ABSTRACT
Background: This study aimed to evaluate the immunogenicity of two doses of ChAdOx1 nCoV-19 and the immune response post-COVID-19 infection in ESRD with HD patients. Method(s): The blood samples were obtained at baseline, 1-month, and 3-month follow-up after each shot or recovery. All participants were measured for anti-spike IgG by the ELISA method using Euroimmun. Result(s): This study found a significant increase in anti-spike IgG after 1 month of two-shot ChAdOx1 nCoV-19 vaccination, followed by a significant decrease after 3 months. On the other hand, the anti-spike IgG was maintained in the post-recovery group. There was no significant difference in the change of anti-spike IgG between oneshot ChAdOx1 nCoV-19 vaccinated and post-recovery groups for both 1-month and 3-month follow-ups. The seroconversion rate for the vaccinated group was 60.32% at one-month after one-shot vaccination and slightly dropped to 58.73% at 3-month followup, then was 92.06% at one-month after two-shot vaccination and reduced to 82.26% at 3-month follow-up. For the recovered group, the seroconversion rate was 95.65% at one-month post-recovery and 92.50% at 3-month follow-up. Conclusion(s): This study established the immunogenicity of two-shot ChAdOx1 nCoV-19 in ESRD patients with HD for humoral immunity. After COVID-19 infection, the humoral immune response was strong and could be maintained for at least three months.
ABSTRACT
Purpose: Immunosuppression can impair immunological responses after vaccination in kidney transplant recipients (KTR). However, little is known about the effect of the booster dose of COVID-19 vaccination, with BNT162b2, after two doses of ChAdOx-1 and its response especially comparing among KTR with different immunosuppressive regimen. Method(s): KTRs who had stable allograft function with the regimen of calcineurin inhibitor (CNI) reduction (sirolimus, tacrolimus [Ctrough 2-4 ng/mL], prednisolone;group A) and the standard regimen (tacrolimus [Ctrough 4-7 ng/mL], mycophenolate mofetil, prednisolone;group B) were enrolled for two doses of ChAdOx-1 (three months apart) and a booster dose with BNT162b2 (1 month after ChAdOx-1). KTRs who had history of COVID-19, anti-SARS-CoV-2 antibody positive at baseline, and positive for donor specific antibody (DSA) were excluded. The immune response for vaccination was measured by anti-SARS-CoV-2 antibody one month after two doses of ChAdOx-1 and BNT162b2. DSA (Luminex) was measured at one month after BNT162b2. Result(s): Forty KTR were enrolled with mean age of 47.52 +/- 10.86 years old. There were 21 KTR in group A and 19 KTR in group B. The group A has significantly higher anti-SARS-CoV-2 antibody after 2 doses of ChAdOx-1 (502.05 +/- 612.87 BAU/ml and 66.69 +/-143.01 BAU/ml for group A and B, p < 0.05) and after a booster dose of BNT162b2 (10,291.04 +/- 12,803.95 BAU/ml and 1,264.94 +/-1,935.50 BAU/ml for group A and B, p < 0.05). None of KTRs developed DSA after completing all vaccination including the booster dose. Conclusion(s): The KTR with CNI reduction regimen has significantly higher immunologic response to COVID-19 vaccination. The booster dose of COVID-19 vaccination provides significantly improve in immunological response in both standard and CNI reduction regimens. Two doses of ChAdOx-1 and a booster dose of BNT162b2 did not lead to DSA production in both regimens.
ABSTRACT
Background: Hospital capacity management has been one of the main public health problems in many countries during the COVID-19 outbreak. Field hospitals were developed as a means of taking care of patients with limited resource utilization. Objective: To demonstrate clinical presentations and treatment outcomes of patients infected with COVID-19 treated at a field hospital. Additionally, cost and utilization were also evaluated. Materials and Methods: The present study was a retrospective study. Data from the medical records of the patients diagnosed with COVID-19 admitted and discharged from a field hospital between April 2021 and June 2021 were reviewed. Clinical presentation, treatment outcomes, cost, and utilization were analyzed, classified by disease severity. Results: Seventy-two patients with a mean age (SD) of 30.2 (8.4) years were enrolled in the present study. Thirty-six patients (50.0%) were asymptomatic. Nasal congestion was the most common symptom of COVID-19 (30.6%). Patients with mild pneumonia had higher body mass index (BMI) and older age than asymptomatic cases, and symptomatic COVID-19 cases without pneumonia (p=0.014, 0.028, respectively). The two common final diagnoses were acute pharyngitis (27.8%) and pneumonia (26.4%). Asymptomatic pneumonia was found in 5.6%. The mortality rate was 0% in the field hospital. The average length of stay was 12 days, and the mean total cost of treatment was 48,396 THB per patient. The patients with mild pneumonia had significant higher total cost of treatment than asymptomatic cases and symptomatic COVID-19 cases without pneumonia. Conclusion: Field hospitals could be the most efficient option for taking care of COVID-19 patients when healthcare resources in hospital are limited. COVID-19 patients’ triage was important to determine the outcomes. Asymptomatic cases, symptomatic cases without pneumonia, and cases with mild pneumonia could be treated in a field hospital with cost-effective outcomes. © 2022 JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND.