Introduction
Clinical characteristics and prognosis of patients on hemodialysis with COVID-19
Anti-COVID-19 drugs authorized for emergency use
Convalescent plasma
Intravenous immunoglobulin
Monoclonal antibodies
Paxlovid (nirmatrelvir + ritonavir)
Molnupiravir
VV116
Azvudine
Metformin
Advantages and disadvantages of anti-COVID-19 drugs authorized for emergency use
Medicines | Cases (n) | AE (%) | SAE (%) | Common AE | Identifier |
---|---|---|---|---|---|
Convalescent plasma | 468 | NA | NA | Bleeding, Venous thromboembolism, Arterial thromboembolism | NCT04364737 [35] |
Intravenous immunoglobulin | 68 | 75.0% | 32.0% | Abdominal or back pain, fever, headache, chills, rash, fatigue, nausea or vomiting | NCT04350580 [42] |
REGN-COV2 | 3688 | 7.1–8.4% | 1.1–1.7% | Infusion-related reactions and hypersensitivity reactions | NCT04425629 [46] |
LY-CoV555 + LY-CoV016 | 518 | 13.3% | 1.4% | Nausea, rash, dizziness, diarrhea and hypertension | NCT04427501 [47] |
AZD7442 | 3461 | 35.3% | 1.4% | Injection site reactions | NCT04625725 [48] |
Paxlovid | 1109 | 22.6% | 1.6% | Dysphagia, diarrhea and vomiting | NCT04960202 [50] |
Molnupiravir | 710 | 30.4% | 6.9% | Diarrhea, malignancy and dizziness | NCT04575597 [54] |
VV116 | 384 | 67.4% | 0.3% | Dysgeusia, hypertriglyceridemia and hyperlipidemia | NCT05341609 [58] |
Azvudine | 10 | 0.0% | 0.0% | NA | ChiCTR2000029853 [60] |
Metformin | 663 | NA | NA | Rhinorrhea, cough, fatigue, myalgia and headache | NCT04510194 [68] |
Safety of COVID-19 vaccination in patients treated with hemodialysis
Author, years | PHD (n) | Control (n) | Intervention | Safety outcome | Efficacy outcome |
---|---|---|---|---|---|
Goupil et al.[82], 2021 | 154 | • Healthy control (40) • Convalescent plasma (16) | One dose of BNT162b2 | NA | • A single dose of BNT162b2 vaccine failed to elicit a humoral immune response in most PHD without previous SARS-CoV-2 infection • The antibody response was delayed in PHD with previous SARS-CoV-2 infection |
Zitt et al.[80], 2021 | 50 | NA | Two doses of BNT162b2 | • Most common local reactions: pain at the injection site (38% and 29.2% after the first and second injection, respectively) • Most common systemic reactive events: diarrhea (4% mild, 4% moderate) and fatigue (8% mild) | • Higher age and immunosuppression were associated with lower, calcitriol treatment and prior seroconversion to hepatitis B vaccination with significantly higher antibody concentration • A high immunogenicity in PHD |
Jahn et al. [83], 2021 | 72 | Healthy control (16) | Two doses of BNT162b2 | NA | • PHD under 60 years of age responded equally to healthy controls • The antibody response in PHD negatively correlated with age |
Speer et al. [93], 2021 | 22 | Healthy control (46) | Two doses of BNT162b2 | NA | • A reduced antibody response to the first and second doses of BNT162b2 in PHD • The majority (82%) develop neutralizing antibodies after the second dose but at lower levels than healthy controls |
Raja et al. [100], 2022 | 72 | Healthy control (72) | One dose of ChAdOx1 nCoV-19 | NA | • A weak antibody response to the ChAdOx1 nCoV-19 in PHD • Older age was associated with no responders |
Agur et al. [101], 2022 | 80 | Healthy control (56) | Three doses of BNT162b2 | NA | • A third dose of BNT162b2 substantially improved humoral response in PHD • Baseline antibody level, dialysis therapy, and hypoalbuminemia were independent predictors of impaired antibody response |
Dheir et al. [91], 2022 | 50 | • Kidney transplant recipients (64) • Healthy control (41) | Two doses of CoronaVac | NA | • A negative correlation between antibody seroconversion and age • The antibody response in PHD is almost comparable to healthy controls but kidney transplant patients have a poor response |
Melin et al. [96], 2022 | 50 | NA | Two doses of BNT162b2 | NA | • A third dose of BNT162b2 gives a robust and improved immunological response in PHD |
Espi et al. [92], 2022 | 106 | Healthy control (30) | Two doses of BNT162B2 | NA | • Impaired humoral and cellular immune responses to SARS-CoV-2 mRNA vaccine in virus-unexposed PHD |
Gonzalez-Perez et al. [9], 2022 | 39 | Healthy control (92) | • Patients (two doses of mRNA-1273) • Control (two doses of BNT162b2) | NA | • PHD develop strong cellular and humoral immune responses to 1273-mRNA vaccination |
Stumpf et al. [79], 2022 | 1168 | PPD (58) | Two doses of mRNA-1273 or BNT162B2 | • Vaccination-related clinical side effects (fever and arm pain) occurred more often in PPD than in PHD | • No difference in COVID-19 mRNA vaccination-related adaptive immune responses in PPD and PHD |
Puspitasari et al. [102], 2023 | 38 | NA | Two doses of the CoronaVac and booster dose of BNT162b2 | • Most common AE: mild pain at the injection site (55.26%), mild fatigue (10.53%), and swelling at the injection site (10.53%) • No SAE | • A good antibody response to the BNT162b2 booster vaccination in PHD |