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Pai MF, Tung KT, Hsu SP, Peng YS, Lin WY, Yang JY, Wu HY, Chiu YL, Shu KH, Tsai WC. Adverse events following the first, second and third doses of a COVID-19 vaccine in hemodialysis patients. Ren Fail 2023; 45:2172432. [PMID: 36715434 PMCID: PMC9888469 DOI: 10.1080/0886022x.2023.2172432] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND This study aimed to identify adverse events following the first three doses of COVID-19 vaccines in hemodialysis (HD) patients. Risk factors associated with postvaccination adverse events were explored. METHODS Postvaccination adverse events in 438 HD patients who received 3 doses of COVID-19 vaccines were prospectively assessed. The adverse events among three doses were compared using generalized linear mixed models. Factors associated with adverse events were assessed with multivariate analyses. RESULTS The vast majority of participants received Oxford/AstraZeneca ChAdOx1 as their first two doses and Moderna mRNA-1273 as their third dose. Overall, 79%, 50% and 84% of the participants experienced at least one adverse event after their first, second, and third doses, respectively. These adverse events were mostly minor, short-lived and less than 5% reported daily activities being affected. Compared with the first dose, the second dose caused a lower rate of adverse events. Compared with the first dose, the third dose elicited a higher rate of injection site reactions and a lower rate of systemic reactions. Multivariate analyses showed that every 10-year increase of age (odds ratio 0.67, 95% confidence intervals 0.57-0.79) was associated with decreased risk of adverse events, while female sex (2.82, 1.90-4.18) and arteriovenous fistula (1.73, 1.05-2.84) were associated with increased risk of adverse events. Compared with Oxford/AstraZeneca ChAdOx1, Moderna mRNA-1273 was associated with an increased risk of injection site reactions. CONCLUSIONS COVID-19 vaccination was well tolerated in HD patients. Age, sex, dialysis vascular access and vaccine types were associated with postvaccination adverse events.
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Affiliation(s)
- Mei-Fen Pai
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan
| | - Kuei-Ting Tung
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Shih-Ping Hsu
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan,School of Life Science, National Taiwan Normal University, Taipei City, Taiwan
| | - Yu-Sen Peng
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Applied Cosmetology, Lee-Ming Institute of Technology, New Taipei City, Taiwan,Department of Electrical Engineering, Yuan Ze University, Taoyuan City, Taiwan
| | - Wan-Yu Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Ju-Yeh Yang
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan,Center for General Education, Lee-Ming Institute of Technology, New Taipei City, Taiwan
| | - Hon-Yen Wu
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei City, Taiwan
| | - Yen-Ling Chiu
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan,Graduate Program in Biomedical Informatics, Yuan Ze University, Taoyuan City, Taiwan
| | - Kai-Hsiang Shu
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei City, Taiwan
| | - Wan-Chuan Tsai
- Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan,Center for General Education, Lee-Ming Institute of Technology, New Taipei City, Taiwan,CONTACT Wan-Chuan Tsai Division of Nephrology, Department of Internal Medicine; Center for General Education, Lee-Ming Institute of Technology, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Rd, Banciao District, New Taipei City 220, New Taipei City, Taiwan
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Almdallaleh SA, Alsuwaida AO, Altalhi AM, ALJayar DM, Massad EE, Hamid MM, Jaganathan PP, Al-Hababi FH. Renin-angiotensin-system blockers and IgG antibodies in end-stage renal disease hemodialysis-receiving patients diagnosed with COVID-19 infection. Saudi Med J 2023; 44:875-881. [PMID: 37717960 PMCID: PMC10505288 DOI: 10.15537/smj.2023.44.9.20230129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/01/2023] [Indexed: 09/19/2023] Open
Abstract
OBJECTIVES To evaluate the prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections among patients receiving in-center hemodialysis (ICHD), the relationship between the IgG antibody levels against the virus and SARS-CoV-2-associated symptoms, hemodialysis adequacy, and the antihypertensives used in order to control blood pressure. METHODS A prospective observational study was carried out at a tertiary care center, King Fahad Kidney Center, Riyadh, Kingdom of Saudi Arabia, between November 2020 and January 2021. A total of 214 ICHD patients with end-stage renal disease (ESRD) were included, and the levels of their anti-SARS-CoV-2 IgG antibodies were assessed after obtaining their informed consent. RESULTS Our tests indicated that 15% of the patients in the study's population had detectable SARS-CoV-2 IgG antibodies, with more than half of them (53%) being asymptomatic. We also found that ESRD patients on angiotensin converting enzyme inhibitors or angiotensin receptor blockers (ACEIs/ARBs) had higher levels of SARS-CoV-2 IgG antibodies than patients not receiving this group of medications. CONCLUSION More studies are required to assess whether patients with a SARS-CoV-2 infection that do not have an indication for being prescribed ACEIs/ARBs would benefit from receiving these medications.
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Affiliation(s)
- Sultan A. Almdallaleh
- From the Department of Nephrology (Almdallaleh, Altalhi, Massad, Hamid); from the Department of Medicine (ALJayar); from the Department of Research Support (Jaganathan), Research and Innovation Center, King Saud Medical City, from the Department of Medicine (Alsuwaida), King Saud University, and from the Department of Virology Laboratory (Al-Hababi), Riyadh Regional Laboratory, Riyadh, Kingdom of Saudi Arabia
| | - Abdulkareem O. Alsuwaida
- From the Department of Nephrology (Almdallaleh, Altalhi, Massad, Hamid); from the Department of Medicine (ALJayar); from the Department of Research Support (Jaganathan), Research and Innovation Center, King Saud Medical City, from the Department of Medicine (Alsuwaida), King Saud University, and from the Department of Virology Laboratory (Al-Hababi), Riyadh Regional Laboratory, Riyadh, Kingdom of Saudi Arabia
| | - Abdulhadi M. Altalhi
- From the Department of Nephrology (Almdallaleh, Altalhi, Massad, Hamid); from the Department of Medicine (ALJayar); from the Department of Research Support (Jaganathan), Research and Innovation Center, King Saud Medical City, from the Department of Medicine (Alsuwaida), King Saud University, and from the Department of Virology Laboratory (Al-Hababi), Riyadh Regional Laboratory, Riyadh, Kingdom of Saudi Arabia
| | - Dina M. ALJayar
- From the Department of Nephrology (Almdallaleh, Altalhi, Massad, Hamid); from the Department of Medicine (ALJayar); from the Department of Research Support (Jaganathan), Research and Innovation Center, King Saud Medical City, from the Department of Medicine (Alsuwaida), King Saud University, and from the Department of Virology Laboratory (Al-Hababi), Riyadh Regional Laboratory, Riyadh, Kingdom of Saudi Arabia
| | - Elzibair E. Massad
- From the Department of Nephrology (Almdallaleh, Altalhi, Massad, Hamid); from the Department of Medicine (ALJayar); from the Department of Research Support (Jaganathan), Research and Innovation Center, King Saud Medical City, from the Department of Medicine (Alsuwaida), King Saud University, and from the Department of Virology Laboratory (Al-Hababi), Riyadh Regional Laboratory, Riyadh, Kingdom of Saudi Arabia
| | - Mazaher M. Hamid
- From the Department of Nephrology (Almdallaleh, Altalhi, Massad, Hamid); from the Department of Medicine (ALJayar); from the Department of Research Support (Jaganathan), Research and Innovation Center, King Saud Medical City, from the Department of Medicine (Alsuwaida), King Saud University, and from the Department of Virology Laboratory (Al-Hababi), Riyadh Regional Laboratory, Riyadh, Kingdom of Saudi Arabia
| | - Parameaswari P. Jaganathan
- From the Department of Nephrology (Almdallaleh, Altalhi, Massad, Hamid); from the Department of Medicine (ALJayar); from the Department of Research Support (Jaganathan), Research and Innovation Center, King Saud Medical City, from the Department of Medicine (Alsuwaida), King Saud University, and from the Department of Virology Laboratory (Al-Hababi), Riyadh Regional Laboratory, Riyadh, Kingdom of Saudi Arabia
| | - Fadel H. Al-Hababi
- From the Department of Nephrology (Almdallaleh, Altalhi, Massad, Hamid); from the Department of Medicine (ALJayar); from the Department of Research Support (Jaganathan), Research and Innovation Center, King Saud Medical City, from the Department of Medicine (Alsuwaida), King Saud University, and from the Department of Virology Laboratory (Al-Hababi), Riyadh Regional Laboratory, Riyadh, Kingdom of Saudi Arabia
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