确定慢性肾脏疾病人群对COVID-19疫苗接种的纵向血清学反应:一项临床研究方案

IF 1.6 Q3 UROLOGY & NEPHROLOGY Canadian Journal of Kidney Health and Disease Pub Date : 2023-01-01 DOI:10.1177/20543581231160511
Kevin Yau, Omosomi Enilama, Adeera Levin, Marc G Romney, Joel Singer, Peter Blake, Jeffrey Perl, Jerome A Leis, Robert Kozak, Hubert Tsui, Shelly Bolotin, Vanessa Tran, Christopher T Chan, Paul Tam, Miten Dhruve, Christopher Kandel, Jose Estrada-Codecido, Tyler Brown, Aswani Siwakoti, Kento T Abe, Queenie Hu, Karen Colwill, Anne-Claude Gingras, Matthew J Oliver, Michelle A Hladunewich
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引用次数: 1

摘要

背景:慢性肾脏疾病(CKD)患者受到2019冠状病毒病(COVID-19)大流行的不成比例的影响,包括更高的感染率、住院率和死亡率。关于对COVID-19疫苗接种策略的反应性和免疫原性的数据有限,但需要为这一高危人群的疫苗接种策略提供信息。目的:本研究的目的是表征COVID-19疫苗接种的纵向血清学反应。设计:这是一项前瞻性观察队列研究。背景:参加安大略省和不列颠哥伦比亚省的门诊肾脏项目。患者:多达2500名接受COVID-19疫苗接种的CKD G3b-5D患者,包括接受透析和肾移植的患者(CKD G1T-5T)。检测方法:采用ELISA(酶联免疫吸附法)从血清或干血斑点检测中检测严重急性呼吸综合征冠状病毒2 (SARS-CoV-2) IgG抗体(抗刺突抗体、抗受体结合域抗体、抗核衣壳抗体)。在一部分参与者中,将评估针对新变体的中和抗体。收集外周血单个核细胞,对SARS-CoV-2特异性细胞免疫进行探索性免疫分析。方法:在接种任何COVID-19疫苗之前或之后招募参与者,并在接种后1、3、6、9和12个月的多个时间点采集血液进行血清学检测。在可能的情况下,将在剂量或加强剂之前收集样本。在最后一次接种COVID-19疫苗后,参与者将留在研究中至少1年。优势和局限性:本研究的适应性设计允许根据新出现的证据或围绕疫苗接种的公共卫生政策的快速变化进行有计划的修改。局限性包括由于人群快速接种疫苗而不完整的早期采血时间点。结论:这项针对肾脏疾病患者的大型多中心血清学研究将产生CKD谱系中接种疫苗后SARS-CoV-2免疫反应动力学的数据,提供对COVID-19疫苗所赋予免疫的幅度和持续时间的见解,并允许表征与免疫反应相关的因素。这项研究的结果可用于为400万加拿大CKD患者提供免疫指南和公共卫生建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Determining the Longitudinal Serologic Response to COVID-19 Vaccination in the Chronic Kidney Disease Population: A Clinical Research Protocol.

Background: People living with chronic kidney disease (CKD) have been disproportionately affected by the coronavirus disease 2019 (COVID-19) pandemic, including higher rates of infection, hospitalization, and death. Data on responsiveness to COVID-19 vaccination strategies and immunogenicity are limited, yet required to inform vaccination strategies in this at-risk population.

Objective: The objective of this study is to characterize the longitudinal serologic response to COVID-19 vaccination.

Design: This is a prospective observational cohort study.

Setting: Participating outpatient kidney programs within Ontario and British Columbia.

Patients: Up to 2500 participants with CKD G3b-5D receiving COVID-19 vaccination, including participants receiving dialysis and kidney transplant recipients (CKD G1T-5T).

Measurements: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibodies (anti-spike, anti-receptor binding domain, anti-nucleocapsid) will be detected by ELISA (enzyme-linked immunosorbent assay) from serum or dried blood spot testing. In a subset of participants, neutralizing antibodies against novel variants of concern will be evaluated. Peripheral blood mononuclear cells will be collected for exploratory immune profiling of SARS-CoV-2 specific cellular immunity.

Methods: Participants will be recruited prior to or following any COVID-19 vaccine dose and have blood sampled for serological testing at multiple timepoints: 1, 3, 6, 9, and 12 months post vaccination. When possible, samples will be collected prior to a dose or booster. Participants will remain in the study for at least 1 year following their last COVID-19 vaccine dose.

Strengths and limitations: The adaptive design of this study allows for planned modification based on emerging evidence or rapid changes in public health policy surrounding vaccination. Limitations include incomplete earlier timepoints for blood collection due to rapid vaccination of the population.

Conclusions: This large multicenter serologic study of participants living with kidney disease will generate data on the kinetics of SARS-CoV-2 immune response to vaccination across the spectrum of CKD, providing insights into the amplitude and duration of immunity conferred by COVID-19 vaccination and allowing for characterization of factors associated with immune response. The results of this study may be used to inform immunization guidelines and public health recommendations for the 4 million Canadians living with CKD.

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来源期刊
CiteScore
3.00
自引率
5.90%
发文量
84
审稿时长
12 weeks
期刊介绍: Canadian Journal of Kidney Health and Disease, the official journal of the Canadian Society of Nephrology, is an open access, peer-reviewed online journal that encourages high quality submissions focused on clinical, translational and health services delivery research in the field of chronic kidney disease, dialysis, kidney transplantation and organ donation. Our mandate is to promote and advocate for kidney health as it impacts national and international communities. Basic science, translational studies and clinical studies will be peer reviewed and processed by an Editorial Board comprised of geographically diverse Canadian and international nephrologists, internists and allied health professionals; this Editorial Board is mandated to ensure highest quality publications.
期刊最新文献
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