COVID-19 Risk for Dialysis Patients Tied to Antibody Response to Vaccine

Prognostic Implications of Left Ventricular Global Longitudinal Strain in Predialysis
Prognostic Implications of Left Ventricular Global Longitudinal Strain in Predialysis
Patients with low circulating SARS-CoV-2 RBD IgG antibodies have increased infection risk, regardless of vaccination status.

HealthDay News — During the omicron-predominant period, three doses of an mRNA COVID-19 vaccine were associated with improved protection against infection for patients receiving dialysis, but patients with low circulating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor binding domain (RBD) immunoglobulin G (IgG) antibodies have increased infection risk, regardless of vaccination status, according to a study published online Aug. 15 in the Journal of the American Society of Nephrology.

Maria Montez-Rath, Ph.D., from Stanford University in California, and colleagues followed monthly semiquantitative SARS-CoV-2 RBD IgG index values in a randomly selected nationwide cohort of patients receiving dialysis. The relative risk for documented SARS-CoV-2 infection was estimated by vaccination and circulating RBD IgG during the omicron-dominant period of Dec. 25, 2021, to Jan. 31, 2022.

The researchers found that 25 percent of the 3,576 patients receiving dialysis received a third mRNA vaccine dose as of Dec. 1, 2022. Early antibody responses to the third dose were generally robust, with a median peak index IgG value of 150. SARS-CoV-2 infection was documented in 7 percent of patients during the study period. Patients without vaccination and with one or two versus three doses had a higher risk for infection. The risk for infection was higher among patients with circulating RBD IgG <23 versus IgG ≥23, irrespective of vaccine doses.

“Measuring a person’s circulating antibody response to SARS-CoV-2 virus may help us identify the highest risk persons eligible for enhanced protection among patients on dialysis, and other immunocompromised or frail populations,” a coauthor said in a statement.

Several authors disclosed financial ties to Ascend Clinical Laboratories.

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