TY - JOUR
T1 - Immunogenicity and Safety of COVID-19 Vaccines in Patients Receiving Renal Replacement Therapy
T2 - A Systematic Review and Meta-Analysis
AU - Ma, Becky Mingyao
AU - Tam, Anthony Raymond
AU - Chan, Kam Wa
AU - Ma, Maggie Kam Man
AU - Hung, Ivan Fan Ngai
AU - Yap, Desmond Yat Hin
AU - Chan, Tak Mao
N1 - DY received research donations from the Wai Im Charitable Foundation and the Chan Sui Kau Family Benefits and Charitable Foundation. DY and TM received research funding support from the Mr and Mrs Tam Wing Fun Edmund Renal Research Fund. TM also received research funding support from the Wai Hung Charitable Foundation and Mr. S. Ho.
Publisher Copyright:
Copyright © 2022 Ma, Tam, Chan, Ma, Hung, Yap and Chan.
PY - 2022/3/9
Y1 - 2022/3/9
N2 - Background: Systematic data on the efficacy and safety of COVID-19 vaccine in patients on renal replacement therapy (RRT) remains limited. We conducted a meta-analysis on the efficacy and safety of COVID-19 vaccine in patients on RRT. Methods: Eligible studies were identified by systematic literature search in four electronic databases. Twenty-seven studies (4,264 patients) were included for meta-analysis. 99% patients received mRNA vaccine. Results: Patients on RRT showed inferior seropositivity after two-dosed COVID-19 vaccine, 44% lower than the general population. Kidney transplant recipients (KTRs) had significantly lower seropositivity than patients on haemodialysis (HD) or peritoneal dialysis (PD) (26.1 vs. 84.3% and 92.4% respectively, p < 0.001 for both). Compared with healthy controls, KTRs, HD and PD patients were 80% (95% CI: 62–99%), 18% (95% CI: 9–27%) and 11% (95% CI: 1–21%) less likely to develop antibodies after vaccination (p < 0.001, <0.001 and 0.39 respectively). In KTRs, every 1% increase in using mycophenolate was associated with 0.92% reduction in seropositivity (95% CI: −1.68, −0.17, p = 0.021) at population level. The overall adverse event rate attributed to vaccination was 2.1%. Most events were mild. Conclusion: Patients on RRT, particularly KTRs, had significantly reduced antibody response after two-dosed COVID-19 vaccination. Vaccination is generally well tolerated. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021261879.
AB - Background: Systematic data on the efficacy and safety of COVID-19 vaccine in patients on renal replacement therapy (RRT) remains limited. We conducted a meta-analysis on the efficacy and safety of COVID-19 vaccine in patients on RRT. Methods: Eligible studies were identified by systematic literature search in four electronic databases. Twenty-seven studies (4,264 patients) were included for meta-analysis. 99% patients received mRNA vaccine. Results: Patients on RRT showed inferior seropositivity after two-dosed COVID-19 vaccine, 44% lower than the general population. Kidney transplant recipients (KTRs) had significantly lower seropositivity than patients on haemodialysis (HD) or peritoneal dialysis (PD) (26.1 vs. 84.3% and 92.4% respectively, p < 0.001 for both). Compared with healthy controls, KTRs, HD and PD patients were 80% (95% CI: 62–99%), 18% (95% CI: 9–27%) and 11% (95% CI: 1–21%) less likely to develop antibodies after vaccination (p < 0.001, <0.001 and 0.39 respectively). In KTRs, every 1% increase in using mycophenolate was associated with 0.92% reduction in seropositivity (95% CI: −1.68, −0.17, p = 0.021) at population level. The overall adverse event rate attributed to vaccination was 2.1%. Most events were mild. Conclusion: Patients on RRT, particularly KTRs, had significantly reduced antibody response after two-dosed COVID-19 vaccination. Vaccination is generally well tolerated. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42021261879.
KW - chronic kidney disease
KW - COVID-19
KW - immunogenicity
KW - safety
KW - vaccine
UR - http://www.scopus.com/inward/record.url?scp=85127402171&partnerID=8YFLogxK
U2 - 10.3389/fmed.2022.827859
DO - 10.3389/fmed.2022.827859
M3 - Review article
AN - SCOPUS:85127402171
SN - 2296-858X
VL - 9
JO - Frontiers in Medicine
JF - Frontiers in Medicine
M1 - 827859
ER -
