COVID-19 vaccine in hemodialysis patients: Time for a boost

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Figure 1
- Immunoglobulin G antibody levels according to the number of coronavirus disease-19 (COVID-19) vaccine doses in patients with prior COVID-19 infection (n=35). Bars show mean ± standard error of the mean (SEM). OD: optical density, vs: versus
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Figure 2
- Immunoglobulin G antibody levels according to the number of coronavirus disease-19 (COVID-19) vaccine doses in patients without prior COVID-19 infection (n=132). Bars show mean ± standard error of the mean (SEM). OD: optical density, vs: versus

Table 1

- Sample characteristics (N=167).

Variables	n (%)
Gender
Male	49 (29.3)
Female	118 (70.7)
Age group (years)
<19	5 (3.0)
20-40	51 (30.5)
41-60	60 (35.9)
>60	51 (30.5)
Time of diagnosis with renal failure
Before vaccine was started	115 (68.9)
After vaccination was started	52 (31.1)
Cause of renal failure
Diabetes	62 (37.1)
Hypertension	32 (19.2)
Hereditary/congenital	9 (5.4)
Other disease(s)	18 (10.8)
Unknown	46 (27.5)
Previous COVID-19 infection
No	132 (79.0)
Yes	35 (21.0)
Type of vaccines received
Same type/single dose	111 (66.5)
2 different types	56 (33.5)
Number of doses
One	7 (4.2)
2	66 (39.5)
3	94 (56.3)
Time since last dose
10 weeks	91 (54.5)
12 weeks	76 (45.5)

Values are presented as nubers and precentages (%). COVID-19: coronavirus disease-19

Table 2

- Associations between different groups and characteristics of renal failure patients receiving hemodialysis.

Variables	Positive (n=133)	Negative (n=34)	P-values
Gender
Male	40 (81.6)	9 (18.4)	0.833
Female	93 (78.8)	25 (21.2)	0.833
Age group (years)
<19	4 (80.0)	1 (20.0)	0.842
20-40	39 (76.5)	12 (23.5)
41-60	50 (83.3)	10 (16.7)
>60	40 (78.4)	11 (21.6)
Time of diagnosis with renal failure
Before vaccine was started	93 (80.9)	22 (19.1)	0.542
After vaccination was started	40 (76.9)	12 (23.1)	0.542
Cause of renal failure
Diabetes	47 (75.8)	15 (24.2)	0.890
Hypertension	25 (78.1)	7 (21.9)
Hereditary/congenital	8 (88.9)	1 (11.1)
Other disease(s)	15 (83.3)	3 (16.7)
Unknown	38 (82.6)	8 (17.4)
Previous COVID-19 infection
No	108 (81.8)	24 (18.2)	0.236
Yes	25 (71.4)	10 (28.6)	0.236
Type of vaccines received
Homogenous	86 (77.5)	25 (22.5)	0.417
Heterogeneous	47 (83.9)	9 (16.1)	0.417
Number of doses
One	0 (0.0)	7 (100)	< 0.001^*
2	51 (77.3)	15 (22.7)
3	82 (87.2)	12 (12.8)
Time since last dose
10 weeks	77 (84.5)	14 (15.4)	0.087
12 weeks	56 (73.7)	20 (26.3)	0.087

Values are presented as numbers and precentages (%).
↵* Significant at 95% confidence level. Data presented are obtained from Fisher’s exact test. COVID-19: coronavirus disease-19

Table 3

- Association between antibody levels and characteristics of renal failure patients on hemodialysis.

Variables	Mean±SD	Median (IQR)	P-values
Gender
Male	2.26±1.15	3.00 (1.75-3.00)	0.119
Female	2.08±1.18	2.86 (1.35-3.00)	0.119
Age group (years)
<19	2.12±1.32	3.00 (0.81-3.00)	0.990
20-40	2.08±1.24	3.00 (1.24-3.00)
41-60	2.21±1.09	3.00 (1.69-3.00)
>60	2.09±1.21	3.00 (1.28-3.00)
Time of diagnosis with renal failure
Before vaccine was started	2.18±1.15	3.00 (1.52-3.00)	0.772
After vaccination was started	2.04±1.21	3.00 (1.30-3.00)	0.772
Cause of renal failure
Diabetes	2.04±1.24	3.00 (0.84-3.00)	0.623
Hypertension	2.01±1.18	2.56 (1.27-3.00)
Hereditary/congenital	2.14±1.09	3.00 (1.29-3.00)
Other disease(s)	2.37±1.11	3.00 (2.25-3.00)
Unknown	2.26±1.13	3.00 (1.88-3.00)
Previous COVID-19 infection
No	2.21±1.13	3.00 (1.54-3.00)	0.182
Yes	1.86±1.30	2.58 (0.04-3.00)	0.182
Type of vaccines received
Homogenous	2.05±1.20	2.94 (1.27-3.00)	0.178
Heterogeneous	2.31±1.10	3.00 (2.02-3.00)	0.178
Number of doses
One	0.04±0.02	0.03 (0.03-0.03)	<0.001^*
2	1.87±1.16	2.21 (1.20-3.00)
3	2.48±1.01	3.00 (2.37-3.00)
Time since last dose
10 weeks	2.27±1.10	3.00 (1.59-3.00)	0.063
12 weeks	2.00±1.24	2.58 (0.09-3.00)	0.063

Values are presented as mean ± standard deviation (SD) and median and interquartile range (IQR).

↵* Significant at 95% confidence level. Data presented are obtained from Mann-Whitney and Kruskal-Wallis tests. COVID-19: coronavirus disease-19

Table 4

- Simple linear regression analysis of predictors of antibody levels among renal failure patients on hemodialysis.

Variables	Beta	Standard error	95% confidence interval	P-values	R-square
Gender	-0.18	0.20	-0.57 - 0.22	0.372	0.01
Age (years)	0.00	0.01	-0.01 - 0.01	0.948	0.00
Time of diagnosis with renal failure	-0.13	0.20	-0.52 - 0.25	0.499	0.00
Cause of renal failure	0.07	0.05	-0.04 - 0.18	0.205	0.10
Previous COVID-19 infection	-0.35	0.22	-0.78 - 0.09	0.120	0.02
Type of vaccines received	0.26	0.19	-0.12 - 0.64	0.174	0.01
Number of doses	0.84	0.14	0.56 - 1.13	<0.001^*	0.17
Time since last dose (weeks)	-0.16	0.09	-0.33 - 0.02	0.089	0.02