Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, 330006, People's Republic of China.
School of Public Health and Management, Nanchang Medical College, No. 1689, Meiling Avenue, Wanli, Nanchang, 330004, People's Republic of China.
Inflamm Res. 2023 May;72(5):989-1000. doi: 10.1007/s00011-023-01723-1. Epub 2023 Apr 1.
COVID-19 infection poses a special challenge to patients with dialysis patients. The purpose of this study was to evaluate the clinical manifestations of dialysis patients with COVID-19 and the protective effect of the vaccine.
We included 41 studies based on big data, mainly analyzing the clinical symptoms of dialysis patients with COVID-19, the proportion of severe patients before and after vaccination, and the humoral reaction of vaccine in the body.
6.1% to 35.7% of dialysis patients with COVID-19 developed respiratory distress symptoms and needed to be admitted to an intensive care unit for mechanical ventilation. The incidence and mortality of COVID-19 in dialysis patients before vaccination were 5.5% and 1.1%, respectively, and decreased to 4.5% and 0.6% in breakthrough infected patients. There was no statistical difference in serum conversion rates between dialysis patients and healthy controls, but the neutralizing antibody titer in the control group was 1922 (IQR 533 to 3186) AU/mL, and the neutralizing antibody titer in dialysis patients significantly decreased to 367 (IQR 171 to 1650) AU/mL (P=0.046).
Dialysis is associated with an increased risk of severe COVID-19, and generally has a poor seroconversion response to vaccines. It also confirms the protective effect of vaccines on high-risk populations such as dialysis.
COVID-19 感染对透析患者构成特殊挑战。本研究旨在评估 COVID-19 透析患者的临床表现和疫苗的保护作用。
我们纳入了基于大数据的 41 项研究，主要分析 COVID-19 透析患者的临床症状、疫苗接种前后重症患者的比例以及疫苗在体内的体液反应。
6.1%至 35.7%的 COVID-19 透析患者出现呼吸窘迫症状，需要入住重症监护病房进行机械通气。疫苗接种前 COVID-19 在透析患者中的发病率和死亡率分别为 5.5%和 1.1%，而突破性感染患者降至 4.5%和 0.6%。透析患者与健康对照组之间的血清转化率无统计学差异，但对照组的中和抗体滴度为 1922（IQR 533 至 3186）AU/mL，而透析患者的中和抗体滴度显著下降至 367（IQR 171 至 1650）AU/mL（P=0.046）。
透析与 COVID-19 重症风险增加相关，对疫苗的血清转化率通常较差。这也证实了疫苗对透析等高危人群的保护作用。
