Hara Akemi, Watanabe Shun, Sawano Toyoaki, Sonoda Yuki, Saito Hiroaki, Ozaki Akihiko, Wakui Masatoshi, Zhao Tianchen, Yamamoto Chika, Kobashi Yurie, Abe Toshiki, Kawamura Takeshi, Sugiyama Akira, Nakayama Aya, Kaneko Yudai, Shimmura Hiroaki, Tsubokura Masaharu
Clinical Research Center, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Fukushima, Japan.
Department of Urology, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Fukushima, Japan.
Vaccines (Basel). 2025 Jul 13;13(7):750. doi: 10.3390/vaccines13070750.
Hemodialysis patients, due to impaired kidney function and compromised immune responses, face increased risks from SARS-CoV-2. Anti-nucleocapsid IgG (anti-IgG N) antibodies are a commonly used marker to assess prior infection in the general population; however, their efficacy for hemodialysis patients remains unclear. A retrospective study of 361 hemodialysis patients evaluated anti-IgG N antibodies for detecting prior SARS-CoV-2 infection. Antibody levels were measured using a chemiluminescence immunoassay (CLIA) over the four time points. Boxplots illustrated antibody distribution across sampling stages and infection status. Logistic regression and receiver operating characteristic (ROC) curve analysis determined diagnostic accuracy, sensitivity, specificity, and optimal cutoff values. Among the 361 hemodialysis patients, 36 (10.0%) had SARS-CoV-2 infection. Sex distribution showed a trend toward significance ( = 0.05). Boxplot analysis showed that anti-IgG N levels remained low in non-infected patients but increased in infected patients, peaking at the third sampling. Anti-IgG N demonstrated high diagnostic accuracy (AUC: 0.973-0.865) but declined over time ( = 0.00525). The optimal cutoff at C1 was 0.01 AU/mL (sensitivity 1.00, specificity 0.94). Adjusted models had lower predictive value. Anti-IgG N antibodies showed high diagnostic accuracy for detecting prior SARS-CoV-2 infection in hemodialysis patients, though performance declined over time. These findings highlight the need for tailored diagnostic strategies in this vulnerable population.
由于肾功能受损和免疫反应受损，血液透析患者面临的感染新型冠状病毒的风险增加。抗核衣壳IgG（抗IgG N）抗体是评估普通人群既往感染情况的常用标志物；然而，其在血液透析患者中的有效性仍不明确。一项对361例血液透析患者的回顾性研究评估了抗IgG N抗体在检测既往新型冠状病毒感染中的作用。在四个时间点使用化学发光免疫分析法（CLIA）测量抗体水平。箱线图展示了各采样阶段和感染状态下的抗体分布情况。逻辑回归和受试者工作特征（ROC）曲线分析确定了诊断准确性、敏感性、特异性和最佳临界值。在这361例血液透析患者中，36例（10.0%）感染了新型冠状病毒。性别分布呈现出显著趋势（P = 0.05）。箱线图分析显示，未感染患者的抗IgG N水平保持较低，但感染患者的抗IgG N水平升高，在第三次采样时达到峰值。抗IgG N显示出较高的诊断准确性（AUC：0.973 - 0.865），但随时间下降（P = 0.00525）。C1时的最佳临界值为0.01 AU/mL（敏感性1.00，特异性0.94）。校正模型的预测价值较低。抗IgG N抗体在检测血液透析患者既往新型冠状病毒感染方面显示出较高的诊断准确性，尽管其性能随时间下降。这些发现凸显了针对这一弱势群体制定个性化诊断策略的必要性。
