BACKGROUND: Although reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rare among individuals with few coronavirus disease 2019 (COVID-19) risk factors, the ability of naturally acquired immunity to prevent reinfection among patients with ESKD is not known. METHODS: This prospective study was conducted among adults with ESKD treated with in-center hemodialysis (ICHD) in the United States. Exposure was ascribed on the basis of the presence or absence of IgG against SARS-CoV-2 at baseline, and separately, a history of documented COVID-19 before study entry. Outcomes were assessed after an infection-free period, and were any SARS-CoV-2 infection (i.e., detected by protocolized PCR tests or during routine clinical surveillance), and clinically manifest COVID-19 (consisting of only the latter). RESULTS: Of 2337 consented participants who met study inclusion criteria, 9.5% were anti-SARS-CoV-2 IgG positive at baseline; 3.6% had a history of COVID-19. Over 6679 patient-months of follow-up, 263 participants had evidence of any SARS-CoV-2 infection, including 141 who had clinically manifest COVID-19. Presence of anti-SARS-CoV-2 IgG (versus its absence) at baseline was associated with lower risk of any SARS-CoV-2 infection (incidence rate ratio, 0.55; 95% confidence interval, 0.32 to 0.95) and clinically manifest COVID-19 0.21 (95% confidence interval, 0.07 to 0.67). CONCLUSION: Among patients with ESKD, naturally acquired anti-SARS-CoV-2 IgG positivity is associated with a 45% lower risk of subsequent SARS-CoV-2 infection, and a 79% lower risk of clinically manifest COVID-19. Because natural immunity is incomplete, patients with ESKD should be prioritized for SARS-CoV-2 vaccination, independent of their COVID-19 disease history.
BACKGROUND: Although reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rare among individuals with few coronavirus disease 2019 (COVID-19) risk factors, the ability of naturally acquired immunity to prevent reinfection among patients with ESKD is not known. METHODS: This prospective study was conducted among adults with ESKD treated with in-center hemodialysis (ICHD) in the United States. Exposure was ascribed on the basis of the presence or absence of IgG against SARS-CoV-2 at baseline, and separately, a history of documented COVID-19 before study entry. Outcomes were assessed after an infection-free period, and were any SARS-CoV-2 infection (i.e., detected by protocolized PCR tests or during routine clinical surveillance), and clinically manifest COVID-19 (consisting of only the latter). RESULTS: Of 2337 consented participants who met study inclusion criteria, 9.5% were anti-SARS-CoV-2 IgG positive at baseline; 3.6% had a history of COVID-19. Over 6679 patient-months of follow-up, 263 participants had evidence of any SARS-CoV-2 infection, including 141 who had clinically manifest COVID-19. Presence of anti-SARS-CoV-2 IgG (versus its absence) at baseline was associated with lower risk of any SARS-CoV-2 infection (incidence rate ratio, 0.55; 95% confidence interval, 0.32 to 0.95) and clinically manifest COVID-19 0.21 (95% confidence interval, 0.07 to 0.67). CONCLUSION: Among patients with ESKD, naturally acquired anti-SARS-CoV-2 IgG positivity is associated with a 45% lower risk of subsequent SARS-CoV-2 infection, and a 79% lower risk of clinically manifest COVID-19. Because natural immunity is incomplete, patients with ESKD should be prioritized for SARS-CoV-2 vaccination, independent of their COVID-19 disease history.
Authors: Kathleen Dooling; Nancy McClung; Mary Chamberland; Mona Marin; Megan Wallace; Beth P Bell; Grace M Lee; H Keipp Talbot; José R Romero; Sara E Oliver Journal: MMWR Morb Mortal Wkly Rep Date: 2020-12-11 Impact factor: 17.586
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Authors: Scott Sibbel; Katherine McKeon; Jiacong Luo; Karl Wendt; Adam G Walker; Tara Kelley; Rachael Lazar; Meredith L Zywno; Jeffrey J Connaire; Francesca Tentori; Amy Young; Steven M Brunelli Journal: J Am Soc Nephrol Date: 2021-11-17 Impact factor: 10.121
Authors: Chiara Cantarelli; Andrea Angeletti; Laura Perin; Luis Sanchez Russo; Gianmarco Sabiu; Manuel Alfredo Podestà; Paolo Cravedi Journal: Clin Kidney J Date: 2022-07-27
Authors: Steven M Brunelli; Scott Sibbel; Steph Karpinski; Gilbert Marlowe; Adam G Walker; Jeffrey Giullian; David Van Wyck; Tara Kelley; Rachael Lazar; Meredith L Zywno; Jeffrey J Connaire; Amy Young; Francesca Tentori Journal: J Am Soc Nephrol Date: 2022-02-08 Impact factor: 14.978
Authors: Eduardo Gallego-Valcarce; Amir Shabaka; Mariana Leon-Poo; Enrique Gruss; Juan Manuel Acedo-Sanz; Alfredo Cordón; Clara Cases-Corona; Gema Fernandez-Juarez Journal: Front Med (Lausanne) Date: 2022-07-12