Background: Patients with ESKD on maintenance dialysis receive dialysis in common spaces with other patients and have a higher risk of severe SARS-CoV-2 infections. They may have persistently or intermittently positive SARS-CoV-2 RT-PCR tests after infection. We describe the clinical course of SARS-CoV-2 infection and the serologic response in a convenience sample of patients with ESKD to understand the duration of infectivity. Methods: From August to November 2020, we enrolled patients on maintenance dialysis with SARS-CoV-2 infections from outpatient dialysis facilities in Atlanta, Georgia. We followed participants for approximately 42 days. We assessed COVID-19 symptoms and collected specimens. Oropharyngeal (OP), anterior nasal (AN), and saliva (SA) specimens were tested for the presence of SARS-CoV-2 RNA, using RT-PCR, and sent for viral culture. Serology, including neutralizing antibodies, was measured in blood specimens. Results: Fifteen participants, with a median age of 58 (range, 37‒77) years, were enrolled. Median duration of RT-PCR positivity from diagnosis was 18 days (interquartile range [IQR], 8‒24 days). Ten participants had at least one, for a total of 41, positive RT-PCR specimens ≥10 days after symptoms onset. Of these 41 specimens, 21 underwent viral culture; one (5%) was positive 14 days after symptom onset. Thirteen participants developed SARS-CoV-2-specific antibodies, 11 of which included neutralizing antibodies. RT-PCRs remained positive after seroconversion in eight participants and after detection of neutralizing antibodies in four participants; however, all of these samples were culture negative. Conclusions: Patients with ESKD on maintenance dialysis remained persistently and intermittently SARS-CoV-2-RT-PCR positive. However, of the 15 participants, only one had infectious virus, on day 14 after symptom onset. Most participants mounted an antibody response, including neutralizing antibodies. Participants continued having RT-PCR-positive results in the presence of SARS-CoV-2-specific antibodies, but without replication-competent virus detected.
Background: Patients with ESKD on maintenance dialysis receive dialysis in common spaces with other patients and have a higher risk of severe SARS-CoV-2 infections. They may have persistently or intermittently positive SARS-CoV-2 RT-PCR tests after infection. We describe the clinical course of SARS-CoV-2 infection and the serologic response in a convenience sample of patients with ESKD to understand the duration of infectivity. Methods: From August to November 2020, we enrolled patients on maintenance dialysis with SARS-CoV-2 infections from outpatient dialysis facilities in Atlanta, Georgia. We followed participants for approximately 42 days. We assessed COVID-19 symptoms and collected specimens. Oropharyngeal (OP), anterior nasal (AN), and saliva (SA) specimens were tested for the presence of SARS-CoV-2 RNA, using RT-PCR, and sent for viral culture. Serology, including neutralizing antibodies, was measured in blood specimens. Results: Fifteen participants, with a median age of 58 (range, 37‒77) years, were enrolled. Median duration of RT-PCR positivity from diagnosis was 18 days (interquartile range [IQR], 8‒24 days). Ten participants had at least one, for a total of 41, positive RT-PCR specimens ≥10 days after symptoms onset. Of these 41 specimens, 21 underwent viral culture; one (5%) was positive 14 days after symptom onset. Thirteen participants developed SARS-CoV-2-specific antibodies, 11 of which included neutralizing antibodies. RT-PCRs remained positive after seroconversion in eight participants and after detection of neutralizing antibodies in four participants; however, all of these samples were culture negative. Conclusions: Patients with ESKD on maintenance dialysis remained persistently and intermittently SARS-CoV-2-RT-PCR positive. However, of the 15 participants, only one had infectious virus, on day 14 after symptom onset. Most participants mounted an antibody response, including neutralizing antibodies. Participants continued having RT-PCR-positive results in the presence of SARS-CoV-2-specific antibodies, but without replication-competent virus detected.
Authors: Ger Rijkers; Jean-Luc Murk; Bas Wintermans; Bieke van Looy; Marcel van den Berge; Jacobien Veenemans; Joep Stohr; Chantal Reusken; Pieter van der Pol; Johan Reimerink Journal: J Infect Dis Date: 2020-09-14 Impact factor: 5.226
Authors: Anita S Iyer; Forrest K Jones; Ariana Nodoushani; Jason B Harris; Richelle C Charles; Meagan Kelly; Margaret Becker; Damien Slater; Rachel Mills; Erica Teng; Mohammad Kamruzzaman; Wilfredo F Garcia-Beltran; Michael Astudillo; Diane Yang; Tyler E Miller; Elizabeth Oliver; Stephanie Fischinger; Caroline Atyeo; A John Iafrate; Stephen B Calderwood; Stephen A Lauer; Jingyou Yu; Zhenfeng Li; Jared Feldman; Blake M Hauser; Timothy M Caradonna; John A Branda; Sarah E Turbett; Regina C LaRocque; Guillaume Mellon; Dan H Barouch; Aaron G Schmidt; Andrew S Azman; Galit Alter; Edward T Ryan Journal: Sci Immunol Date: 2020-10-08
Authors: Jeroen J A van Kampen; David A M C van de Vijver; Pieter L A Fraaij; Bart L Haagmans; Mart M Lamers; Nisreen Okba; Johannes P C van den Akker; Henrik Endeman; Diederik A M P J Gommers; Jan J Cornelissen; Rogier A S Hoek; Menno M van der Eerden; Dennis A Hesselink; Herold J Metselaar; Annelies Verbon; Jurriaan E M de Steenwinkel; Georgina I Aron; Eric C M van Gorp; Sander van Boheemen; Jolanda C Voermans; Charles A B Boucher; Richard Molenkamp; Marion P G Koopmans; Corine Geurtsvankessel; Annemiek A van der Eijk Journal: Nat Commun Date: 2021-01-11 Impact factor: 14.919
Authors: Eduardo Lacson; Daniel Weiner; Karen Majchrzak; Wendy Puryear; John Hosford; Aaron Palmer; Jonathan Runstadler; Klemens B Meyer; Doug S Johnson Journal: Kidney Med Date: 2020-12-29
Authors: Jennifer E Flythe; Magdalene M Assimon; Matthew J Tugman; Emily H Chang; Shruti Gupta; Jatan Shah; Marie Anne Sosa; Amanda DeMauro Renaghan; Michal L Melamed; F Perry Wilson; Javier A Neyra; Arash Rashidi; Suzanne M Boyle; Shuchi Anand; Marta Christov; Leslie F Thomas; Daniel Edmonston; David E Leaf Journal: Am J Kidney Dis Date: 2020-09-19 Impact factor: 11.072
Authors: Jeffrey Silberzweig; J Ganesh Bhat; Mary O Dittrich; Raghu Durvasula; Jeff Giullian; Jeffrey L Hymes; Doug Johnson; Brigitte Schiller; Richard Spech; Leslie Spry; Geoffrey Scott Walker; Suzanne Watnick; Jerry Yee; Barry I Freedman Journal: J Am Soc Nephrol Date: 2022-06-02 Impact factor: 14.978