Immunogenicity and safety of the three-dose COVID-19 vaccine regimen in patients receiving renal replacement therapy: a systematic review and meta-analysis

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-01-19 DOI:10.1159/000536308

B. Ma, A. Tam, Kam Wa Chan, Ivan Fan Ngai Hung, Sydney Chi Wai Tang, Tak Mao Chan, D. Y. Yap

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Abstract

Background A three-dose regimen is the current standard for COVID-19 vaccination, but systematic data on immunogenicity and safety in CKD patients remains limited. Objectives We conducted a meta-analysis on the immunogenicity and safety of three-dose COVID-19 vaccination in patients on renal replacement therapy (RRT). Methods Systematic literature search in four electronic databases yielded twenty eligible studies (2117 patients, 94% received mRNA vaccines) for meta-analysis. Results The overall seropositivity rate of anti-SARS-CoV-2 was 74.2% (95% CI: 65.0%-83.4%) after three-dose COVID-19 vaccination. The seropositivity rate of anti-SARS-CoV-2 in kidney transplant recipients (KTRs) was 64.6% (95% CI: 58.7%-70.5%), and 43.5% (95% CI: 38.5%-48.6%) of non-responders after second dose became seropositive after third dose. The seropositivity rate of anti-SARS-CoV-2 was 92.9% (95% CI: 89.5%-96.2%) in dialysis patients, and 64.6% (95% CI: 46.8%-82.3%) of non-responders after second dose became seropositive after third dose. In KTRs, each year increase in transplant vintage was associated with 35.6% increase in anti-SARS-CoV-2 seropositivity (95% CI: 15.9%-55.4%, p=0.01). There were no serious adverse events attributed to vaccination in KTRs and the commonest local and systemic adverse events were injection site pain and fatigue respectively.

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接受肾脏替代疗法的患者接种三剂 COVID-19 疫苗的免疫原性和安全性：系统回顾和荟萃分析

背景三剂方案是目前 COVID-19 疫苗接种的标准，但有关 CKD 患者免疫原性和安全性的系统数据仍然有限。方法在四个电子数据库中进行系统文献检索，共获得 20 项符合条件的研究（2117 名患者，94% 接种了 mRNA 疫苗），并进行了荟萃分析。结果接种三剂 COVID-19 疫苗后，抗 SARS-CoV-2 的总体血清阳性率为 74.2%（95% CI：65.0%-83.4%）。肾移植受者（KTR）的抗 SARS-CoV-2 血清阳性率为 64.6%（95% CI：58.7%-70.5%），43.5%（95% CI：38.5%-48.6%）的第二剂无应答者在第三剂后血清阳性。透析患者的抗 SARS-CoV-2 血清阳性率为 92.9%（95% CI：89.5%-96.2%），64.6%（95% CI：46.8%-82.3%）的第二剂无反应者在第三剂后血清阳性。在 KTR 中，移植年份每增加一年，抗 SARS-CoV-2 血清阳性率就会增加 35.6%（95% CI：15.9%-55.4%，P=0.01）。在 KTR 中，接种疫苗没有导致严重的不良反应，最常见的局部和全身不良反应分别是注射部位疼痛和疲劳。

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来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567