SARS-CoV-2 Antibody Seroprevalence Among Maintenance Dialysis Patients in the United States

Walker, Adam G.; Sibbel, Scott; Wade, Curtis L; Moulton, Nick; Marlowe, Gilbert; Young, Amy; Fadem, Stephen Z.; Brunelli, Steven M.

doi:10.1016/j.xkme.2021.01.002

Cited by 12 publications

(17 citation statements)

References 20 publications

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“…Spread of COVID-19 was global and showed a highly heterogeneous distribution, changing significantly across the cities in the same country (China, Spain). A speculative explanation of this variable disease spreading pattern suggests that COVID-19 pandemic manifested with local outbreaks rather than reflecting national trends [ 155 ].…”

Section: Discussionmentioning

confidence: 99%

The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

et al. 2021

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Background Patients undergoing in-centre haemodialysis (HD) are particularly exposed to the dire consequences of COVID-19. The present systematic scoping review aims to identify the extent, range, and nature of articles related to COVID-19 and maintenance HD: it reports specifically the prevalence of the COVID-19 pandemic in the HD population, implementation of strategies for the prevention, mitigation and containment of the COVID-19 pandemic in HD centres, demographic and clinical characteristics, and outcomes of the pediatric and adult HD patients. Methods A multi-step systematic search of the literature in Pubmed, Scopus, Ovid Medline, Embase and Web of Science, published between December 1, 2019, and January 30, 2021 was performed. Two authors separately screened the titles and abstracts of the documents and ruled out irrelevant articles. A report of the papers that met inclusion criteria was performed; then, a descriptive analysis of the characteristics of the included articles and a narrative synthesis of the results were performed. Results The review process ended with the inclusion of 145 articles. Most of them were based on single-centre experiences, which spontaneously developed best practices. Most studies were conducted in high-income countries (69.7%) and a part of them (9.6%) were not in English. Prevalence of COVID-19 among dialysis patients accounted for 0%-37.6%. Preventive measures were reported in 54% of the included articles, with particular emphasis on education, triage, hygiene, and containment measures. Patients experienced a heterogeneous spectrum of symptoms that led 35%-88.2% of them to hospital admission. Median and mean hospital length of stay ranged from 8 to 28.5 and 16.2 to 22 days, respectively. Admission to intensive care units varied widely across studies (from 2.6% to 70.5%) and was associated with high mortality (42.8%-100%). Overall, prognosis was poor in 0%-47% of the hospitalized patients. Conclusions This systematic scoping review provides an overview of the current knowledge on the impact of COVID-19 on the frail world of HD patients. Furthermore, it may help to implement the existing strategies of COVID-19 prevention and provide a list of unmet needs (safe transport, testing, shelter). Finally, it may be a stimulus for performing systematic reviews and meta-analyses which will form the basis for evidence-based guidelines.

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Section: Discussionmentioning

confidence: 99%

The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

et al. 2021

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“…It is likely that a poor nutritional status (as reflected by low serum albumin values) could support the acquisition of SARS-CoV-2 infection and consequent anti-SARS-CoV-2 antibody detection in serum. Of note, the sero-prevalence of anti-SARS-CoV-2 antibody among healthcare workers and healthy blood donors at the same hospital was 7.6% (309/4055) [ 12 ] and 5.2% (95% CI, 2.4–9.0) [ 13 ], respectively, based on two surveys performed a few months before the current survey. Anti-SARS-CoV-2 antibody detected among healthcare workers were anti-S1 and anti-S2 IgG antibodies; and healthy blood donors showed IgM/IgG antibody against the SARS-CoV-2 nucleocapsid protein.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors for Anti-SARS-CoV-2 Antibody in Chronic Kidney Disease (Dialysis Independent and Not)

et al. 2022

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Background: The evidence in the medical literature regarding the prevalence of antibody towards SARS-CoV-2 in patients with chronic kidney disease is limited, particularly among those at the pre-dialysis stage. Aim: We have prospectively performed a cohort study at a third-level university hospital to evaluate frequency and risk factors for anti-SARS-CoV-2-positive serology among chronic kidney disease patients. Methods: We have tested a cohort of consecutive outpatients with chronic kidney disease on regular follow-up at a major metropolitan hospital, during the SARS-CoV-2 outbreak in Italy. We adopted an enzyme immunoassay for the assessment of IgM/IgG antibodies to SARS-CoV-2 in human serum or plasma (DIA.PRO COVID-19 Serological Assay); the assay detects antibodies against Spike (1/2) and Nucleocapsid proteins of the SARS-CoV-2 genome. Results: There were 199 (65.8%) out of 302 patients with dialysis-independent CKD; 2 patients were anti-SARS-CoV-2 IgM antibody positive, 23 were anti-SARS-CoV-2 IgM/IgG positive and 37 had detectable anti-SARS-CoV-2 IgG antibody in serum. The prevalence of anti-SARS-CoV-2 IgG was 20.5% (60/302). All patients positive for anti-SARS-CoV-2 antibody tested negative by nasopharyngeal swab. A significant and independent relationship between anti-SARS-CoV-2-positive serologic status and serum albumin (a marker of nutritional status) was observed (p < 0.046). The prevalence of anti-SARS-CoV-2 antibody was greater in CKD than in control populations (health care workers and blood donors) attending the hospital a few months before the current study (7.6% and 5.2%, respectively). Conclusions: The great prevalence of anti-SARS-CoV-2 antibody in our study group could be, at least partially, explained with the fact that our patients were living in Milan, an area severely hit by SARS-CoV-2 infection. It seems that a poor nutritional status supports the acquisition of SARS-CoV-2 antibody in CKD patients. Clinical studies to understand the mechanisms responsible for the high frequency of SARS-CoV-2 infection are under way.

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“…Clinical surveillance protocols at the dialysis organization have been described elsewhere. 9, 10 To summarize, at the time of each clinic visit, all patients undergo a standardized COVID-19 screening. Patients who screen positive for COVID-19 symptoms, or who indicate a recent contact with COVID-19–infected individuals, immediately receive PCR testing.…”

Section: Methodsmentioning

confidence: 99%

“…We previously used this assay for research purposes due to its selectivity for SARS-CoV-2 antibodies and low-levels of cross-reactivity to other coronaviruses or influenza viruses. 9, 10 IgM levels were not measured based on pilot data demonstrating that measured IgM response was implausibly low in this population (<20% positive even in the 28-day period following documented SARS-CoV-2 infection).…”

Section: Methodsmentioning

confidence: 99%

Comparative Effectiveness of BNT162b2 versus Ad26.COV2.S for the Prevention of COVID-19 among Dialysis Patients

Brunelli

Sibbel

Karpinski

et al. 2021

Preprint

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Background: mRNA-based SARS-CoV-2 vaccines have been shown to be highly effective among dialysis patients. Because individual vaccines may be differentially available or acceptable to patients, it is important to understand comparative effectiveness of other vaccines, such those based on adeno-virus technologies. Methods: This retrospective study compared the clinical effectiveness of Ad26.COV2.S (Janssen/Johnson and Johnson) to BNT162b2 among dialysis patients. Patients initiating BNT162b2 (Pfizer/BioNTech) were matched 1:1 to Ad26.COV2.S recipients based on age, race, US state of residence, calendar week of first vaccine receipt, and history of COVID-19. The primary outcome was the comparative rate of COVID-19 considered over 3 follow-up intervals: weeks 1-3, 4-6, and ≥ 7 post-vaccination. In a subset of consented Ad26.COV2.S patients, blood samples were collected ≥28 days after vaccination and anti-SARS-Cov-2 immunoglobulin G antibodies were measured. Results: There were 2659 matched pairs of patients who received a first dose of each vaccine. During weeks 1-3, incidence rates were 1.13 vs 1.39 per 1000 patient-weeks (pt-wks) for BNT162b2 and Ad26.COV2.S recipients, respectively (incident rate difference [IRD]: 0.25; 95% CI: 0.90, 1.36). During weeks 4-6, incidence rates were 0.78 vs 0.39 per 1000 pt-wks for BNT162b2 and Ad26.COV2.S recipients, respectively (IRD: -0.39; 95% CI: -1.16, 0.38). After week 7, incidence rates were 1.29 vs 1.39 per 1000 pt-wks for BNT162b2 and Ad26.COV2.S recipients, respectively (IRD: 0.10; 95% CI: -0.35, 0.55). Results were similar when considering only patients without a history of COVID-19 and among matched pairs in which BNT162b2 recipients completed the 2-dose regimen. SARS-CoV-2 antibodies were detected in 59.4% (95% CI: 53.0%-65.5%) of Ad26.COV2.S patients. Conclusion: In a large real-world cohort of dialysis patients, no difference was detected in the clinical effectiveness of BNT162b2 and Ad26.COV2.S, despite an inconsistent antibody response to the latter. These data support the use of either agent in ongoing vaccination efforts in this population.

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SARS-CoV-2 Antibody Seroprevalence Among Maintenance Dialysis Patients in the United States

Cited by 12 publications

References 20 publications

The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

The frail world of haemodialysis patients in the COVID-19 pandemic era: a systematic scoping review

Prevalence and Risk Factors for Anti-SARS-CoV-2 Antibody in Chronic Kidney Disease (Dialysis Independent and Not)

Comparative Effectiveness of BNT162b2 versus Ad26.COV2.S for the Prevention of COVID-19 among Dialysis Patients

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