Immune Responses to SARS-CoV-2 Infection and Vaccination in Dialysis Patients and Kidney Transplant Recipients

Patrick Affeldt; Felix Carlo Koehler; Karl August Brensing; Vivien Adam; Julia Burian; Linus Butt; Martin Gies; Franziska Grundmann; Steffen Hinrichs; Wibke Johannis; Nils Kalisch; Matthias Meyer-Delpho; Simon Oehm; Eva Platen; Claudia Schöler; Eva Heger; Gertrud Steger; Dirk Stippel; Aileen Ziegelhöfer; Thomas Benzing; Florian Klein; Christine Kurschat; Roman-Ulrich Müller; Veronica Di Cristanziano

doi:10.3390/microorganisms10010004

Microorganisms (Dec 2021)

Immune Responses to SARS-CoV-2 Infection and Vaccination in Dialysis Patients and Kidney Transplant Recipients

Patrick Affeldt,
Felix Carlo Koehler,
Karl August Brensing,
Vivien Adam,
Julia Burian,
Linus Butt,
Martin Gies,
Franziska Grundmann,
Steffen Hinrichs,
Wibke Johannis,
Nils Kalisch,
Matthias Meyer-Delpho,
Simon Oehm,
Eva Platen,
Claudia Schöler,
Eva Heger,
Gertrud Steger,
Dirk Stippel,
Aileen Ziegelhöfer,
Thomas Benzing,
Florian Klein,
Christine Kurschat,
Roman-Ulrich Müller,
Veronica Di Cristanziano

Affiliations

Patrick Affeldt: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Felix Carlo Koehler: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Karl August Brensing: Nierenzentrum Bonn, 53175 Bonn, Germany
Vivien Adam: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Julia Burian: Nieren- und Dialysezentrum Rheinbach, 53359 Rheinbach, Germany
Linus Butt: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Martin Gies: KfH-Nierenzentrum Köln-Longerich, 50737 Cologne, Germany
Franziska Grundmann: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Steffen Hinrichs: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Wibke Johannis: Institute for Clinical Chemistry, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50937 Cologne, Germany
Nils Kalisch: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Matthias Meyer-Delpho: Dialysezentrum Siegburg, 53721 Siegburg, Germany
Simon Oehm: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Eva Platen: Nierenzentrum Eifel, 53894 Mechernich, Germany
Claudia Schöler: KfH-Nierenzentrum Köln-Longerich, 50737 Cologne, Germany
Eva Heger: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Gertrud Steger: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Dirk Stippel: Department of General, Visceral, Cancer and Transplant Surgery, Faculty of Medicine, University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Aileen Ziegelhöfer: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Thomas Benzing: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Florian Klein: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Christine Kurschat: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Roman-Ulrich Müller: Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Veronica Di Cristanziano: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany

DOI: https://doi.org/10.3390/microorganisms10010004
Journal volume & issue: Vol. 10, no. 1
p. 4

Abstract

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Dialysis patients and kidney transplant (KTX) recipients suffer from an impaired immune system and show a decreased response to the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) vaccination. We performed a retrospective analysis of 1505 serological SARS-CoV-2 measurements obtained from 887 dialysis patients and 86 KTX recipients. The results were separated by patient subgroups (dialysis/KTX) as well as SARS-CoV-2 status. The latter criterion included SARS-CoV-2-naïve patients with or without COVID-19 vaccination and convalescent patients receiving a booster shot. Serologies of 27 vaccinated healthy individuals served as the reference group. Vaccine-induced cellular immune response was quantified by an interferon-γ release assay in 32 KTX recipients. We determined seroconversion rates of 92.6%, 93.4%, and 71.4% in dialysis patients vaccinated with either BNT162b2, mRNA-1273, or AZD1222, respectively. Vaccination-induced anti-SARS-CoV-2 antibody titers were lower in dialysis patients compared to healthy individuals, and vaccination with mRNA-1273 induced higher titers than BNT162b2. The initial seroconversion rate was 39.5% in KTX recipients vaccinated with BNT162b2. A linear regression model identified medication with mycophenolate-mofetil/mycophenolic acid as an independent risk factor for missing seroconversion. Within a cohort of 32 KTX recipients, cellular and humoral immune reactivity to SARS-CoV-2 was detectable in three patients only. Conclusively, vaccine-induced seroconversion rates were similar in dialysis patients compared to healthy individuals but were strongly impaired in KTX recipients. Anti-SARS-CoV-2 IgG titers elicited by double active immunization were significantly lower in both cohorts compared to healthy individuals, and immune responses to vaccination vanished quickly.

Published in Microorganisms

ISSN: 2076-2607 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Science: Biology (General)
Website: https://www.mdpi.com/journal/microorganisms

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