Abstract

Backgound: The immune system is profoundly affected by uremia. End stage kidney disease (ESKD) patients may be more vulnerable to infections and may have suboptimal response to vaccination. For the SARS-COV-2 (COVID-19), patients with ESKD are at increased risk of infection and mortality. However, the representation of patients with CKD and ESKD in clinical trials of COVID-19 vaccines is low.
Patients and methods: We investigated dialysis patients and a control group that had completed 2 doses vaccination with the mRNA BNT162b2 vaccine for anti-spike protein antibody response. Results: One hundred sixty chronic dialysis patients (127 hemodialysis,33 peritoneal dialysis) and one hundred thirty-two control group persons were analyzed. 90 % of the dialysis group and 100% of the control group were positive for anti-spike antibodies, (p<0. 0001). The median level of anti-spike antibody was 116.5 AU/ml (IQR 66-160 AU/ml) in the dialysis group and 176.5 AU/ml (IQR 142-235 AU/ml) in the control group, (p<0.001). Six hemodialysis patients (3.75%) and none in the control group developed COVID-19 new infection (confirmed by positive COVID-19 RT-PCR) more than 7 days after completion of the recommended vaccination regimen, (P=0.033). Discussion: In this study Our main findings for the dialysis population as compared to a control group, are:1. Lower response rate to the vaccine,2. Lower anti-spike antibodies level and 3. Higher rate of COVID-19 infection after completion of vaccination. Other preliminary reports on the immunogenicity of the COVID- 19 BNT162b2 vaccine report similar findings. Considering the results of our study, and while many limitations related to COVID-19 are expected to ease, we may consider maintaining physical distancing and other recommended measures in place for better protection of the dialysis population. Biography: Noa Berar Yanay, MD, MHA, Specialist in Nephrology, specialist in Internal Medicine, Head of nephrology, Hillel Yaffe Medical Center, Hadera, Israel

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