Frequency of SARS-CoV-2 infection in hemodialysis patients

Abstract

Patients with end-stage chronic kidney disease treated with hemodialysis are at risk of infection and severe course of the new coronavirus infection. This opinion was based on the data obtained as a result of PCR testing during the active phase of the disease with detailed clinical symptoms. However, this diagnostic method does not allow one to fully assess the prevalence of infection in the population.

The aim – studying of the frequency of SARS-CoV-2 infection in patients receiving hemodialysis treatment and the spectrum of antiviral antibodies, depending on the nature of the course of COVID-19.

Material and methods. 100 patients with chronic kidney disease (stage 5D) treated at the outpatient Dialysis Center (MCVTP) were included in the study by a simple random sample. The assessment of SARS-CoV-2 infection was carried out by analyzing the material of smears obtained from the naso-oropharynx by PCR and blood serum samples by ELISA. The study excluded 14 patients with dubious results for the determination of serological markers SARS-CoV-2 and 1 patient with active infection, who was isolated from the RNA of the virus.

Results. IgM and IgG antibodies were detected in 49 (57.6%) of the 85 examined patients. 24 of them (group 1) were diagnosed with COVID-19 infection with typical clinical symptoms 3–9 months ago, and 25 (group 2) had no clinical manifestations of the acute respiratory infection at the appropriate time suggesting an asymptomatic course of the disease. IgM class antibodies were detected with equal frequency in group 1 and in group 2 (33.3 vs 24.0%, respectively, p<0.6). IgG antibodies exclusively to the nucleocapsid N-protein (IgGn) were detected only in the latent form of the disease (32%), while antibodies against the S-protein (spike protein) of the virus (IgGs and IgGn+s) were detected more often in the manifest form compared to the asymptomatic one (100 vs 60%, respectively, p<0.05).

Conclusion. In a random cohort of patient receiving hemodialysis treatment, more than half were asymptomatic.Despite a wide range of prevention measures, SARS-CoV-2 infection among patients treated with hemodialysis is more than 2 times higher than in the general population.

Keywords:COVID-19, SARS-CoV-2, IgM/IgG antibodies, hemodialysis

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Research concept and design – Zubkin M.L., Shilo V.Yu., Tomilina N.A., Kryukov E.V.; collection and processing of material – Novikova L.I, Borisova O.Yu., Bochkareva S.S., Dragina L.A., Rybakova O.B., Gudova N.V., Volodina E.V.; statistical data processing – Kim I.G., Chervinko V.I.; text writing – Zubkin M.L., Novikova L.I., Kim I.G., Chervinko V.I., Kryukov E.V.; editing – Zubkin M.L., Tomilina N.A., Novikova L.I.; approval of the final version of the article – Zubkin M.L., Tomilina N.A., Novikova L.I.; responsibility for the integrity of all parts of the article – Zubkin M.L., Kryukov E.V., Shilo V.Yu.

For citation: Zubkin M.L., Shilo V.Yu., Novikova L.I., Borisova O.Yu., Kim I.G., Bochkareva S.S., Dragina L.A., Rybakova O.B., Gudova N.V., Volodina E.V., Chervinko V.I., Tomilina N.A., Kryukov E.V. Frequency of SARS-CoV-2 infection in hemodialysis patients. Economic aspects of COVID-19 treatment in a hospital setting. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2021; 10 (3): 23–32. DOI: https://doi.org/10.33029/2305-3496-2021-10-3-23-32 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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