SARS-CoV-2 Infection during the Omicron Surge among Patients Receiving Dialysis : The Role of Circulating Receptor-Binding Domain Antibodies and Vaccine Doses
Copyright © 2022 by the American Society of Nephrology..
BACKGROUND: It is unclear whether circulating antibody levels conferred protection against SARS-CoV-2 infection among patients receiving dialysis during the Omicron-dominant period.
METHODS: We followed monthly semiquantitative SARS-CoV-2 RBD IgG index values in a randomly selected nationwide cohort of patients receiving dialysis and ascertained SARS-CoV-2 infection during the Omicron-dominant period of December 25, 2021 to January 31, 2022 using electronic health records. We estimated the relative risk for documented SARS-CoV-2 infection by vaccination status and by circulating RBD IgG using a log-binomial model accounting for age, sex, and prior COVID-19.
RESULTS: Among 3576 patients receiving dialysis, 901 (25%) received a third mRNA vaccine dose as of December 24, 2021. Early antibody responses to third doses were robust (median peak index IgG value at assay limit of 150). During the Omicron-dominant period, SARS-CoV-2 infection was documented in 340 (7%) patients. Risk for infection was higher among patients without vaccination and with one to two doses (RR, 2.1; 95% CI, 1.6 to 2.8, and RR, 1.3; 95% CI, 1.0 to 1.8 versus three doses, respectively). Irrespective of the number of vaccine doses, risk for infection was higher among patients with circulating RBD IgG <23 (506 BAU/ml) (RR range, 2.1 to 3.2, 95% CI, 1.3 to 3.4 and 95% CI, 2.2 to 4.5, respectively) compared with RBD IgG ≥23.
CONCLUSIONS: Among patients receiving dialysis, a third mRNA vaccine dose enhanced protection against SARS-CoV-2 infection during the Omicron-dominant period, but a low circulating RBD antibody response was associated with risk for infection independent of the number of vaccine doses. Measuring circulating antibody levels in this high-risk group could inform optimal timing of vaccination and other measures to reduce risk of SARS-CoV-2 infection.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
Journal of the American Society of Nephrology : JASN - 33(2022), 10 vom: 18. Okt., Seite 1832-1839 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Montez-Rath, Maria E [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 13.01.2023 Date Revised 02.10.2023 published: Print-Electronic UpdateOf: medRxiv. 2022 Mar 18;:. - PMID 35313586 Citation Status MEDLINE |
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| doi: |
10.1681/ASN.2022040504 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM344923916 |
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| 100 | 1 | |a Montez-Rath, Maria E |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a SARS-CoV-2 Infection during the Omicron Surge among Patients Receiving Dialysis |b The Role of Circulating Receptor-Binding Domain Antibodies and Vaccine Doses |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 13.01.2023 | ||
| 500 | |a Date Revised 02.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a UpdateOf: medRxiv. 2022 Mar 18;:. - PMID 35313586 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 by the American Society of Nephrology. | ||
| 520 | |a BACKGROUND: It is unclear whether circulating antibody levels conferred protection against SARS-CoV-2 infection among patients receiving dialysis during the Omicron-dominant period | ||
| 520 | |a METHODS: We followed monthly semiquantitative SARS-CoV-2 RBD IgG index values in a randomly selected nationwide cohort of patients receiving dialysis and ascertained SARS-CoV-2 infection during the Omicron-dominant period of December 25, 2021 to January 31, 2022 using electronic health records. We estimated the relative risk for documented SARS-CoV-2 infection by vaccination status and by circulating RBD IgG using a log-binomial model accounting for age, sex, and prior COVID-19 | ||
| 520 | |a RESULTS: Among 3576 patients receiving dialysis, 901 (25%) received a third mRNA vaccine dose as of December 24, 2021. Early antibody responses to third doses were robust (median peak index IgG value at assay limit of 150). During the Omicron-dominant period, SARS-CoV-2 infection was documented in 340 (7%) patients. Risk for infection was higher among patients without vaccination and with one to two doses (RR, 2.1; 95% CI, 1.6 to 2.8, and RR, 1.3; 95% CI, 1.0 to 1.8 versus three doses, respectively). Irrespective of the number of vaccine doses, risk for infection was higher among patients with circulating RBD IgG <23 (506 BAU/ml) (RR range, 2.1 to 3.2, 95% CI, 1.3 to 3.4 and 95% CI, 2.2 to 4.5, respectively) compared with RBD IgG ≥23 | ||
| 520 | |a CONCLUSIONS: Among patients receiving dialysis, a third mRNA vaccine dose enhanced protection against SARS-CoV-2 infection during the Omicron-dominant period, but a low circulating RBD antibody response was associated with risk for infection independent of the number of vaccine doses. Measuring circulating antibody levels in this high-risk group could inform optimal timing of vaccination and other measures to reduce risk of SARS-CoV-2 infection | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a ESKD | |
| 650 | 4 | |a SARS-CoV-2 | |
| 650 | 4 | |a chronic dialysis | |
| 650 | 4 | |a clinical epidemiology | |
| 650 | 4 | |a immunology | |
| 650 | 7 | |a Vaccines |2 NLM | |
| 650 | 7 | |a Antibodies, Viral |2 NLM | |
| 650 | 7 | |a Immunoglobulin G |2 NLM | |
| 700 | 1 | |a Garcia, Pablo |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Jialin |e verfasserin |4 aut | |
| 700 | 1 | |a Cadden, LinaCel |e verfasserin |4 aut | |
| 700 | 1 | |a Hunsader, Patti |e verfasserin |4 aut | |
| 700 | 1 | |a Morgan, Curt |e verfasserin |4 aut | |
| 700 | 1 | |a Kerschmann, Russell |e verfasserin |4 aut | |
| 700 | 1 | |a Beyer, Paul |e verfasserin |4 aut | |
| 700 | 1 | |a Dittrich, Mary |e verfasserin |4 aut | |
| 700 | 1 | |a Block, Geoffrey A |e verfasserin |4 aut | |
| 700 | 1 | |a Parsonnet, Julie |e verfasserin |4 aut | |
| 700 | 1 | |a Chertow, Glenn M |e verfasserin |4 aut | |
| 700 | 1 | |a Anand, Shuchi |e verfasserin |4 aut | |
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