Severity of COVID-19 after Vaccination among Hemodialysis Patients
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Le résumé fourni par la source
BACKGROUND AND OBJECTIVES: Patients receiving hemodialysis are at high risk from coronavirus disease 2019 (COVID-19) and demonstrate impaired immune responses to vaccines. There have been several descriptions of their immunologic responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, but few studies have described the clinical efficacy of vaccination in patients on hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a multicenter observational study of the London hemodialysis population undergoing surveillance PCR testing during the period of vaccine rollout with BNT162b2 and AZD1222, all of those positive for SARS-CoV-2 were identified. Clinical outcomes were analyzed according to predictor variables, including vaccination status, using a mixed effects logistic regression model. Risk of infection was analyzed in a subgroup of the base population using a Cox proportional hazards model with vaccination status as a time-varying covariate. RESULTS: SARS-CoV-2 infection was identified in 1323 patients of different ethnicities (Asian/other, 30%; Black, 38%; and White, 32%), including 1047 (79%) unvaccinated, 86 (7%) after first-dose vaccination, and 190 (14%) after second-dose vaccination. The majority of patients had a mild course; however, 515 (39%) were hospitalized, and 172 (13%) died. Older age, diabetes, and immune suppression were associated with greater illness severity. In regression models adjusted for age, comorbidity, and time period, prior two-dose vaccination was associated with a 75% (95% confidence interval, 56 to 86) lower risk of admission and 88% (95% confidence interval, 70 to 95) fewer deaths compared with unvaccinated patients. No loss of protection was seen in patients over 65 years or with increasing time since vaccination, and no difference was seen between vaccine types. CONCLUSIONS: These data demonstrate a substantially lower risk of severe COVID-19 after vaccination in patients on dialysis who become infected with SARS-CoV-2.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Severity of COVID-19 after Vaccination among Hemodialysis Patients
- Date Crossref
- 01/06/2022
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Imperial College Healthcare NHS Trust Hammersmith Hospital pays non établi dans la noticeÉtablissement de santé
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Hammersmith Hospital pays non établi dans la noticeÉtablissement de santé
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Imperial College London Department of Immunology and Inflammation pays non établi dans la noticeUniversité ou école supérieure
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University College London Department of Renal Medicine pays non établi dans la noticeUniversité ou école supérieure
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Guy's and St Thomas' NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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St George’s University Hospitals NHS Foundation Trust pays non établi dans la noticeÉtablissement de santé
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Epsom and St Helier University Hospitals NHS Trust pays non établi dans la noticeÉtablissement de santé
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Barts Health NHS Trust pays non établi dans la noticeÉtablissement de santé
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King's College Hospital NHS Foundation Trust Department of Renal Medicine pays non établi dans la noticeÉtablissement de santé
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Royal Free London NHS Foundation Trust Renal Medicine pays non établi dans la noticeÉtablissement de santé
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Guy’s and St. Thomas’ NHS Foundation Trust Kidney Services pays non établi dans la noticeOrganisation à but non lucratif
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St. George’s University Hospitals NHS Foundation Trust Renal and Transplantation pays non établi dans la noticeUniversité ou école supérieure
Hammersmith Hospital — Imperial College Healthcare NHS Trust, Hammersmith Hospital et Department of Immunology and Inflammation — Imperial College London, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.