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

期刊介绍： ACS Applied Electronic Materials is an interdisciplinary journal publishing original research covering all aspects of electronic materials. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials science, engineering, optics, physics, and chemistry into important applications of electronic materials. Sample research topics that span the journal's scope are inorganic, organic, ionic and polymeric materials with properties that include conducting, semiconducting, superconducting, insulating, dielectric, magnetic, optoelectronic, piezoelectric, ferroelectric and thermoelectric. Indexed/Abstracted： Web of Science SCIE Scopus CAS INSPEC Portico