Hemodialysis Patients Show a Highly Diminished Antibody Response after COVID-19 Compared to Healthy Controls
Preprint doi: https://doi.org/10.1101/2021.03.26.21254259
Benedikt Simon, Harald Rubey, Andreas Treipl, Martin Gromann, Boris Hemedi, Sonja Zehetmayer, Bernhard Kirsch
Items in both categories Kidney and Virus are listed here:
- Kidney patients who happened to be getting high-dose Calcitriol were 9X less likely to die of COVID-19 - April 6, 2021
- Hemodialysis associated with very poor mRNA response (wonder if low vitamin D) – March 26, 2021
- 26 health factors increase the risk of COVID-19 – all are proxies for low vitamin D
- Kidney diseases and COVID-19 – probably helped by Vitamin D etc. – Jan 19, 2021
- Chronic Kidney Disease decreases Vitamin D in 4 ways – Nov 2017
- Hemodialysis patients (CKD) helped by weekly 50,000 IU of vitamin D – Jan 2017
- Patients on Hemodialysis 3X more likely if die of heart failure if low Magnesium – meta-analysis Jan 2021
- Kidney Dialysis clinics reluctant to add vitamin D treatment as they are not reimbursed – Oct 2012
- 4X more Chronic Kidney disease patients are now using vitamin D – March 2014
- Adding Vitamin decreased kidney deaths by 4x – Dec 2010
- This is the result of about 10 trials with about 5,000 kidney disease patients.
- Note: some of the trials were terminated as they felt it was
- morally wrong to not give vitamin D to all of the Kidney patients
- Kidney Dialysis often filters out Vitamin D, a problem for vegetarians and others- Feb 2021
- More than 30 ng of vitamin D is sometimes needed (Kidney needs 50 ng) – March 2019
Background and Objectives Hemodialysis patients are prone to infection with SARS-COV2 and show a high probability of a severe course of disease and high mortality when infected. In many countries hemodialysis patients are prioritised in vaccination programs to protect this vulnerable community. However, no hemodialysis patients were included in efficacy trials of SARS CoV-2 vaccines and therefore efficacy and safety data for this patient group are lacking. These data would be critical, since hemodialysis patients showed decreased responses against various other vaccines and this could mean decreased response to SARS CoV-2 vaccines.
Design, setting, participants, and measurements We conducted a prospective cohort study consisting of a group of 81 hemodialysis patients and 80 healthy controls who were vaccinated with mRNA vaccine BNT162b2 (BionTech/Pfizer, 2 doses with an interval of 21 days). Anti-SARS-COV-2 S antibody response in all participants was measured 21 days after the second dose. The groups were compared with univariate quantile regressions and a multiple analysis. Adverse events (AEs) of the vaccination were assessed with a standardized questionnaire. We also performed a correlation of HBs-Antibody response with the SARS-COV-2 antibody response in the hemodialysis patients.
Results Dialysis patients had significantly lower Anti-SARS-COV-2 S antibody titres than healthy control patients 21 days after vaccination with BNT162b2 (median dialysis Patients 171 U/ml versus median controls 2500 U/ml). Age also had a significant but less pronounced influence on antibody titres. Dialysis patients showed less AEs than the control group. No significant correlation was found for Hepatitis B vaccine antibody response and SARS CoV-2 vaccine antibody response.
Conclusions Hemodialysis patients exhibit highly diminished SARS-COV-2 S antibody titres compared to a cohort of controls. Therefore these patients could be much less protected by SARS CoV-2 mRNA vaccination than expected. Alternative vaccination schemes must be considered and preventive measures must be maintained after vaccination.