Persistence of antibody response to SARS-CoV-2 in a cohort of haemodialysis patients with COVID-19
Persistence of antibody response to SARS-CoV-2 in a cohort of haemodialysis patients with COVID-19
复制标题
DOI：
10.1093/ndt/gfab066
复制
发表时间：
2021-03-15
影响因子：
6.1
通讯作者：
McCafferty, Kieran
中科院分区：
文献类型：
--
作者：
Forbes, Suzanne;Davari, Maria;McCafferty, Kieran
背景血液透析（HD）患者极易感染2019冠状病毒病（COVID-19）。感染后的免疫反应尚不清楚。我们发现在这一人群中有很高的血清转化率，95%的人产生了抗体。目前尚不清楚这些抗体是否存在以及持续多久。在这里，我们调查这与系列抗体（Ab）测试。我们确定了2020年3月至5月期间确诊为严重急性呼吸道综合征冠状病毒2型的HD患者，并测量了幸存者的每月抗体（免疫球蛋白G/免疫球蛋白M）。我们使用半定量截止指数来创建定性结果，并绘制光密度（OD）随时间的变化曲线。我们使用线性回归来检查斜率，并记录峰值OD和达到峰值OD的时间。我们将这些与基线人口统计学、疾病严重程度和合并症的标志物相关联。共分析了122例患者。在至少148天的随访期间，所有患者均保持Ab阳性。71%具有阳性梯度，表明Ab阳性随时间增加。我们发现，年龄（P = 0.01），聚合酶链反应阳性的持续时间（P = 0.06）和症状的存在（P = 0.05）与较长的时间峰值OD。免疫抑制并没有改变峰值OD，但确实导致了一个非显着增加的时间达到峰值OD，更多的患者有随后的抗体水平下降（P = 0.02）。糖尿病患者更可能有正斜率（比值比2.26）。这些结果表明，HD患者在确诊COVID-19感染后具有稳健和持续的Ab应答，没有迹象表明免疫抑制会削弱这种应答。虽然目前还不清楚这些抗体能提供什么保护，但令人鼓舞的是，HD患者应该对疫苗接种做出反应。
Background. Haemodialysis (HD) patients are extremely vulnerable to coronavirus disease 2019 (COVID-19). Their immune response after infection is unclear. We have found high seroconversion rates in this population, with 95% developing antibodies. It is unclear if and how long these antibodies persist. Here we investigate this with serial antibody (Ab) testing.Methods. We identified HD patients who had confirmedsevere acute respiratory syndrome coronavirus 2 between March and May 2020 and measured monthly antibodies (immunoglobulin G/immunoglobulin M) in those who survived. We used a semiquantitative cut-off index to create a qualitative result and plotted optical density (OD) over time. We used linear regression to examine the slope, as well as noting peak OD and time to peak OD. We correlated these against baseline demographics, markers of illness severity and comorbidities.Results. A total of 122 patients were analysed. All remained Ab positive during follow-up for a minimum of 148 days. Seventyone percent had a positive gradient indicating increasing Ab positivity over time. We found that age (P = 0.01), duration of polymerase chain reaction positivity (P = 0.06) and the presence of symptoms (P = 0.05) were associated with a longer time to peak OD. Immunosuppression did not alter peak OD but did lead to a non-significant increase in time to peak OD, and more patients had a subsequent decrease in Ab levels (P = 0.02). Diabetic patients were more likely to have a positive slope (odds ratio 2.26).Conclusions. These results indicate that HD patients have a robust and sustained Ab response after confirmed COVID-19 infection with no suggestion that immunosuppression weakens this response. Although it is unclear what protection these antibodies confer, this is encouraging that HD patients should respond to vaccination.