Longitudinal SARS-CoV-2 neutralization of Omicron BA.1, BA.5 and BQ.1.1 after four vaccinations and the impact of breakthrough infections in haemodialysis patients.

Platen, Louise; Liao, Bo-Hung; Tellenbach, Myriam; Cheng, Cho-Chin; Holzmann-Littig, Christopher; Christa, Catharina; Dächert, Christopher; Kappler, Verena; Bester, Romina; Werz, Maia Lucia; Schönhals, Emely; Platen, Eva; Eggerer, Peter; Tréguer, Laëtitia; Küchle, Claudius; Schmaderer, Christoph; Heemann, Uwe; Keppler, Oliver T; Renders, Lutz; Braunisch, Matthias Christoph; Protzer, Ulrike

doi:10.1093/ckj/sfad147

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Title:: Longitudinal SARS-CoV-2 neutralization of Omicron BA.1, BA.5 and BQ.1.1 after four vaccinations and the impact of breakthrough infections in haemodialysis patients.
Document type:: Journal Article
Author(s):: Platen, Louise; Liao, Bo-Hung; Tellenbach, Myriam; Cheng, Cho-Chin; Holzmann-Littig, Christopher; Christa, Catharina; Dächert, Christopher; Kappler, Verena; Bester, Romina; Werz, Maia Lucia; Schönhals, Emely; Platen, Eva; Eggerer, Peter; Tréguer, Laëtitia; Küchle, Claudius; Schmaderer, Christoph; Heemann, Uwe; Keppler, Oliver T; Renders, Lutz; Braunisch, Matthias Christoph; Protzer, Ulrike
Abstract:: BACKGROUND: Individuals on haemodialysis (HD) are more vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than the general population due to end-stage kidney disease-induced immunosuppression. METHODS: A total of 26 HD patients experiencing SARS-CoV-2 infection after a third vaccination were matched 1:1 with 26 of 92 SARS-CoV-2-naïve patients by age, sex, dialysis vintage and immunosuppressive drugs receiving a fourth vaccination with a messenger RNA-based vaccine. A competitive surrogate neutralization assay was used to monitor vaccination success. To determine infection neutralization titres, Vero-E6 cells were infected with SARS-CoV-2 variants of concern (VoCs), Omicron sublineage BA.1, BA.5 and BQ.1.1. The 50% inhibitory concentration (IC50, serum dilution factor 1:x) was determined before, 4 weeks after and 6 months after the fourth vaccination. RESULTS: A total of 52 HD patients received four coronavirus disease 2019 (COVID-19) vaccinations and were followed up for a median of 6.3 months. Patient characteristics did not differ between the matched cohorts. Patients without a SARS-CoV-2 infection had a significant reduction of real virus neutralization capacity for all Omicron sublineages after 6 months (P < .001 each). Those patients with a virus infection did not experience a reduction in real virus neutralization capacity after 6 months. Compared with the other Omicron VoC, the BQ.1.1 sublineage had the lowest virus neutralization capacity. CONCLUSIONS: SARS-CoV-2-naïve HD patients had significantly decreased virus neutralization capacity 6 months after the fourth vaccination, whereas patients with a SARS-CoV-2 infection had no change in neutralization capacity. This was independent of age, sex, dialysis vintage and immunosuppression. Therefore, in infection-naïve HD patients a fifth COVID-19 vaccination might be reasonable 6 months after the fourth vaccination.
Journal title abbreviation:: Clin Kidney J
Year:: 2023
Journal volume:: 16
Journal issue:: 12
Pages contribution:: 2447-2460
Fulltext / DOI:: doi:10.1093/ckj/sfad147
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/38046025
Print-ISSN:: 2048-8505
TUM Institution:: Institut für Virologie (Prof. Protzer); Professur für Nephrologie (Prof. Heemann)
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