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Abstract: TH-PO921

SARS-CoV-2 Anti-Spike IgG Antibody Binding Units and Associated Outcomes in Maintenance Dialysis Patients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Manley, Harold J., Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Harford, Antonia, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Frament, Jill M., Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Mcnamara, Margaret, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Li, Nien Chen, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Majchrzak, Karen M., Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Hsu, Caroline M., Tufts Medical Center, Boston, Massachusetts, United States
  • Weiner, Daniel E., Tufts Medical Center, Boston, Massachusetts, United States
  • Miskulin, Dana, Tufts Medical Center, Boston, Massachusetts, United States
  • Johnson, Doug, Dialysis Clinic Inc, Nashville, Tennessee, United States
  • Lacson, Eduardo K., Dialysis Clinic Inc, Nashville, Tennessee, United States
Background

Maintenance dialysis patients’ SARS-CoV-2 receptor binding spike antibody (RBD s-Ab) levels decline rapidly in the months following initial vaccination. We describe the association of RBD s-Ab levels with a subsequent diagnosis of COVID-19 and COVID-related hospitalization or death.

Methods

We identified all vaccinated adult maintenance dialysis patients at Dialysis Clinic, Inc. who were diagnosed with COVID-19 between June 20, 2021 and May 8, 2022. Descriptive analyses illustrate the association of RBD s-Ab levels assessed 7-45 days prior to COVID-19 diagnosis with COVID-related hospitalization or death.

Results

There were 340 maintenance dialysis patients with RBD s-Ab levels assessed at a median 23 [16,40] days prior to COVID diagnosis, with mean age 65±13 years, 51% female, 51% White, 91% HD and vintage 4.3±4.3 years. While COVID-19 diagnosis and COVID-related hospitalization or death events occurred across RBD s-Ab levels (Figure), 74 of 93 (80%) COVID-related hospitalizations and 24 of 25 deaths (96%) occurred at RBD s-Ab level <500 BAU/mL

Conclusion

Maintenance dialysis patients are at risk for serious COVID events when RBD s-Ab < 500 BAU/mL. Routine RBD s-Ab measurement informing personalized vaccination strategies to keep titers above 500 BAU/mL may benefit this high-risk population.

RBD s-Ab levels were converted to WHO standard antibody binding units (BAU) per mL (Freeman J and Conklin J. J Virological Methods 2022)