第一次疫苗接种后透析患者SARS-CoV-2细胞和体液免疫的流行情况

R. Duarte, Rosa Soares, I-Tse Lu, F. Ferrer, Paula Gama, H. Gonçalves, K. Lopes, F. Sofia, Carlos Cortes, Ana Vila Lobos
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摘要

背景:免疫接种仍然是预防COVID-19严重感染的关键。本研究旨在描述肾内科中心接种疫苗8个月后维持透析患者体液和细胞免疫的流行情况。方法:真实世界单中心流行横断面研究,纳入腹膜透析和血液透析患者。体液反应为特异性IgG(抗刺突蛋白受体结合域IgG),细胞反应为T细胞反应性,通过干扰素γ定量作为抗原反应。结果:入选的86例患者中,体液免疫和细胞免疫分别为79.4%和84.1%。抗刺突蛋白受体结合域IgG与特异性T细胞反应性相关(ρ=0.58;p < 0.001)。伴随高合并症负担和低血清白蛋白的疫苗接种患者存在免疫缺失风险(p<0.05)。结论:葡萄牙维持性透析患者对严重急性呼吸综合征冠状病毒2型的体液免疫和细胞免疫水平较高。高合并症负担和低血清白蛋白是免疫反应缺失的危险因素。
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Prevalence of SARS-CoV-2 Cellular and Humoral Immunity Amongst Patients on Dialysis After the First Vaccination Campaign
Background: Immunisation remains critical in prevention of serious COVID-19 infection. This study aimed to characterise the prevalence of humoral and cellular immunity in patients on maintenance dialysis in a nephrology centre 8 months after vaccination onset. Methods: Real-world single-centre prevalence cross-sectional study enrolling patients on peritoneal and haemodialysis. Humoral response was measured as specific IgG (anti-spike protein receptor-binding domain IgG) and cellular response as T cell reactivity through interferon γ quantification as response to antigen. Results: Of the 86 patients enrolled, 79.4% and 84.1% showed humoral and cellular immunity, respectively. Anti-spike protein receptor-binding domain IgG correlated with specific T cell reactivity (ρ=0.58; p<0.001). Vaccinated patients with associated high comorbidity burden and low serum albumin were at risk of absent immunity (p<0.05). Conclusion: The prevalence of humoral and cellular immunity against severe acute respiratory syndrome coronavirus 2 in vaccinated Portuguese patients on maintenance dialysis is high. High comorbidity burden and low serum albumin are risk factors for absent immune response.
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