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SARS-CoV-2 infection in vaccinated maintenance hemodialysis patients despite anti-spike seroconversion: a report of 3 breakthrough cases

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Biedunkiewicz B., Tylicki L., Puchalska-Reglińska E., Dąbrowska M., Ślizień W., Kubanek A., Rąbalski Ł., Kosiński M., Grzybek M., Renke M., Dębska-Ślizień A.

European Journal of Translational and Clinical Medicine

2022

vol. 5

issue 1

12-16

Chronically hemodialyzed (HD) patients are at a high risk of developing very severe forms of COVID-19 disease. In this article we describe three HD patients (all males, aged 70, 70 and 74 years) vaccinated intramuscularly with a two-dose mRNA BNT162b2 vaccine; BionTech/Pfizer Comirnaty, in whom subsequent breakthrough SARS-CoV-2 infections developed. All patients achieved post-vaccine seroconversion for anti-spike antibodies with IgG titers of 445, 227 and 92.5 AU/mL (cut-off, 13 AU/mL) case 1, 2 and 3 respectively. SARS-CoV-2 infection was diagnosed 44, 28 and 48 days after the second dose of BNT162b2 and confirmed with the polymerase-chain-reaction (PCR) test. Two asymptomatic patients underwent this test because of their direct contact with a person with confirmed COVID-19. The third patient reported only a non-significant drop in oxygen saturation, and was hospitalized (case 3). All these patients were characterized by a low post-vaccination neutralizing antibody titer and a high production of these antibodies after falling ill (795, 845 and 5770). Perhaps this production of antibodies is responsible for the mild course of the disease, and the likely reduction of mortality. These breakthrough cases in no way undermine the importance of the vaccinations, and on the contrary argue for their urgency.

Aliskiren reduces albuminuria after kidney transplantation

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Tylicki L., Debska-Slizien A., Lizakowski S., Przybylska M., Heleniak Z., Renke M., Chamienia A., Biedunkiewicz B., Rutkowski P., Małgorzewicz S., Rutkowski B.

2017

vol. 64

issue 2

221-226

Background: The renoprotective effects of the direct renin inhibitor, aliskiren, in renal transplant recipients have been supposed, but not finally proven. We performed an exploratory double-blind, losartan controlled, cross-over study to evaluate the influence of aliskiren, direct renin inhibitor, on albuminuria and other surrogate markers of kidney injury in patients after renal transplantation. The safety of this therapy was also evaluated. Method: 16 of 18 patients (12 M, 4 F), 48.3 ± 9.0 years, 57.7 ± 9.1 months after kidney transplantation, with hypertension and stable serum creatinine 1.4 ± 0.08 mg/dl without proteinuria, completed the protocol. Each patient underwent two 8-week treatment periods (one with 150 mg of aliskiren, and one with 50 mg of losartan) in random order, allowing an 8-week placebo washout between them. Results: There were no differences in albuminuria, transforming growth factor β-1 and 15-F2t-isoprostanes urine excretion between aliskiren and losartan. Creatinine serum level, eGFR, 24 h systolic and 24 h diastolic blood pressure were stable through the study. There were no differences in haemoglobin and potassium serum concentration between studied drugs. Conclusion: Aliskiren decreases albuminuria in renal transplant recipients with clinically minimal side effects. The effect does not differ from that of losartan.

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1 Acta Biochimica Polonica

1 European Journal of Translational and Clinical Medicine

1 2022

1 2017

2 Biedunkiewicz B.

2 Renke M.

2 Tylicki L.

1 Chamienia A.

1 Debska-Slizien A.

1 Dąbrowska M.

1 Dębska-Ślizień A.

1 Grzybek M.

1 Heleniak Z.

1 Kosiński M.

1 Kubanek A.

1 Lizakowski S.

1 Małgorzewicz S.

1 Przybylska M.

1 Puchalska-Reglińska E.

1 Rutkowski B.

1 Rutkowski P.

1 Rąbalski Ł.

1 Ślizień W.

Search results

SARS-CoV-2 infection in vaccinated maintenance hemodialysis patients despite anti-spike seroconversion: a report of 3 breakthrough cases

Aliskiren reduces albuminuria after kidney transplantation