Influencers of COVID Vaccine Response in Dialysis Patients

METHODOLOGY:

Researchers in France performed a retrospective observational study to identify factors associated with a poor humoral response after completion of the SARS-CoV-2 mRNA vaccination schedule (three doses) in 80 adult patients (median age, 71 years; 44% women) undergoing maintenance dialysis for more than 3 months.
Anti-SARS-CoV-2 antibody levels were measured using a quantitative serology test at two timepoints: 3 months after the third dose and either 7 months after the third dose or 3 months after the fourth (second booster) dose.
On the basis of antibody titres at 3 months after the third dose, the patients were classified as low responders (n = 28; anti-SARS-CoV-2 antibody level, 50-1830 AU/mL) and responders (n = 52; anti-SARS-CoV-2 antibody level > 1830 AU/mL).
Data on laboratory values, dialysis parameters, history of kidney disease, chronic heart failure, and immunosuppressive treatments were extracted from medical records.
The primary endpoint was the humoral immune response, evaluated using the SARS-CoV-2 antibody level at 3 months after the third dose.

Low responders were more likely to have chronic heart failure (P < .00001), worse functional abilities and well-being (P = .004), hypoalbuminaemia (P < .001), lymphopenia (P = .003), rhesus status positivity (P = .02), and no response to a hepatitis B virus vaccine (P = .02) than responders.
No significant differences were observed between both groups regarding the history of kidney transplantation, use of immunosuppressive therapy, and haemodialysis parameters.
In multivariate analysis, chronic heart failure (odds ratio [OR], 20.63; P < .0001) and lower serum albumin levels (OR, 0.63; P = .0004) were associated with a poor response to the SARS-CoV-2 mRNA vaccine.
However, post-vaccination SARS-CoV-2 infection rates did not differ significantly between low responders and responders (P = .59).

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