25ef336f7343ff42b0fd77361f86c718 292088.pdf 01fdd6dd2c2bc92c8f9ff11a8ed44bcad0fc623a 292088.pdf e2b1d4696b130b360666cee7abb28d6cd96792698d01b6127f5832247a3e242a 292088.pdf Title: Long-Term Dynamic Humoral Response to SARS-CoV-2 mRNA Vaccines in Patients on Peritoneal Dialysis Subject: Introduction. Patients on peritoneal dialysis (PD) present an impaired humoral response against SARS-CoV-2, at least after the initial vaccination and booster dose. Until now, the effect of a fourth dose has not been established. The aim of the present study is to evaluate the long-term dynamics of the humoral response of PD patients to multiple doses of SARS-CoV-2 vaccines, focusing on the effect of the fourth dose. Methods. This is an analysis of the prospective and multicentric SENCOVAC study. We included patients on PD without additional immunosuppression that had received at least 3 SARS-CoV-2 mRNA vaccine doses. We evaluated anti-spike antibody titers after the initial vaccination, third and fourth doses, using prespecified fixed assessments (i.e., baseline, 28 days, 3, 6, and 12 months after completing the initial vaccine schedule). Breakthrough infections were also collected. Results. We included 164 patients on PD (69% males, 62 13 years old). In patients who had received only two doses, the rates of positive humoral response progressively decreased from 96% at 28 days to 80% at 6 months, as did with anti-spike antibody titers. At 6 months, 102 (62%) patients had received the third vaccine dose. Patients with the third dose had higher rates of positive humoral response (p = 0.01) and higher anti-spike antibody titers (p < 0.001) at 6 months than those with only 2 doses. At 12 months, the whole cohort had received 3 vaccine doses, and 44 (27%) patients had an additional fourth dose. The fourth dose was not associated to higher rates of positive humoral response (100 vs. 97%, p = 0.466) or to statistically significant differences in anti-spike antibody titers as compared to three doses (p = 0.371) at 12 months. Prior antibody titers were the only predictor for subsequent higher anti-spike antibody titer (B 0.53 [95%CI 0.27–0.78], p < 0.001). The 2 (1.2%) patients that developed COVID-19 during follow-up had mild disease. Conclusions. PD presents an acceptable humoral response with three doses of SARS-CoV-2 vaccines that improve the progressive loss of anti-spike antibody titers following two vaccine doses. Keywords: SARS-CoV-2; COVID-19; humoral response; anti-spike antibodies; peritoneal dialysis; chronic kidney disease; booster Author: Borja Quiroga, María José Soler, Alberto Ortiz, Ron T. Gansevoort, Alba Leyva, José Rojas and Patricia de Sequera Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Oct 21 03:23:38 2022 CEST ModDate: Fri Oct 21 04:00:24 2022 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1283864 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- EIFDAO+VnURWPalladioL Type 1 Custom yes yes no 10 0 OPBYFS+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 GCQWME+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 WVYQKA+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 VDNGGL+CMSY10 Type 1 Builtin yes yes no 28 0 YSPQJI+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 HNMFAF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 78 0 HNMFBG+PalatinoLinotype TrueType WinAnsi yes yes no 81 0 HNMFBI+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 84 0 HNMFAF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 91 0 HNMFBG+PalatinoLinotype TrueType WinAnsi yes yes no 94 0 HNMFBI+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 97 0 HNMFAF+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 108 0 HNMFBG+PalatinoLinotype TrueType WinAnsi yes yes no 111 0 HNMFBI+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 114 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 121 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-05-16 02:38:55 CEST RepresentationInformation: 292088.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-05-15 19:15:05 CEST Size: 1283864 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 251 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design Destination: subsection.2.1 Item: Title: Population Destination: subsection.2.2 Item: Title: Objectives and Outcomes Destination: subsection.2.3 Item: Title: Variables Destination: subsection.2.4 Item: Title: Statistics Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: Baseline Characteristics Destination: subsection.3.1 Item: Title: Humoral Response after the Initial Vaccination Schedule Destination: subsection.3.2 Item: Title: Humoral Response after the Third Dose at 6 Months Destination: subsection.3.3 Item: Title: Humoral Response after the Fourth Dose at 6 Months Destination: subsection.3.4 Item: Title: Factors Associated with Stronger Humoral Response at 12 Months Destination: subsection.3.5 Item: Title: Breakthrough Infections Destination: subsection.3.6 Item: Title: Discussion Destination: section.4 Item: Title: References Destination: section.4 Info: Title: Long-Term Dynamic Humoral Response to SARS-CoV-2 mRNA Vaccines in Patients on Peritoneal Dialysis Author: Borja Quiroga, María José Soler, Alberto Ortiz, Ron T. Gansevoort, Alba Leyva, José Rojas and Patricia de Sequera Subject: Introduction. Patients on peritoneal dialysis (PD) present an impaired humoral response against SARS-CoV-2, at least after the initial vaccination and booster dose. Until now, the effect of a fourth dose has not been established. The aim of the present study is to evaluate the long-term dynamics of the humoral response of PD patients to multiple doses of SARS-CoV-2 vaccines, focusing on the effect of the fourth dose. Methods. This is an analysis of the prospective and multicentric SENCOVAC study. We included patients on PD without additional immunosuppression that had received at least 3 SARS-CoV-2 mRNA vaccine doses. We evaluated anti-spike antibody titers after the initial vaccination, third and fourth doses, using prespecified fixed assessments (i.e., baseline, 28 days, 3, 6, and 12 months after completing the initial vaccine schedule). Breakthrough infections were also collected. Results. We included 164 patients on PD (69% males, 62 13 years old). In patients who had received only two doses, the rates of positive humoral response progressively decreased from 96% at 28 days to 80% at 6 months, as did with anti-spike antibody titers. At 6 months, 102 (62%) patients had received the third vaccine dose. Patients with the third dose had higher rates of positive humoral response (p = 0.01) and higher anti-spike antibody titers (p < 0.001) at 6 months than those with only 2 doses. At 12 months, the whole cohort had received 3 vaccine doses, and 44 (27%) patients had an additional fourth dose. The fourth dose was not associated to higher rates of positive humoral response (100 vs. 97%, p = 0.466) or to statistically significant differences in anti-spike antibody titers as compared to three doses (p = 0.371) at 12 months. Prior antibody titers were the only predictor for subsequent higher anti-spike antibody titer (B 0.53 [95%CI 0.27 0.78], p < 0.001). The 2 (1.2%) patients that developed COVID-19 during follow-up had mild disease. Conclusions. PD presents an acceptable humoral response with three doses of SARS-CoV-2 vaccines that improve the progressive loss of anti-spike antibody titers following two vaccine doses. Keywords: SARS-CoV-2; COVID-19; humoral response; anti-spike antibodies; peritoneal dialysis; chronic kidney disease; booster Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Oct 21 03:23:38 CEST 2022 ModDate: Fri Oct 21 04:00:24 CEST 2022 ID: 0x67ea247eef248559a4121e0c9fb90020, 0x67ea247eef248559a4121e0c9fb90020 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: YSPQJI+VnURWPalladioL-Bold FontSubset: true FirstChar: 178 LastChar: 189 FontDescriptor: FontName: YSPQJI+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: GCQWME+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: GCQWME+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: WVYQKA+URWPalladioL-Ital FontSubset: true FirstChar: 46 LastChar: 121 FontDescriptor: FontName: 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