MO836: Patients Receiving Haemodialysis Maintain Sars-Cov-2 Immunity Comparable With Healthy Individuals: A Prospective Cohort Study

Abstract

BACKGROUND AND AIMS Patients with end-stage kidney disease receiving maintenance haemodialysis (HD) are at increased risk for mortality after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared with the general population. However, it is currently unknown whether the long-term SARS-CoV-2 humoral and cellular immune responses in patients receiving HD are comparable to individuals with normal kidney function. We aimed to investigate the 6-month kinetics of SARS-CoV-2 IgG antibody and specific T-cell levels in patients receiving HD compared with those in healthy individuals. METHOD The prospective cohort study included 24 patients treated with maintenance HD and 27 healthy controls with confirmed history of coronavirus disease (COVID-19). Nobody of them received vaccination before and during the study period. In all participants, the levels of specific IgG were quantified at three timepoints: 10, 18 and 26 weeks from disease onset. In a subgroup of patients, specific CD4+ and CD8+ T-lymphocyte responses were evaluated using IGRA test. RESULTS The incidence of COVID-19-related symptoms did not differ between the groups, except for the loss of smell, which occurred much more frequently among healthy subjects (70% versus 30.4% in HD group, P = 0.01). The seropositivity rate declined in healthy subjects over time and was 85% and 70.4% at weeks 18 and 26, respectively. All HD patients remained seropositive over the study period. Seropositivity rate at week 26 was greater among patients receiving HD: RR = 1.4 [95% confidence interval (95% CI): 1.17–1.94] (reciprocal of RR = 0.7, 95% CI: 0.52–0.86), P = 0.0064. In both groups, IgG levels decreased from week 10 to week 26, but antibodies vanished more rapidly in controls than in HD group (ANOVA P = 0.0012)—Figure 1. The magnitude of T-cell response was significantly lower in controls than in HD patients at weeks 10 (P = 0.019) and 26 (P = 0.0098) after COVID-19 diagnosis, but not at week 18—Figure 2. CONCLUSION Compared with healthy adults, patients receiving HD maintain significant long-term humoral and cellular immune responses following natural COVID-19. SARS-CoV-2 IgG antibodies did not decline more rapidly in patients receiving HD than in healthy controls over 6-months period.