BackgroundPatients with chronic kidney disease and undergoing hemodialysis are at greater risk of developing COVID-19. In spite of vaccine efficacy, SARS-CoV-2 breakthrough infection has been reported in several studies. This study was carried out to assess if seroconversion could predict SARS-CoV-2 breakthrough infection in a cohort of vaccinated patients undergoing hemodialysis. MethodologyPatients undergoing maintenance hemodialysis for at least three months and who had received two doses of BBV152 or AZD1222 vaccine were included in the study. Their baseline IgG antibodies to SARS-CoV-2 were measured and followed up for a median of three months during the third wave of COVID-19 in India with SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) to detect breakthrough infections. ResultsOf 80 patients enrolled, seroconversion was seen in 81% of the cases, and SARS-CoV-2 breakthrough cases have been detected in 16% (13/80; 95% CI 8.95-26.18) patients undergoing hemodialysis. Of the 13 patients, seven patients required hospitalization and others had a mild outcome. There was no correlation of baseline seropositivity with breakthrough infections or hospitalization. ConclusionsA majority of patients who underwent hemodialysis are seropositive post-vaccination. The breakthrough infection did not correlate with baseline seroconversion. Thus, there would be other predictors of breakthrough COVID-19 infections that need to be recognized in this susceptible population.

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Because procalcitonin has been recommended as a bacterial infection marker, this study was conducted to investigate the utility of serum PCT as an early marker to decide on intervention for urinary tract infection.  We did a one-year retrospective analysis with 200 individuals who had febrile urinary tract infections. The independent risk variables for distinguishing urosepsis from febrile urinary tract infection were identified using univariate and multivariate logistic analysis. To examine the prediction accuracy of the procalcitonin/albumin ratio, a receiver operating characteristic (ROC) curve analysis was performed. The procalcitonin/albumin ratios in the urosepsis group were greater than those in the febrile urinary tract infection group were 84.62 percent and 96.00 percent, respectively. Furthermore, in the subset of 65 patients with urosepsis, the procalcitonin/albumin ratio in the uroseptic shock group was higher than in the non-urosepsis group. Our findings show that the procalcitonin/albumin ratio can distinguish between urosepsis and febrile urinary tract infection early in the diagnostic process. Furthermore, patients with urosepsis who had greater procalcitonin/albumin ratios were more likely to develop uroseptic shock. Our findings show that the procalcitonin/albumin ratio can be employed in clinical practise as a quick and low-cost biomarker.