Boulanger Henri, Saksi Salima Ahriz, Achiche Jedjiga, Batusanski Florence, Stawiarski Nicolas, Diddaoui Ali, Fromentin Luc, Chawki Mokhtar
Department of Nephrology and Dialysis, ELSAN, Clinique de l'Estrée, 35 Rue d'Amiens, 93240 Stains, France.
Medical Analysis Laboratory, Biogroup, 40 Rue du Bois Moussais, 93240 Stains, France.
Int J Nephrol. 2021 Dec 1;2021:4747221. doi: 10.1155/2021/4747221. eCollection 2021.
The humoral response to SARS-CoV-2 infection in hemodialysis patients needs to be clarified.
In this retrospective study performed in two dialysis facilities, we measured the circulating levels of SARS-CoV-2 antibodies in patients who were on maintenance hemodialysis during the first wave of the epidemic in March and April 2020 and were still alive 6 months later. We also investigated associations between the patients diagnosed as infected during the first wave and several clinical, biological, and radiological parameters of COVID-19. Finally, we compared these circulating levels of SARS-CoV-2 antibodies with those of a control group of healthcare workers infected during the same period.
Of the 299 hemodialysis patients who recovered from the first wave of the epidemic 6 months before, 59 had a positive SARS-CoV-2 antibody whereas only 45 patients were diagnosed as infected during the first wave of the epidemic. All infected hemodialysis patients developed circulating antibodies. Using a clustering method, a significant correlation was identified between the cluster with the lowest circulating levels of SARS-CoV-2 antibodies and the severity of COVID-19 based on several parameters including CRP, BNP, lymphocyte count, neutrophil-lymphocyte ratio, and oxygen requirements, as well as pulmonary involvement on chest scan. Moreover, the circulating levels of the SARS-CoV-2 antibodies in surviving hemodialysis patients ( = 59) were similar to those of the control group ( = 17).
The main finding of this study is that all of the surviving hemodialysis patients who were diagnosed with SARS-CoV-2 infection from March to April 2020 developed a persistent humoral response with significant circulating levels of SARS-CoV-2 antibodies, 6 months later. Another important finding is that surviving hemodialysis patients who had more severe disease had lower circulating levels of SARS-CoV-2 antibodies. Finally, circulating levels of SARS-CoV-2 antibodies were similar in surviving hemodialysis patients and healthcare workers without kidney disease.
血液透析患者对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的体液反应有待阐明。
在两家透析机构进行的这项回顾性研究中，我们测量了2020年3月和4月疫情第一波期间接受维持性血液透析且6个月后仍存活的患者体内SARS-CoV-2抗体的循环水平。我们还调查了在第一波疫情期间被诊断为感染的患者与新型冠状病毒肺炎（COVID-19）的几个临床、生物学和放射学参数之间的关联。最后，我们将这些SARS-CoV-2抗体的循环水平与同期感染的医护人员对照组的水平进行了比较。
在6个月前从第一波疫情中康复的299名血液透析患者中，59名SARS-CoV-2抗体呈阳性，而在第一波疫情期间只有45名患者被诊断为感染。所有感染的血液透析患者均产生了循环抗体。使用聚类方法，基于包括C反应蛋白（CRP）、脑钠肽（BNP）、淋巴细胞计数、中性粒细胞与淋巴细胞比值以及氧气需求等多个参数，以及胸部扫描显示的肺部受累情况，在SARS-CoV-2抗体循环水平最低的聚类与COVID-19的严重程度之间发现了显著相关性。此外，存活的血液透析患者（n = 59）体内SARS-CoV-2抗体的循环水平与对照组（n = 17）相似。
本研究的主要发现是，所有在2020年3月至4月被诊断为感染SARS-CoV-2的存活血液透析患者在6个月后都产生了持续的体液反应，SARS-CoV-2抗体循环水平显著。另一个重要发现是，病情较重的存活血液透析患者体内SARS-CoV-2抗体的循环水平较低。最后，存活的血液透析患者和无肾脏疾病的医护人员体内SARS-CoV-2抗体的循环水平相似。
