tetano
Editor, Senior Moderator
J Am Soc Nephrol
. 2021 Jul 2;ASN.2021030387.
doi: 10.1681/ASN.2021030387. Online ahead of print.
Antibody Status, Disease History, and Incidence of SARS-CoV-2 Infection Among Patients on Chronic Dialysis
Dena Cohen[SUP] 1 [/SUP], Scott Sibbel[SUP] 2 [/SUP], Gilbert Marlowe[SUP] 3 [/SUP], Kelsey Bludorn[SUP] 4 [/SUP], Dawn Miller[SUP] 5 [/SUP], Tara Kelley[SUP] 6 [/SUP], Jeffrey Connaire[SUP] 7 [/SUP], Amy Young[SUP] 8 [/SUP], Francesca Tentori[SUP] 9 [/SUP], Steven Brunelli[SUP] 10 [/SUP]
Affiliations
Abstract
Background: Although reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rare among individuals with few coronavirus disease 2019 (COVID-19) risk factors, the ability of naturally acquired immunity to prevent reinfection among patients with end-stage kidney disease (ESKD) is not known. Methods: This prospective study was conducted among adults with ESKD treated with in-center hemodialysis (ICHD) in the United States. Exposure was ascribed based on the presence or absence of immunoglobulin G (IgG) against SARS-CoV-2 at baseline, and separately, a history of documented COVID-19 prior to study entry. Outcomes were assessed following a disease-free washout period, and were: any SARS-CoV-2 infection (ie, detected by protocolized PCR tests or during routine clinical surveillance), and clinically manifest COIVD-19 (consisting of only the latter). Results: Of 2337 consented participants who met study inclusion criteria, 9.5% were anti-SARS-CoV-2 IgG positive at baseline; 3.6% had a history of COVID-19. Over 6679 patient-months of follow-up, 263 participants had evidence of any SARS-CoV-2 infection, including 141 who had clinically manifest COIVD-19. Presence of anti-SARS-CoV-2 IgG (versus its absence) at baseline was associated with lower risk of any SARS-CoV-2 infection (incidence rate ratio 0.55, 95% confidence interval 0.32, 0.95) and clinically manifest COVID-19 0.21 (95% confidence interval 0.07, 0.67). Conclusion: Among ESKD patients, naturally acquired anti-SARS-CoV-2 IgG positivity is associated with a 45% lower risk of subsequent SARS-CoV-2 infection, and a 79% lower risk of clinically manifest COVID-19. Since natural immunity is incomplete, ESKD patients should be prioritized for SARS-CoV-2 vaccination, independent of their COVID-19 disease history.
. 2021 Jul 2;ASN.2021030387.
doi: 10.1681/ASN.2021030387. Online ahead of print.
Antibody Status, Disease History, and Incidence of SARS-CoV-2 Infection Among Patients on Chronic Dialysis
Dena Cohen[SUP] 1 [/SUP], Scott Sibbel[SUP] 2 [/SUP], Gilbert Marlowe[SUP] 3 [/SUP], Kelsey Bludorn[SUP] 4 [/SUP], Dawn Miller[SUP] 5 [/SUP], Tara Kelley[SUP] 6 [/SUP], Jeffrey Connaire[SUP] 7 [/SUP], Amy Young[SUP] 8 [/SUP], Francesca Tentori[SUP] 9 [/SUP], Steven Brunelli[SUP] 10 [/SUP]
Affiliations
- PMID: 34215666
- DOI: 10.1681/ASN.2021030387
Abstract
Background: Although reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rare among individuals with few coronavirus disease 2019 (COVID-19) risk factors, the ability of naturally acquired immunity to prevent reinfection among patients with end-stage kidney disease (ESKD) is not known. Methods: This prospective study was conducted among adults with ESKD treated with in-center hemodialysis (ICHD) in the United States. Exposure was ascribed based on the presence or absence of immunoglobulin G (IgG) against SARS-CoV-2 at baseline, and separately, a history of documented COVID-19 prior to study entry. Outcomes were assessed following a disease-free washout period, and were: any SARS-CoV-2 infection (ie, detected by protocolized PCR tests or during routine clinical surveillance), and clinically manifest COIVD-19 (consisting of only the latter). Results: Of 2337 consented participants who met study inclusion criteria, 9.5% were anti-SARS-CoV-2 IgG positive at baseline; 3.6% had a history of COVID-19. Over 6679 patient-months of follow-up, 263 participants had evidence of any SARS-CoV-2 infection, including 141 who had clinically manifest COIVD-19. Presence of anti-SARS-CoV-2 IgG (versus its absence) at baseline was associated with lower risk of any SARS-CoV-2 infection (incidence rate ratio 0.55, 95% confidence interval 0.32, 0.95) and clinically manifest COVID-19 0.21 (95% confidence interval 0.07, 0.67). Conclusion: Among ESKD patients, naturally acquired anti-SARS-CoV-2 IgG positivity is associated with a 45% lower risk of subsequent SARS-CoV-2 infection, and a 79% lower risk of clinically manifest COVID-19. Since natural immunity is incomplete, ESKD patients should be prioritized for SARS-CoV-2 vaccination, independent of their COVID-19 disease history.