Spike and neutralizing antibodies response to COVID-19 vaccination in haemodialysis patients

Matthieu Giot (1) , Toscane Fourié (2, 3) , Guillaume Lano (1, 4) , Paola Mariela Saba Villarroel (2) , Xavier De Lamballeri (2) , Marion Gully (1) , Laurent Samson (1) , Julien Farault (1) , Dammar Bouchouareb (1) , Océane Jehel (1) , Philippe Brunet (1, 4) , Noémie Jourde-Chiche (1, 4) , Laetitia Ninove (5, 3) , Thomas Robert (5, 1)

1 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
2 UVE - Unité des Virus Emergents
3 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
4 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
5 MMG - Marseille medical genetics - Centre de génétique médicale de Marseille

Humoral response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines needs to be evaluated in the fragile population of patients on maintenance haemodialysis (HD). Methods We analysed the antibody response to the spike (S) antigen of SARS-CoV-2 before and after each dose of the messenger RNA (mRNA) Comirnaty vaccine (BNT162b2; BioNTech & Pfizer) in patients from a single dialysis centre and detected the presence of neutralizing antibodies (Nabs). Results Among the 90 vaccinated HD patients (mean age 69 years, 61% male), 19 (21%) had a history of SARS-CoV-2 infection. A seroconversion with anti-S immunoglobulin G antibodies (Sabs) was documented in 20% of patients after the first dose (early responders) and in 77% after the second dose, while 23% were non-responders. Cardiac disease, cirrhosis and gamma globulin levels were independently predictive of the absence of seroconversion. Nabs were detected in 15.4% of early responders after the first dose and in 84.6% of early responders and 57.9% of late responders after the second dose. Sab titres after the second dose were higher in patients with Nab than without Nab {598 [interquartile range (IQR) 246–882]) versus 134 [IQR 61–390]; P < 0.0001}. All patients with a history of SARS-CoV-2 infection developed both Sabs and Nabs and their titres for Sabs and Nabs were higher than in late responders. Conclusions Most HD patients develop a substantial humoral response against SARS-CoV2, with Nabs, following the mRNA vaccine. Whether this immunity persists over time and is able to efficiently protect patients from coronavirus disease 2019 remains to be determined.

Mots clés: BNT162 vaccine; COVID-19; SARS-CoV-2; haemodialysis; renal dialysis; vaccine

Domaines: Médecine humaine et pathologie

Matthieu Giot, Toscane Fourié, Guillaume Lano, Paola Mariela Saba Villarroel, Xavier De Lamballeri, et al.. Spike and neutralizing antibodies response to COVID-19 vaccination in haemodialysis patients. Clinical Kidney Journal, 2021, 14 (10), pp.2239-2245. ⟨10.1093/ckj/sfab128⟩. ⟨hal-03662398⟩