Impact of Prolonged SARS-CoV-2 Dosing Interval in Hemodialysis Patients
Notice bibliographique
Résumé
In their cohort study, Kittrakulrat et al. reported that in patients with advanced chronic kidney disease (CKD), a shorter interval between HBV vaccination doses led to a significantly higher seroconversion rate 1Kittrakulrat J. Tiankanon K. Kerr S.J. et al.A Randomized Controlled Study of Efficacy and Safety of Accelerated Versus Standard Hepatitis B Vaccination in Patients With Advanced CKD.Kidney International Reports. 2024/04/01/ 2024; 9: 853-862https://doi.org/10.1016/j.ekir.2024.01.014Abstract Full Text Full Text PDF Scopus (0) Google Scholar. This finding is in line with our findings on the response rate to SARS-CoV-2 vaccinations in patients receiving hemodialysis. We conducted a prospective cohort study of chronic hemodialysis patients without prior SARS-CoV-2 infection from 7 centers. Patients received two doses of SARS-CoV-2 mRNA vaccine at variable dosing intervals (21 to 113 days) (Figure 1A). We assessed anti-receptor binding domain (RBD) IgG levels 3-6 weeks after each dose, and evaluated if dosing interval was associated with “positive anti-RBD response” (IgG level >10 relative light units (RLU)). In our cohort, 85/400 (21%) had positive anti-RBD response after one dose, compared to 19/20 healthy controls (p< p<0.0001). Of the 315 who did not respond to the first dose, 258 (82%) developed positive anti-RBD response after the second dose. Importantly, a longer interval between doses was associated with lower risk of eliciting anti-RBD IgG to the 2nd dose, contrary to what is observed in immunocompetent individuals 2Grunau B. Goldfarb D.M. Asamoah-Boaheng M. et al.Immunogenicity of Extended mRNA SARS-CoV-2 Vaccine Dosing Intervals.JAMA. 2021; https://doi.org/10.1001/jama.2021.21921Crossref Scopus (51) Google Scholar, 3Tauzin A. Gong S.Y. Beaudoin-Bussières G. et al.Strong humoral immune responses against SARS-CoV-2 Spike after BNT162b2 mRNA vaccination with a 16-week interval between doses.Cell Host Microbe. Jan 12 2022; 30: 97-109.e5https://doi.org/10.1016/j.chom.2021.12.004Abstract Full Text Full Text PDF PubMed Scopus (54) Google Scholar, 4Payne R.P. Longet S. Austin J.A. et al.Immunogenicity of standard and extended dosing intervals of BNT162b2 mRNA vaccine.Cell. Nov 11 2021; 184: 5699-5714.e11https://doi.org/10.1016/j.cell.2021.10.011Abstract Full Text Full Text PDF PubMed Scopus (201) Google Scholar. In unadjusted analyses, dialysis duration, use of immunosuppressive medication, and dosing interval were each significantly associated with lower risk of developing anti-RBD IgG levels >10 RLU, whereas diabetes, age, and sex were not (Table S2). In multivariable analyses, an interval of >=8 weeks between doses was independently associated with lower odds of developing a positive anti-RBD IgG responses after the second dose (adjusted odds ratio 0.41, 95% CI 0.21-0.78, p=0.007) (Table S3). A positive anti-RBD response was observed in 120/137 (88%) who received the two doses <8 weeks apart, compared to 138/178 (78%) in those who received their doses >8 weeks apart, with median anti-RBD IgG levels significantly lower in the latter group (Figure 1B&C). In conclusion, our findings align with the current study, namely that shorter intervals between vaccine doses improve seroconversion rates in CKD and dialysis. Efforts to evaluate optimal vaccine dosing intervals in patients with kidney disease for all vaccinations should be encouraged. This work was funded by the Canadian Institutes of Health Research, grant no. 447760 to RSS, by le Ministère de l’Économie et de l’Innovation du Québec, Programme de soutien aux organismes de recherche et d’innovation to A.F. and by the Fondation du CHUM. This work was also supported by the following to A.F.: CIHR foundation grant #352417, CIHR operating Pandemic and Health Emergencies Research grant #177958, CIHR stream 1 and 2 for SARS-CoV-2 Variant Research, and Exceptional Fund COVID-19 from the Canada Foundation for Innovation (CFI) #41027. A.F. is the recipient of Canada Research Chair on Retroviral Entry no. RCHS0235 950-232424. D.E.K. is a FRQS Merit Research Scholar. RS, RG, ACNF, FM, CL and WBS were/are supported by the Fonds de Recherche du Québec – Santé (FRQS) Clinician-Researcher Awards. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».