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Ren Fail . Patients receiving hemodialysis do not lose SARS-CoV-2 antibodies more rapidly than non-renal controls: a prospective cohort study

tetano

Editor, Senior Moderator
Ren Fail


. 2022 Dec;44(1):392-398.
doi: 10.1080/0886022X.2022.2042310.
Patients receiving hemodialysis do not lose SARS-CoV-2 antibodies more rapidly than non-renal controls: a prospective cohort study


Ekaterina Parshina[SUP] 1 [/SUP], Alexey Zulkarnaev[SUP] 2 [/SUP], Alexey Tolkach[SUP] 1 [/SUP], Andrey Ivanov[SUP] 3 [/SUP], Pavel Kislyy[SUP] 1 [/SUP], Abduzhappar Gaipov[SUP] 4 [/SUP]



Affiliations

Abstract

Background: Patients with end-stage kidney disease receiving maintenance hemodialysis (HD) are at increased risk for mortality after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared with the general population. However, it is currently unknown whether the long-term SARS-CoV-2 humoral and cellular immune responses in patients receiving HD are comparable to individuals with normal kidney function.
Method: The prospective cohort study included 24 patients treated with maintenance HD and 27 non-renal controls with confirmed history of coronavirus disease (COVID-19). In all participants the levels of specific IgG were quantified at three timepoints: 10, 18, and 26 weeks from disease onset. In a subgroup of patients, specific T-cell responses were evaluated.
Results: The seropositivity rate declined in controls over time and was 85% and 70.4% at weeks 18 and 26, respectively. All HD patients remained seropositive over the study period. Seropositivity rate at week 26 was greater among patients receiving HD: RR = 1.4 [95%CI: 1.17-1.94] (reciprocal of RR = 0.7 [95% CI: 0.52-0.86]), p = 0.0064. In both groups, IgG levels decreased from week 10 to week 26, but antibodies vanished more rapidly in controls than in HD group (ANOVA p = 0.0012). The magnitude of T-cell response was significantly lower in controls than in HD patients at weeks 10 (p = 0.019) and 26 (p = 0.0098) after COVID-19 diagnosis, but not at week 18.
Conclusion: Compared with non-renal adults, patients receiving HD maintain significant long-term humoral and cellular immune responses following natural COVID-19.

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