Longevity of SARS-CoV-2 immune responses in hemodialysis patients and protection against reinfection.
Longevity of SARS-CoV-2 immune responses in hemodialysis patients and protection against reinfection.
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DOI：
10.1016/j.kint.2021.03.009
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发表时间：
2021-06
影响因子：
19.6
通讯作者：
Willicombe M
中科院分区：
文献类型：
--
作者：
Clarke CL;Prendecki M;Dhutia A;Gan J;Edwards C;Prout V;Lightstone L;Parker E;Marchesin F;Griffith M;Charif R;Pickard G;Cox A;McClure M;Tedder R;Randell P;Greathead L;Guckian M;McAdoo SP;Kelleher P;Willicombe M
接受中心血液透析 (ICHD) 的终末期肾病患者 SARS-CoV-2 感染率很高。感染后，接受 ICHD 的患者经常会产生针对 SARS-CoV-2 的循环抗体，即使是无症状感染。在这里，我们研究了接受 ICHD 的患者对 SARS-CoV-2 感染的免疫反应的持久性和功能性。对 356 名此类患者进行了 SARS-CoV-2 抗体纵向筛查，并进行了有症状和无症状感染的常规 PCR 检测。定期对患者进行核衣壳蛋白（抗 NP）和受体结合域（抗 RBD）抗体筛查，并对六个月后血清阴性的患者进行 SARS-CoV-2 特异性 T 细胞反应筛查。 129 名患者 (36.2%) 在零时间时具有可检测到的抗 NP 抗体，其中 127 名患者还具有可检测到的抗 RBD。值得注意的是，六个月时，分别有 71/111 (64.0%) 和 99/116 (85.3%) 的患者仍呈抗 NP 和抗 RBD 血清阳性。对于保留抗体的患者，六个月后抗 NP 和抗 RBD 水平均显着降低。 11 名在零时间时呈抗 NP 血清阳性的患者，在六个月时没有检测到抗体；其中 8 人被发现具有 SARS-CoV-2 抗原特异性 T 细胞反应。无论六个月时的抗体状态如何，基线 SARS-CoV-2 血清学呈阳性的患者在接下来的六个月内经 PCR 确诊感染的可能性显着降低。因此，接受 ICHD 的患者在感染 SARS-CoV-2 六个月后会产生持久的免疫反应，只有不到 3% 的患者没有表现出体液或细胞免疫的证据。
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.
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发表时间：
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