SARS-CoV-2 MRNA Vaccine-Induced Cellular and Humoral Immunity in Hemodialysis Patients

Overview

Journal Biomedicines

Specialty Biomedical Engineering

Date 2022 Mar 25

PMID 35327438

Authors

Ewa Kwiatkowska

Krzysztof Safranow

Iwona Wojciechowska-Koszko

Paulina Roszkowska

Violetta Dziedziejko

Marek Myslak

Jacek Rozanski

Kazimierz Ciechanowski

Tomasz Stompor

Jaroslaw Przybycinski

Piotr Wisniewski

Norbert Kwella

Sebastian Kwiatkowski

Tomasz Prystacki

Wojciech Marcinkowski

Leszek Domanski

Affiliations

Soon will be listed here.

Abstract

Background/aims: Chronic kidney disease CKD patients on intermittent hemodialysis IHD are exposed to SARS-CoV-2 infection and carry a risk of developing severe symptoms. The aim of this study was to evaluate the humoral and cellular immunity induced by two doses of mRNA vaccines, the Pfizer-BioNTech (Comirnaty) COVID-19 Vaccine and the Moderna (mRNA-1273) COVID-19 vaccine.

Patients And Methods: The study included 281 patients from five dialysis centers in northern Poland. Within 2 weeks prior to the first dose of the vaccine, a blood sample was collected for an evaluation of SARS-CoV-2 antibodies. Thirty to forty-five days after the second dose of the vaccine, a blood sample was taken to evaluate humoral and cellular response.

Results: Patients with stage 5 CKD on IHD were characterized by a considerable SARS-CoV-2 vaccine-induced seroconversion rate. The strongest factors influencing the antibodies AB level after vaccination were a pre-vaccination history of SARS-CoV-2 infection, age, the neutrophil-to-lymphocyte ratio NLR, neutrophil absolute count, and the hemoglobin level. Cellular immunity was higher in patients with a pre-vaccination history of SARS-CoV-2 infection. Cellular immunity depended on the albumin level. Positive cellular response to vaccination was a positive factor reducing all-cause mortality, except for COVID-19 mortality (no such deaths were reported during our follow-up). Cellular immunity and humoral immunity were positively mutually dependent. High levels of albumin and hemoglobin, low neutrophil count, and a reduced NLR, translated into better response to vaccination.

Conclusions: Patients with stage 5 CKD on IHD were characterized by a considerable SARS-CoV-2 vaccine-induced seroconversion rate and a good rate of cellular immunity. The factors that change with exacerbating inflammation and malnutrition (albumin, hemoglobin, neutrophil count, the NLR) affected the efficacy of the vaccination.

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