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- Title
Serial SARS-CoV-2 Receptor-Binding Domain Antibody Responses in Patients Receiving Dialysis.
- Authors
Anand, Shuchi; Montez-Rath, Maria E.; Han, Jialin; Garcia, Pablo; Cadden, LinaCel; Hunsader, Patti; Kerschmann, Russell; Beyer, Paul; Boyd, Scott D.; Chertow, Glenn M.; Parsonnet, Julie
- Abstract
<bold>Background: </bold>Assessing the evolution of SARS-CoV-2 immune response among patients receiving dialysis can define its durability in a highly clinically relevant context because patients receiving dialysis share the characteristics of persons most susceptible to SARS-CoV-2 infection.<bold>Objective: </bold>To evaluate the persistence of SARS-CoV-2 receptor-binding domain (RBD) IgG in seroprevalent patients receiving dialysis.<bold>Design: </bold>Prospective.<bold>Setting: </bold>Nationwide sample from dialysis facilities.<bold>Patients: </bold>2215 patients receiving dialysis who had evidence of SARS-CoV-2 infection as of July 2020.<bold>Measurements: </bold>Remainder plasma from routine monthly laboratories was used to measure semiquantitative RBD IgG index value over 6 months.<bold>Results: </bold>A total of 2063 (93%) seroprevalent patients reached an assay detectable response (IgG index value ≥1). Most (n = 1323, 60%) had responses in July with index values classified as high (IgG ≥10); 1003 (76%) remained within this stratum. Adjusted median index values declined slowly but continuously (July vs. December values were 21 vs. 13; P < 0.001). The trajectory of the response did not vary by age group, sex, race/ethnicity, or diabetes status. Patients without an assay detectable response (n = 137) were more likely to be White and in the younger (18 to 44 years) or older (≥80 years) age groups and less likely to have diabetes and hypoalbuminemia.<bold>Limitation: </bold>Lack of data on symptoms or reverse transcriptase polymerase chain reaction diagnosis, cohort of persons who survived infection, and use of a semiquantitative assay.<bold>Conclusion: </bold>Despite impaired immunity, most seropositive patients receiving dialysis maintained RBD antibody levels over 6 months. A slow and continual decline in median antibody levels over time was seen, but no indication that subgroups with impaired immunity had a shorter-lived humoral response was found.<bold>Primary Funding Source: </bold>Ascend Clinical Laboratories.
- Subjects
SARS-CoV-2; REVERSE transcriptase polymerase chain reaction; ANTIBODY formation; HEMODIALYSIS patients; INFECTION; HUMORAL immunity
- Publication
Annals of Internal Medicine, 2021, Vol 174, Issue 8, p1073
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/M21-0256