Abstract
Background: Immune response assessed by the quantification of neutralizing antibodies (nAbs) and predictors associated with immunogenicity after the prime-boost ChAdOx1 (Oxford-AstraZeneca) COVID-19 vaccine in hemodialysis (HD) patients remains unclear.
Methods: This prospective study enrolled 174 HD patients and 67 healthy subjects to evaluate antibodies against the spike protein 1 and receptor-binding domain of severe acute respiratory syndrome coronavirus type 2 after prime-booster vaccination, by using enzyme-linked immunosorbent assay and applied spline-based generalized additive model regression analysis to predict 50% neutralization titer (NT 50 ). The correlation between HD parameters and NT 50 was analyzed.
Results: NT 50 was lower in HD patients compared with healthy controls after the prime-boost dose ( p < 0.001). The geometric mean titer ratios were higher in first-dose seronegative than in the seropositive subgroup in HD patients and healthy controls (6.96 vs. 2.36, p = 0.002, and 9.28 vs. 1.26, p = 0.011, respectively). After two doses of ChAdOx1, one-way ANOVA showed that Ca × P was positively associated with NT 50 ( p trend = 0.043) and multiple linear regression showed the similar results ( p = 0.021). Kt/V (a quantification of dialysis adequacy) (OR = 20.295, p = 0.005) could independently predict seroconversion (NT 50 ≥ 35.13 IU/mL).
Conclusion: Adequacy of hemodialysis could independently predict seroconversion in HD subjects vaccinated with prime-boost doses of ChAdOx1.
Keywords: COVID-19; hemodialysis adequacy; neutralization; neutralizing antibodies; vaccine.
【저자키워드】 COVID-19, Vaccine, Neutralizing antibodies, neutralization, hemodialysis adequacy, 【초록키워드】 neutralizing antibody, Vaccine, coronavirus, COVID-19 vaccine, vaccination, antibody, Prospective Study, dialysis, Seroconversion, Hemodialysis, Patient, Neutralizing, predictor, correlation, quantification, ChAdOx1, predict, seropositive, seronegative, dose, Oxford-AstraZeneca, Multiple linear regression, regression analysis, Adequacy, acute respiratory syndrome, subject, healthy control, domain, ANOVA, geometric mean titer, neutralization titer, parameter, enzyme-linked immunosorbent, enrolled, analyzed, evaluate, applied, the spike protein, healthy subject, 1.26, 【제목키워드】 response, ChAdOx1, Adequacy,