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Background: Hemodialysis patients are prone to infection due to the inadequate response of their innate and adaptive immune systems. During the early phase of the coronavirus disease 2019 (COVID-19) pandemic, hemodialysis patients had a high risk of mortality. In this study, we evaluated COVID-19 infection characteristics, seroconversion rates, related factors, and 90-day mortality after the disease in hemodialysis patients before vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Methods: Patients followed in outpatient hemodialysis units were included in the study. The relationships between biochemical and dialysis-related parameters of the patients, polymerase chain reaction positivity, seroconversion and mortality were examined.
Results: The prevalence of COVID-19 infection among hemodialysis patients was 15.3%. The seroconversion rate was 79.1% in 112 days. Higher C-reactive protein levels during COVID-19 infection were associated with higher SARS-CoV-2 immunoglobulin G titers (P = .014, r = 0.384) and higher parathyroid hormone levels were associated with lower antibody titers (P = .009, r = −0.375). These results were regardless of the phosphorus-lowering treatment and serum calcium or phosphorus levels. The mortality rate was 28.5%, and white blood cell count during infection was an independent risk factor for mortality (P = .004; hazard ratio = 1.451; 95% CI, 1.125-1.872).
Conclusion: In experimental studies, it has been shown that elevated parathyroid hormone adversely affects the immune response of hemodialysis patients. Our study is the first to show that the high level of parathyroid hormone negatively affects the antibody response during COVID-19 infection.
Cite this article as: Kendi Çelebi Z, Erdoğmuş Ş, Turgut D, İlhan Topçu D, Okan Yıldırım M, Çolak T. Antibody response of coronavirus disease 2019 infection and affecting factors in maintenance hemodialysis patients. Turk J Nephrol. Published online May 3, 2024. doi:10.5152/ turkjnephrol.2024.23605