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Kidney Week

Abstract: PO0752

Persistent Viral Shedding and Antibody Response to the SARS-CoV-2 Virus in Chronic Hemodialysis Patients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Shaikh, Aisha, James J. Peters VA Medical Center, Bronx, New York, United States
  • Zeldis, Etti, James J. Peters VA Medical Center, Bronx, New York, United States
  • Campbell, Kirk N., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Chan, Lili, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Background

The duration of SARS-CoV-2 viral RNA shedding and antibody response of chronic HD patients to the SARS-CoV-2 virus is currently unknown

Methods

This is a retrospective case series of chronic HD patients who tested positive for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2 RNA) on nasal or nasopharyngeal specimen between March 20 and May 28, 2020 at the James J. Peters VA Hospital. Patients were tested at varying intervals to document clearance of virus or for surveillance purposes. SARS-CoV-2 Virus IgG Antibody (Ab) testing was performed on all HD patients with COVID-19 (using the Abbot IgG nucleocapsid antibody test and i2000SR machine, Ref. range of the Ab titer: >1.39 positive)

Results

Of 84 chronic HD patients, 26% (22) were diagnosed with COVID-19. Mean age of those with COVID-19 was 72±9 years old, 86% were Black, 77% had diabetes and all had hypertension. Of these patients, 59% (13/22) required hospitalization and 18% (4/22) died. IgG Ab testing was performed on 19 out of 22 COVID-19 patients. All 19 patients tested positive for IgG Ab with an average Ab titer of 7±1.2. 20 days after the first SARS-CoV-2 RNA positive test, 68% (13/19) patients remained positive on repeat RNA testing. 3 patients tested positive for SARS-CoV-2 RNA on repeat surveillance testing, despite testing negative on 2 prior consecutive nasal or nasopharyngeal specimens (Fig. 1). None of these 3 patients were symptomatic at the time their repeat swabs were positive for SARS-CoV-2 RNA

Conclusion

All HD patients with a confirmed diagnosis of COVID-19 developed IgG Ab to the SARS-CoV-2 virus, but the SARS-Cov-2 RNA was detectable in the swab specimen for a prolonged duration of time. In a few cases, the SARS-CoV-2 RNA became detectable after 2 consecutive negative RNA specimens. It is unknown if the IgG antibodies confer immunity against the SARS-CoV-2 virus. Additionally, the significance of persistent viral RNA shedding in patients who have recovered from COVID-19 remains to be elucidated