Poor neutralization and rapid decay of antibodies to SARS-CoV-2 variants in vaccinated dialysis patients.


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Authors
Bassi, Jessica 
Giannini, Olivier 
Silacci-Fregni, Chiara 
Pertusini, Laura 
Hitz, Paolo 
Abstract

Patients on dialysis are at risk of severe course of SARS-CoV-2 infection. Understanding the neutralizing activity and coverage of SARS-CoV-2 variants of vaccine-elicited antibodies is required to guide prophylactic and therapeutic COVID-19 interventions in this frail population. By analyzing plasma samples from 130 hemodialysis and 13 peritoneal dialysis patients after two doses of BNT162b2 or mRNA-1273 vaccines, we found that 35% of the patients had low-level or undetectable IgG antibodies to SARS-CoV-2 Spike (S). Neutralizing antibodies against the vaccine-matched SARS-CoV-2 and Delta variant were low or undetectable in 49% and 77% of patients, respectively, and were further reduced against other emerging variants. The fraction of non-responding patients was higher in SARS-CoV-2-naïve hemodialysis patients immunized with BNT162b2 (66%) than those immunized with mRNA-1273 (23%). The reduced neutralizing activity correlated with low antibody avidity. Patients followed up to 7 months after vaccination showed a rapid decay of the antibody response with an average 21- and 10-fold reduction of neutralizing antibodies to vaccine-matched SARS-CoV-2 and Delta variant, which increased the fraction of non-responders to 84% and 90%, respectively. These data indicate that dialysis patients should be prioritized for additional vaccination boosts. Nevertheless, their antibody response to SARS-CoV-2 must be continuously monitored to adopt the best prophylactic and therapeutic strategy.

Description

Funder: Swiss Kidney Foundation

Keywords
Research Article, Biology and life sciences, Medicine and health sciences
Journal Title
PLoS One
Conference Name
Journal ISSN
1932-6203
1932-6203
Volume Title
17
Publisher
Public Library of Science (PLoS)
Sponsorship
MRC (via Imperial College London) (MR/W005611/1)