Patients on dialysis are at risk of severe course of SARS-CoV-2 infection. Understanding the neutralizing activity and coverage of SARS-CoV-2 variants of vaccine-elicited antibodies is required to guide prophylactic and therapeutic COVID-19 interventions in this frail population. By analyzing plasma samples from 130 hemodialysis and 13 peritoneal dialysis patients after two doses of BNT162b2 or mRNA-1273 vaccines, we found that 35% of the patients had low-level or undetectable IgG antibodies to SARS-CoV-2 Spike (S). Neutralizing antibodies against the vaccine-matched SARS-CoV-2 and Delta variant were low or undetectable in 49% and 77% of patients, respectively, and were further reduced against other emerging variants. The fraction of non-responding patients was higher in SARS-CoV-2-naïve hemodialysis patients immunized with BNT162b2 (66%) than those immunized with mRNA-1273 (23%). The reduced neutralizing activity correlated with low antibody avidity. Patients followed up to 7 months after vaccination showed a rapid decay of the antibody response with an average 21- and 10-fold reduction of neutralizing antibodies to vaccine-matched SARS-CoV-2 and Delta variant, which increased the fraction of non-responders to 84% and 90%, respectively. These data indicate that dialysis patients should be prioritized for additional vaccination boosts. Nevertheless, their antibody response to SARS-CoV-2 must be continuously monitored to adopt the best prophylactic and therapeutic strategy.
【초록키워드】 COVID-19, neutralizing antibody, SARS-CoV-2, vaccination, spike, antibody, mRNA-1273, SARS-COV-2 infection, Antibody Response, SARS-CoV-2 variant, risk, Intervention, Prophylactic, delta variant, variants, dialysis, BNT162b2, Neutralizing activity, Coverage, Hemodialysis, IgG antibody, therapeutic, Patient, understanding, Peritoneal dialysis, patients, therapeutic strategy, Antibody avidity, dose, reduction, average, fraction, mRNA-1273 vaccines, non-responder, immunized, plasma sample, Course, the patient, required, reduced, correlated, the antibody response, of BNT162b2, undetectable, 【제목키워드】 antibody, neutralization, SARS-CoV-2 variant, dialysis, Patient, Poor,