SARS-CoV-2 mRNA Vaccine-Induced Cellular and Humoral Immunity in Hemodialysis Patients

Ewa Kwiatkowska; Krzysztof Safranow; Iwona Wojciechowska-Koszko; Paulina Roszkowska; Violetta Dziedziejko; Marek Myślak; Jacek Różański; Kazimierz Ciechanowski; Tomasz Stompór; Jarosław Przybyciński; Piotr Wiśniewski; Norbert Kwella; Sebastian Kwiatkowski; Tomasz Prystacki; Wojciech Marcinkowski; Leszek Domański

doi:10.3390/biomedicines10030636

Biomedicines (Mar 2022)

SARS-CoV-2 mRNA Vaccine-Induced Cellular and Humoral Immunity in Hemodialysis Patients

Ewa Kwiatkowska,
Krzysztof Safranow,
Iwona Wojciechowska-Koszko,
Paulina Roszkowska,
Violetta Dziedziejko,
Marek Myślak,
Jacek Różański,
Kazimierz Ciechanowski,
Tomasz Stompór,
Jarosław Przybyciński,
Piotr Wiśniewski,
Norbert Kwella,
Sebastian Kwiatkowski,
Tomasz Prystacki,
Wojciech Marcinkowski,
Leszek Domański

Affiliations

Ewa Kwiatkowska: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland
Krzysztof Safranow: Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
Iwona Wojciechowska-Koszko: Independent Laboratory of Immunological Diagnostics, Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland
Paulina Roszkowska: Independent Laboratory of Immunological Diagnostics, Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland
Violetta Dziedziejko: Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland
Marek Myślak: Department of Nephrology and Kidney Transplantation, Provincial Integrated Hospital, Arkońska 4, 71-455 Szczecin, Poland
Jacek Różański: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland
Kazimierz Ciechanowski: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland
Tomasz Stompór: Department of Nephrology, Transplantology and Internal Diseases, University of Warmia and Mazury, 10-719 Olsztyn, Poland
Jarosław Przybyciński: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland
Piotr Wiśniewski: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland
Norbert Kwella: Department of Nephrology, Transplantology and Internal Diseases, University of Warmia and Mazury, 10-719 Olsztyn, Poland
Sebastian Kwiatkowski: Department of Obstetrics and Gynecology, Pomeranian Medical University, 70-111 Szczecin, Poland
Tomasz Prystacki: Fresenius Nephrocare, 60-118 Poznań, Poland
Wojciech Marcinkowski: Fresenius Nephrocare, 60-118 Poznań, Poland
Leszek Domański: Clinical Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland

DOI: https://doi.org/10.3390/biomedicines10030636
Journal volume & issue: Vol. 10, no. 3
p. 636

Abstract

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Background/Aims: Chronic kidney disease CKD patients on intermittent hemodialysis IHD are exposed to SARS-CoV-2 infection and carry a risk of developing severe symptoms. The aim of this study was to evaluate the humoral and cellular immunity induced by two doses of mRNA vaccines, the Pfizer-BioNTech (Comirnaty) COVID-19 Vaccine and the Moderna (mRNA-1273) COVID-19 vaccine. Patients and methods: The study included 281 patients from five dialysis centers in northern Poland. Within 2 weeks prior to the first dose of the vaccine, a blood sample was collected for an evaluation of SARS-CoV-2 antibodies. Thirty to forty-five days after the second dose of the vaccine, a blood sample was taken to evaluate humoral and cellular response. Results: Patients with stage 5 CKD on IHD were characterized by a considerable SARS-CoV-2 vaccine-induced seroconversion rate. The strongest factors influencing the antibodies AB level after vaccination were a pre-vaccination history of SARS-CoV-2 infection, age, the neutrophil-to-lymphocyte ratio NLR, neutrophil absolute count, and the hemoglobin level. Cellular immunity was higher in patients with a pre-vaccination history of SARS-CoV-2 infection. Cellular immunity depended on the albumin level. Positive cellular response to vaccination was a positive factor reducing all-cause mortality, except for COVID-19 mortality (no such deaths were reported during our follow-up). Cellular immunity and humoral immunity were positively mutually dependent. High levels of albumin and hemoglobin, low neutrophil count, and a reduced NLR, translated into better response to vaccination. Conclusions: Patients with stage 5 CKD on IHD were characterized by a considerable SARS-CoV-2 vaccine-induced seroconversion rate and a good rate of cellular immunity. The factors that change with exacerbating inflammation and malnutrition (albumin, hemoglobin, neutrophil count, the NLR) affected the efficacy of the vaccination.

Published in Biomedicines

ISSN: 2227-9059 (Online)
Publisher: MDPI AG
Country of publisher: Switzerland
LCC subjects: Science: Biology (General)
Website: http://www.mdpi.com/journal/biomedicines

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