Longevity of SARS-CoV-2 immune responses in hemodialysis patients and protection against reinfection
File(s)
Published version
OA Location
Author(s)
Type
Journal Article
Abstract
Patients with end stage kidney disease receiving in-center hemodialysis (ICHD) have had high rates of SARS-CoV-2 infection. Following infection, patients receiving ICHD frequently develop circulating antibodies to SARS-CoV-2, even with asymptomatic infection. Here, we investigated the durability and functionality of the immune responses to SARS-CoV-2 infection in patients receiving ICHD. Three hundred and fifty-six such patients were longitudinally screened for SARS-CoV-2 antibodies and underwent routine PCR-testing for symptomatic and asymptomatic infection. Patients were regularly screened for nucleocapsid protein (anti-NP) and receptor binding domain (anti-RBD) antibodies, and those who became seronegative at six months were screened for SARS-CoV-2 specific T-cell responses. One hundred and twenty-nine (36.2%) patients had detectable antibody to anti-NP at time zero, of whom 127 also had detectable anti-RBD. Significantly, at six months, 71/111 (64.0%) and 99/116 (85.3%) remained anti-NP and anti-RBD seropositive, respectively. For patients who retained antibody, both anti-NP and anti-RBD levels were reduced significantly after six months. Eleven patients who were anti-NP seropositive at time zero, had no detectable antibody at six months; of whom eight were found to have SARS-CoV-2 antigen specific T cell responses. Independent of antibody status at six months, patients with baseline positive SARS-CoV-2 serology were significantly less likely to have PCR confirmed infection over the following six months. Thus, patients receiving ICHD mount durable immune responses six months post SARS-CoV-2 infection, with fewer than 3% of patients showing no evidence of humoral or cellular immunity.
Date Issued
2021-06-01
Date Acceptance
2021-03-01
Citation
Kidney International, 2021, 99 (6), pp.1470-1477
ISSN
0085-2538
Publisher
Elsevier
Start Page
1470
End Page
1477
Journal / Book Title
Kidney International
Volume
99
Issue
6
Sponsor
Imperial Health Charity
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33774082
PII: S0085-2538(21)00295-7
Grant Number
FA1920_7
Subjects
Covid-19
Haemodialysis
SARS-CoV-2
serology
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2021-03-25