Humoral response after the fourth dose of the SARS-CoV-2 vaccine in the CKD spectrum: a prespecified analysis of the SENCOVAC study
Author:
Quiroga Borja1ORCID, Soler María José23ORCID, Ortiz Alberto34ORCID, Jarava Mantecón Carlos Jesús5, Gomes Pérez Virginia Olinda5, Bordils Antoni6, Lacueva José6, Marin Franco Antonio José7, Delgado Conde Pablo8, Muñoz Ramos Patricia9, Calderón González Carmen10, Cazorla López Juan Manuel11, Sanchez-Rodriguez Jinny4, Sánchez Horrillo Ana1, Monzón Vázquez Tania Raquel12, Leyva Alba13, Rojas José13, Gansevoort Ron T14ORCID, de Sequera Patricia39, Rodríguez María Teresa Jaldo, Valverde Rafael Lucena, Carretero Marta Puerta, Díaz Mayra Ortega, Tocora Daniel Gaitán, Suárez Esther Rodriguez, Santolaya Alfredo José Sáenz, Cobo Patricia Arribas, Talavan Tamar, Calero Raquel Cerrajero, Gracia-Iguacel Carolina, González-Parra Emilio, Pereira Mónica, Martin-Cleary Catalina, Ramos-Verde Ana, Giorgi Martín, Sánchez Carmen, Giraldo Yohana Gil, Horrillo Ana Sánchez, Suárez Pablo Ruano, Perpén Antonio Fernández, Ramos Andrés Fernández, Villanueva Laura Salanova, Cortiñas Alejandra, Arias Pablo A Díez, Cárdenas Alicia Cabrera, de Santos Antonio, Núñez Almudena, Cuadrado Guillermina Barril, de Gante Loreto Mariscal, Repollet Raquel, Polo Concepción Redondo, Moreso Francesc, Azancot María Antonieta, Ramos Natalia, Toapanta Oriol Bestard Nestor, Cidraque Ignacio, Bermejo Sheila, Agraz Irene, Prat Oreto, Medina Carlota, Pardo Emma, Prat Oreto, Saiz Alejandro, Vila Maria Antònia Munar, Guldris Secundino Cigarrán, Granados Nicolás Menéndez, Cabo María Jesús Corton, Alarcón Walter López, Sánchez Soledad Pizarro, Alexandru Simona, Suarez Laura García Puente, Saico Saul Pampa, Tapia Marisol Poma, Zamora Rocío, Hernández Rosa Sánchez, Osorio Laura Rodríguez, García-Fernández Nuria, Moreno Paloma Leticia Martin, González Noelia Ania, Ortiz Ana Sabalza, Iñarrea María Nieves Bastida, Cabrera Sagrario Soriano, López Raquel Ojeda, Peregrí Cayetana Moyano, Morales Maria Luisa Agüera, Cabello Maria Dolores Navarro, Mazuecos Auxiliadora, García Teresa, Narváez Carlos, Orellana Cristhian, Márquez María Gabriela Sánchez, Novillo Carolina Lancho, Ganga Pedro Luis Quirós, Carrión Fernando Vallejo, Herrera Antonio Luis García, Castro Natalia Blanco, Cendrero Rosa María Ruiz-Calero, Hidalgo-Barquero María Victoria Martín, Gallego Román Hernández, Alvarez Álvaro, Leo Eva Vázquez, León José Luis Pizarro, García Manuel Antonio Martínez, Jiménez Benaldina García, Pérez Virginia Olinda Gómez, Moya Juan de Dios Ramiro, Espinosa Diana López, Herrador Alejandro Jiménez, Zurita Manuel Navarro, Díaz Álvarez Leonardo, Martínez ÁlvaroGonzález, Arroyo Sandra Báez, Fernández Raquel Reina, Vargas Marlyn Janella Suárez, Casero Rocío Calurano, Useche Gustavo, García Amparo Bernat, Díaz Ana Beatriz Muñoz, de Miguel Carmen Santamaría, Palacios Ángel, Henningsmeyer Brenda, Calve Esther Orero, Moya José Lacueva, Sato Yurika, Marín Marta Serra, Tejedor Sandra, Vaquera Shaida Martínez, Carnerero di Riso Manuel, Torres Irene, Alfaro Georgina, Halauko Olga, El Rifai Fouad, Martínez Ana Dolores, Justo Ávila Pablo, Sánchez Christian Alfaro, Sainz Marta Sanz, Martín José María Baltar, del Río García Laura, Canga José Luis Pérez, Ochoa Paola Milena Villabón, Pacios Laura Muñiz, Machado Lina León, Morales Augusto Quiroz, Cavalotti Ignacio Manzur, Zorita Itziar Navarro, López Sol Otero, González Sara Outon, Montañez Carlos Soto, Rubio Auxiliadora Bajo, Gilsanz Gloria Del Peso, Gonzalez Marta Ossorio, Villanueva Rafael Sánchez, Oliva Maria Ovidia Lopez, Varela Jesús Calviño, Enríquez Alba García, Casas Carmen Cobelo, Alonso Pablo Otero, Tabares Lourdes González, Barreiro José María Lamas, Solla Luisa Palomares, Gándara Arginino, Nájera de la Garza Walfred, Fleming Francisco Fernández, Goyanes María Gloria Rodríguez, Feijoo Cintia Caramés, Plaza María Mercedes Moreiras, Juan Cristina Bayón, de Arriba de la Fuente Gabriel, Pérez del Valle Katia, Contreras Francisco Javier Pérez, Lara Noelia Balibrea, Ferri Dioné González, Llorente Eduardo Muñoz de Bustillo, Rodríguez Enriqueta González, Perez Virginia Lopez De La Manzanara, Arevalo Marta Calvo, Calvo Jose Antonio Herrero, Carratalá María Rosario Llópez, Rodríguez Leyre María Martin, Salazar Marisa Serrano, Prieto Begoña Bravo, Pérez José María Portolés, Paraíso Antonio Gil, Huarte Emma, Lanau M, Campos Rodrigo Avellaneda, Ubé José Manuel, Godoy Isabel Berdud, Aguilera Esther Torres, Alea Rolando Tello, Saldaña Margie Soledad Del Rosario, Salgueira Mercedes, Aresté Nuria, de los Ángeles Rodríguez María, Collantes Rocío, Martínez Ana Isabel, Moyano María Jesús, Víbora Elena Jiménez, Gash Sandra Castellano, Martínez Lara Ruíz, Cervera María Cinta Aguilar, De Tomas María Teresa Rodrigo, Prieto Beatriz Azcue, Toyos Carmen, Del Rio José Molina, Acosta Adriana Restrepo, Zamacona Amagoia Celayeta, Martin Mª Isabel Jimeno, Ortega Saioa Bilbao, Ruiz Mª Isabel Gallardo, Rubio Ainhoa Hernando, Ledesma Paula Garcia, Alvarez Alvaro Goyoaga, Poch Esteban, Cucchiari David, Monzo José Broseta, Cabrera Beatriz Escamilla, Hernández Aurelio Pastor Rodríguez, Rebollo María Sagrario García, Hernández Juana Margarita Rufino, González Alejandra Yugueros, Alonso Juan Carlos, Más Amparo Martínez, Calvé Manuel, Cardona Marina Garces, Balaguer Vanesa Canto, Pesquera José Ignacio Minguela, Cotilla de la Rosa Eva, Santarelli David Rodríguez, Garcia Alba Santos, Martin-Caro Antonio Cabezas, Santamaria Inmaculada Martinez, Cervienka Michal, Urraca de la Pisa Ana María, Monzon Lidia Sendino, Anachuri Karina Ampuero, Garcia Esther Hernández, Gomez Victoria Oviedo, Estupiñán Raquel Santana, Amado Francisco Valga, Borges Patricia Pérez, Beloso Marta Durán, Alonso Fernanda Arroyo, Felpete Noemí Pérez, Ameneiro Ana Meizoso, Mera Mónica Cunha, Casares Beatriz Gil, Larrondo Sofía Zarraga, Kareaga Naroa Maruki, Salvador del Valle Ainhoa Inza San, García Ana Rosa Muñoz, Linaza Blanca Villacorta, del Toro Espinosa Nuria, Perico Paola Estupiñan, Oliva José Manuel Sánchez, Manrique Joaquín, Castaño Itziar, Purroi Carolina, Gómez Nerea, Mansilla Cristina, Utzurrum Ane, Serna Manuel Ramírez de Arellano, Perich Luis Guirado, Rincón María Muñiz, Perez Virginia Lopez De La Manzanara, Arevalo Marta Calvo, Calvo Jose Antonio Herrero, Villoria Jesús Grande, De Salinas Alfonso Pobes Martínez,
Affiliation:
1. IIS-La Princesa. Nephrology Department, Hospital Universitario de la Princesa , Madrid , Spain 2. Nephrology Department, Vall d'Hebrón University Hospital , Barcelona , Spain 3. RICORS2040 (Kidney Disease) 4. IIS-Fundación Jiménez Diaz, School of Medicine, Universidad Autónoma de Madrid, Fundación Renal Iñigo Álvarez de Toledo-IRSIN, REDinREN, Instituto de Investigación Carlos III , Madrid , Spain 5. Diaverum Andalucía , Spain 6. Diaverum Valencia , Spain 7. Diaverum Castilla León-Galicia , Spain 8. Diaverum Murcia–Alicante , Spain 9. Nephrology Department, Hospital Universitario Infanta Leonor – Universidad Complutense de Madrid, Madrid , Spain 10. Nephrology Department , Complejo Asistencial de Palencia, Palencia , Spain 11. Nephrology Department, Hospital Universitario Puerta del Mar , Cádiz , Spain 12. Nephrology Department, Hospital Universitario “Doctor Negrín” Las Palmas de Gran Canaria, Las Palmas, Spain 13. R&D Department , VIRCELL SL, Granada , Spain 14. Department of Internal Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
Abstract
ABSTRACT
Background
There is scarce evidence on the fourth dose of severe acute respiratory syndrome coronavirus 2 vaccines in chronic kidney disease (CKD) patients. We evaluated the humoral response and effectivity of the fourth dose in the CKD spectrum: non-dialysis CKD (ND-CKD), haemodialysis (HD), peritoneal dialysis (PD) and kidney transplant (KT) recipients.
Methods
This is a prespecified analysis of the prospective, observational, multicentric SENCOVAC study. In patients with CKD who had received a complete initial vaccination and one or two boosters and had anti-Spike antibody determinations 6 and 12 months after the initial vaccination, we analysed factors associated with persistent negative humoral response and higher anti-Spike antibody titres as well as the efficacy of vaccination on coronavirus disease 2019 (COVID-19) severity.
Results
Of 2186 patients (18% KT, 8% PD, 69% HD and 5% ND-CKD), 30% had received a fourth dose. The fourth dose increased anti-Spike antibody titres in HD (P = .001) and ND-CKD (P = .014) patients and seroconverted 72% of previously negative patients. Higher anti-Spike antibody titres at 12 months were independently associated with repeated exposure to antigen (fourth dose, previous breakthrough infections), previous anti-Spike antibody titres and not being a KT recipient. Breakthrough COVID-19 was registered in 137 (6%) patients, 5% of whom required admission. Admitted patients had prior titres <620 UI/ml and median values were lower (P = .020) than in non-admitted patients.
Conclusions
A fourth vaccine dose increased anti-Spike antibody titres or seroconverted many CKD patients, but those with the highest need for a vaccine booster (i.e. those with lower pre-booster antibody titres or KT recipients) derived the least benefit in terms of antibody titres. Admission for breakthrough COVID-19 was associated with low anti-Spike antibody titres.
Funder
Vifor Pharma ISCIII FEDER
Publisher
Oxford University Press (OUP)
Subject
Transplantation,Nephrology
Reference14 articles.
1. Chronic kidney disease is a key risk factor for severe COVID-19: a call to action by the ERA-EDTA;Ortiz;Nephrol Dial Transplant,2021 2. The COVID-19 pandemic: progress in nephrology.;Soler,2022 3. Safety and immediate humoral response of COVID-19 vaccines in chronic kidney disease patients: the SENCOVAC study;Quiroga,2021 4. Loss of humoral response 3 months after SARS-CoV-2 vaccination in the CKD spectrum: the multicentric SENCOVAC study;Quiroga,2022 5. Humoral response to third dose of SARS-CoV-2 vaccines in the CKD spectrum;Quiroga,2022
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