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J Am Soc Nephrol . Kinetics of Anti-SARS-CoV-2 IgG Antibodies in Hemodialysis Patients Six Months after Infection

tetano

Editor, Senior Moderator
J Am Soc Nephrol


. 2021 Feb 26;ASN.2020111618.
doi: 10.1681/ASN.2020111618. Online ahead of print.
Kinetics of Anti-SARS-CoV-2 IgG Antibodies in Hemodialysis Patients Six Months after Infection


Hamza Sakhi[SUP] 1 2 [/SUP], Djamal Dahmane[SUP] 1 [/SUP], Philippe Attias[SUP] 3 [/SUP], Thomas Kofman[SUP] 4 [/SUP], Magali Bouvier[SUP] 5 6 [/SUP], Nathanael Lapidus[SUP] 7 8 [/SUP], Slim Fourati[SUP] 5 6 [/SUP], Khalil El Karoui[SUP] 9 2 [/SUP], Mondor NephroCov Study Group



Collaborators, Affiliations

Abstract

Background: The humoral response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the hemodialysis population, including its dynamics over time, remains poorly understood.
Methods: To analyze initial and long-term humoral responses against SARS-CoV-2 in a hemodialysis population, we retrospectively evaluated findings from SARS-CoV-2 IgG serologic assays targeting the nucleocapsid antigen or spike antigen up to 6 months of follow-up in patients on hemodialysis in the Paris, France, region who had recovered from coronavirus disease 2019 (COVID-19).
Results: Our analysis included 83 patients (median age 65 years); 59 (71%) were male and 28 (34%) had presented with severe COVID-19. We observed positive initial SARS-CoV-2 IgG antinucleocapsid serology in 74 patients (89%) at a median of 67 days postdiagnosis. By multivariable analysis, immunocompromised status was the only factor significantly associated with lack of an IgG antinucleocapsid antibody response. Follow-up data were available at 6 months postdiagnosis for 60 of 74 patients (81%) with positive initial antinucleocapsid serology, and 15 (25%) of them had negative antinucleocapsid serology at month 6. In total, 14 of 15 sera were tested for antispike antibodies, 3 of 14 (21%) of which were also negative. Overall, 97% of antinucleocapsid-antibody-positive specimens were also antispike-antibody positive. Female sex, age >70 years, and nonsevere clinical presentation were independently associated with faster IgG antinucleocapsid titer decay in multivariable analysis. After adjustment for sex and age >70 years, nonsevere clinical presentation was the only factor associated with faster decay of IgG antispike antibodies.
Conclusions: This study characterizes evolution of the SARS-CoV-2 antibody response in patients on hemodialysis and identifies factors that are associated with lack of seroconversion and with IgG titer decay.

Keywords: COVID-19; SARS-CoV-2; SARS-CoV-2 antibody; hemodialysis; serology.
 
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