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Humoral response after the fourth dose of the SARS-CoV-2 vaccine in the CKD spectrum: a prespecified analysis of the SENCOVAC study

2022; Oxford University Press; Volume: 38; Issue: 4 Linguagem: Inglês

10.1093/ndt/gfac307

1460-2385

Borja Quiroga, María José Soler, Alberto Ortíz, Carlos Jesús Jarava Mantecón, Virginia Olinda Gomes Pérez, A. Bordils, José Luis Lacueva, Antonio Franco, Pablo Delgado Conde, Patricia Muñoz Ramos, Carmen Calderón González, Juan Manuel Cazorla López, Jinny Sánchez-Rodríguez, Ana Sánchez Horrillo, Tania Monzón, Alba Leyva, José Antonio Muñoz Rojas, Ron T. Gansevoort, Patricia de Sequera, Maria Teresa Jaldo Rodríguez, Rafael Lucena Valverde, Marta Puerta Carretero, Mayra Ortega Díaz, Daniel Gaitán Tocora, Esther Rodriguez Suárez, Alfredo José Sáenz Santolaya, Patricia Arribas Cobo, Tamar Talavan, Raquel Cerrajero Calero, Carolina Gracia-Iguacel, Emilio González‐Parra, Mônica Corso Pereira, Catalina Martín-Cleary, Ana Ramos-Verde, Martín Giorgi, Sánchez González, Yohana Gil Giraldo, Ana Sánchez Horrillo, Pablo Ruano Suárez, Antonio Fernández Perpén, Andrés Fernández, Laura Salanova Villanueva, Alejandra Cortiñas, Pablo A Díez Arias, Alicia Cabrera Cárdenas, Antonio de Santos, Almudena Hernández Núñez, Guillermina Barril Cuadrado, Loreto Mariscal de Gante, Raquel Repollet, Concepción Redondo Polo, Francesc Moreso, María Azancot, Natàlia Ramos, Oriol Bestard Nestor Toapanta, Ignacio Cidraque, Sheila Bermejo, Irene Agraz, Oreto Prat, Carlota Medina, Emma Pardo, Oreto Prat, A. Sáiz, Maria Antònia Munar Vila, Secundino Cigarrán, Nicolás Menéndez Granados, María Jesús Corton Cabo, Walter López Alarcón, Soledad Pizarro Sánchez, Simona Alexandru, Laura García Puente Suarez, Saúl Pampa Saico, Marisol Poma Tapia, Rocío Zamora, Rosa Sánchez Hernández, Laura Rodríguez Osorio, Núria García-Fernández, Paloma Leticia Martin Moreno, Noelia Ania González, Ana Sabalza Ortiz, María Nieves Bastida Iñarrea, Sagrario Soriano Cabrera, Raquel Ojeda López, Cayetana Moyano Peregrí, M.L. Agüera, M.D. Navarro Cabello, Auxiliadora Mazuecos, Teresa Garcı́a, Carlos F. Narváez, Cristhian Orellana, Marı́a Gabriela Márquez, Carolina Lancho Novillo, Pedro Luis Quirós Ganga, Fernando Vallejo Carrión, Antonio Luis García Herrera, Natalia Blanco Castro, Rosa María Ruiz-Calero Cendrero, María Victoria Martín Hidalgo-Barquero, Román Hernández Gallego, Alvaro Goyoaga Alvarez, Eva Vázquez Leo, José Luis Pizarro León, Manuel Antonio Martínez García, Benaldina García Jiménez, Virginia Olinda Gómez Pérez, Juan de Dios Ramiro Moya, Diana López Espinosa, Alejandro Jiménez Herrador, Manuel Navarro Zurita, Leonardo Díaz Álvarez, ÁlvaroGonzález Martínez, Sandra Báez Arroyo, Raquel Reina Fernández, Marlyn Janella Suárez Vargas, Rocío Calurano Casero, Gustavo Useche, Amparo Bernat García, Ana Beatriz Muñoz Díaz, Carmen Santamaría de Miguel, Ángel Palacios, Brenda Henningsmeyer, Esther Orero Calve, José Lacueva Moya, Yurika Sato, Marta Serra Marín, Sandra Tejedor, Shaida Martínez Vaquera, Manuel Carnerero di Riso, Irene Torres, Georgina Alfaro, Olga Halauko, Fouad El Rifai, Ana Dolores Martínez, Pablo Justo Ávila, Ana Sánchez Horrillo, Marta Sanz Sainz, José María Baltar Martín, Laura García, José Luis Pérez Canga, Paola Milena Villabón Ochoa, Laura Muñiz Pacios, Lina León Machado, Augusto Quiroz Morales, Ignacio Manzur Cavalotti, Itziar Navarro Zorita, Sol Otero López, Sara Outon González, Carlos Soto Montañez, Auxiliadora Bajo Rubio, Gloria del Peso Gilsanz, Marta Ossorio Gonzalez, Rafael Sánchez, María O. López‐Oliva, Jesús Calviño Varela, Alba García Enríquez, Carmen Cobelo Casas, Pablo Otero Alonso, Lourdes González Tabarés, José María Lamas Barreiro, Luisa Palomares Solla, Arginino Gándara, Walfred Nájera de la Garza, Francisco Fernández Fleming, María Gloria Rodríguez Goyanes, Cintia Caramés Feijoo, María Mercedes Moreiras Plaza, Cristina Bayón Juan, Gabriel de Arriba, Katia Pérez del Valle, Francisco Contreras, Noelia Balibrea Lara, Dioné González Ferri, Eduardo Muñoz de Bustillo Llorente, Enriqueta González Rodríguez, Virginia Lopez De La Manzanara Perez, Marta Calvo Arevalo, José Antonio Herrero Calvo, María Rosario Llópez Carratalá, Leyre María Martin Rodríguez, Marisa Serrano Salazar, Begoña Prieto, José Pórtoles, Antonio Gil Paraíso, Emma Huarte, Maria Lanau, Rodrigo Avellaneda Campos, José Manuel Ubé, Isabel Berdud Godoy, Esther Torres Aguilera, Rolando Tello Alea, Margie Soledad Del Rosario Saldaña, Mercedes Salgueira, Nuria Aresté Fosalba, María de los Ángeles Rodríguez Gázquez, Rocío Collantes, Ana Isabel Ortega Martínez, María Jesús Moyano, Elena Jiménez Víbora, Sandra Castellano Gash, Lara Ruíz Martínez, María Cinta Aguilar Cervera, María Teresa Rodrigo De Tomas, Beatriz Azcue Prieto, Carmen Toyos, José Molina Del Rio, Adriana Restrepo Acosta, Amagoia Celayeta Zamacona, Ma Isabel Jimeno Martin, Saioa Bilbao Ortega, Ma Isabel Gallardo Ruiz, A Rubio, Paula Garcia Ledesma, Alvaro Goyoaga Alvarez, Esteban Poch, David Cucchiari, José Jesús Broseta, Beatriz Escamilla Cabrera, Aurelio Pastor Rodríguez Hernández, María Sagrario García Rebollo, Juana Margarita Rufino Hernández, Alejandra Yugueros González, J. C. Alonso, Amparo Martínez Más, Manuel Calvé, Marina Garces Cardona, Vanesa Canto Balaguer, José Ignacio Mínguela Pesquera, Eva Cotilla de la Rosa, David Rodríguez Santarelli, Alba Santos García, Antonio Cabezas Martin-Caro, Inmaculada Martinez Santamaria, Michal Červienka, Ana María Urraca de la Pisa, Lidia Sendino Monzon, Karina Ampuero Anachuri, Esther Hernández Garcia, Victoria Oviedo Gomez, Raquel Santana Estupiñán, Francisco Valga Amado, Patricia Pérez Borges, Marta Durán Beloso, Fernanda Arroyo Alonso, Noemí Pérez Felpete, Ana Meizoso Ameneiro, Mónica Cunha Mera, Beatriz Gil-Casares, Sofía Zárraga Larrondo, Naroa Maruki Kareaga, Ainhoa Inza San Salvador del Valle, Ana Rosa Muñoz García, Blanca Villacorta Linaza, Nuria del Toro Espinosa, Paola Estupiñan Perico, José Manuel Sánchez Oliva, Joaquín Manrique, I. Albo Castaño, Carolina Purroi, Nerea Gómez, Cristina Mansilla, Ane Utzurrum, Manuel Ramírez de Arellano Serna, Luis Guirado Perich, María Muñiz Rincón, Virginia Lopez De La Manzanara Perez, Marta Calvo Arevalo, José Antonio Herrero Calvo, Jesús Villoria, Alfonso Pobes Martínez De Salinas,

COVID-19 Impact on Reproduction

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.