boosters (95 vs. 63; p < 0.001). No correlation was observed between the number of vaccine doses and IGRA positivity.
conclusionDespite multiple vaccine boosters, dialysis and kidney transplant patients exhibited limited and variable cellular immune responses, highlighting the need for improved vaccination and monitoring strategies in these high-risk populations.
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