ABSTRACT
BACKGROUND: There is scarce evidence on fourth doses of SARS-CoV-2 vaccines in chronic kidney disease (CKD) patients. We have evaluated the humoral response and effectivity of the fourth dose in the CKD spectrum: non-dialysis CKD (ND-CKD), hemodialysis (HD), peritoneal dialysis (PD) and kidney transplant (KT) recipients. METHODS: This is a prespecified analysis of the prospective, observational, multicentric SENCOVAC study. In patients with CKD who had received a complete initial vaccination and one or two boosters and had anti-Spike antibody determinations 6 and 12 months after the initial vaccination, we analyzed factors associated to persistent negative humoral response and to higher anti-Spike antibody titers as well as the efficacy of vaccination on COVID-19 severity. RESULTS: Of 2186 patients (18% KT, 8% PD, 69% HD and 5% ND-CKD), 30% had received a fourth dose. The fourth dose increased anti-Spike antibody titers in HD (P = 0.001) and ND-CKD (P = 0.014) patients and seroconverted 72% of previously negative patients. Higher anti-Spike antibody titers at 12 months were independently associated to repeated exposure to antigen (fourth dose, previous breakthrough infections), previous anti-Spike antibody titers and not being a KT. Breakthrough COVID-19 was registered in 137 (6%) patients, of whom 5% required admission. Admitted patients had prior titers below 620 UI/ml and median values were lower (P = 0.020) than in non-admitted patients. CONCLUSIONS: A fourth vaccine dose increased anti-Spike antibody titers or seroconverted many CKD patients, but those with the highest need for a vaccine booster (i.e. those with lower pre-booster antibody titers or KT recipients) derived the least benefit in terms of antibody titers. Admission for breakthrough COVID-19 was associated with low anti-Spike antibody titers.
ABSTRACT
The Degree in Library Science and Documentation of the University of León started during the 1990–1991 academic year. This first curriculum suffered from a strong presence of subjects from the humanities, with a low fraction of experimental work in many subjects because of its inclusion within the Faculty of Philosophy and Letters. The first years attracted large numbers of students. However, the subsequent decrease in the number of students pursuing the degree drove us to initiate a change toward blended and online modalities. The Librarianship and Documentation Area of the University of León (ULe) already has a long history in blended teaching, starting with the Degree in Librarianship and Documentation, which has used the platform aul@unileon since the 2006–2007 academic year;the Degree of Information and Documentation has used the blended modality since the 2010–2011 academic year, and it has been offered in the distance learning modality since the 2014–2015 academic year. These new technologies have been fully introduced into university education and have facilitated the teaching–learning process through the use of interactive programs via the Internet. The main objective of this column is to determine and study the kind of multimedia tools used by professors of the Bachelor of Information and Documentation at the University of León during the teaching–learning process and in virtual teaching before the COVID-19 pandemic, as well as to report which new tools were introduced by the university for this reason. We study the student–teacher and student–student interactions to help promote communication and participatory learning through chats, forums, email, hangouts, Skype, Meet, videoconferences, etc. To carry out this study, two types of methodology were applied: satisfaction surveys implemented by the Quality Office of the ULe to determine the degree of satisfaction of students and teachers, and a study of annual reports.