Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Iran J Kidney Dis. 2021 May;15(3):161-167.
Hemodialysis (HD) patients display metabolic and immunologic alterations that renders their immune responses to be dysregulated. These patients generally have problems in mounting effective immune responses against pathogens such as viruses. On the other hand they typically have higher levels of inflammatory cytokines in their peripheral blood. Both of these features may work in favor of COVID-19. Since robust immune responses are needed to prevent infection in the initial stages of COVID-19, the impaired immune system may not be able to cope effectively with the highly replicating SARS-CoV2. In advanced stages of the disease wherein the inflammation as well as the cytokine storm are the core players, a high baseline inflammatory cytokines could intensify and substantially exacerbate the immunopathological situation. Presence of COVID-19 in HD patients may also be a complex immunological condition. Immunological alterations in HD patients and their potential effects on the fate of the SARSCoV- 2 infection are discussed here. Case reports describing the occurrence of COVID-19 in HD patients have also been reviewed in this study.
血液透析（HD）患者表现出代谢和免疫改变，导致其免疫反应失调。这些患者通常在对病毒等病原体产生有效免疫反应方面存在问题。另一方面，他们的外周血中通常有更高水平的炎症细胞因子。这两个特征都可能有利于 COVID-19。由于 COVID-19 感染的初始阶段需要强大的免疫反应来预防感染，受损的免疫系统可能无法有效应对高度复制的 SARS-CoV2。在疾病的晚期，炎症和细胞因子风暴是核心因素，高基线炎症细胞因子可能会加剧并实质性恶化免疫病理状况。COVID-19 在血液透析患者中的存在也可能是一种复杂的免疫状况。本文讨论了血液透析患者的免疫改变及其对 SARSCoV-2 感染命运的潜在影响。本研究还回顾了描述 COVID-19 在血液透析患者中发生的病例报告。
