Long COVID-19 laboratory findings in hemodialysis patients: Should they be considered post-COVID syndrome?

Stepanova, N.; Rysyev, Andriy

doi:10.34172/jnp.2022.17346

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Проте, проблема COVID-19 у ГД пацієнтів не обмежується гострим періодом хвороби і значний рівень смертності (26% -35,7%) був продемонстрований впродовж 1 року після інфікування [4,5]. Більшість (81%-98%) ГД пацієнтів мають широкий спектр нових, повторних або постійних симптомів, які виникають після інфікування SARSCoV-2 та не можуть бути пояснені альтернативним діагнозом [6][7][8]. Такий стан всесвітня організація охорони здоров'я визначає як постковідний синдром (постковідний стан або довготривалий COVID-19) [9].…”

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Long-COVID sequelae are associated with oxidative stress in hemodialysis patients

Stepanova

Korol

Snisar

et al. 2023

Ukr. J. Nephrol. and Dial.

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pathophysiology of long-COVID sequelae in the general population of SARS-CoV-2-infected patients has been shown to be strongly influenced by oxidative stress. However, the potential role of oxidative stress in the development of long-COVID sequelae in hemodialysis patients (HD) has never been investigated. The present study aimed to evaluate the oxidative status of HD patients 3.5 months after SARS-CoV-2 infection in relation to the presence of long-COVID sequelae and the severity of the acute phase COVID-19. Methods. This cross-sectional cohort study included 63 HD patients with a median age of 55 (43-62.5) years and a dialysis vintage of 42 (25-73) months who had been infected with COVID-19 at least 3 months before recruitment. Patients were divided into two groups according to the occurrence of long-COVID sequelae: Group 1 included 31 (49.2%) HD patients with sequelae, while Group 2 included 32 (50.8%) fully recovered individuals. At 3.5 (3.2-4.6) months after the acute phase of COVID-19, malondialdehyde (MDA) and erythrocyte levels (MDAe), sulfhydryl groups (SH -groups), serum catalase activity, transferrin, and ceruloplasmin were measured. A comparison of the obtained data was performed using the Student’s test or the Mann-Whitney test according to the data distribution. A correlation was evaluated with the Spearman test. Results. HD patients with persistent long-COVID sequelae had significantly higher concentrations of MDAs (p = 0.002), MDAe (p = 0.0006), and CTs (p = 0.02), and lower serum levels of SH-groups (p = 0.03) and ceruloplasmin (p = 0.03) compared with Group 2. The concentration of most studied indicators of pro- and antioxidant status did not depend on the severity of the acute phase COVID-19, and only catalase activity was statistically significantly related to the need for hospitalization (r = 0.59; p = 0.001), oxygen support (r = 0.44; p = 0.02), and the percentage of lung injury according to computed tomography (p = 0.03). Although the serum concentration of transferrin did not differ between the studied groups, the individual analysis showed that its value was statistically higher in HD patients with severe COVID-19 even 3.5 months after infection (p < 0.0001). Conclusions. Long-term COVID-19 sequelae in HD patients are associated with oxidative stress. High levels of catalase activity and serum transferrin 3.5 months after COVID-19 may be a consequence of the severe course of the acute phase of the disease. The obtained data suggest that the use of antioxidants may be one of the possible strategies to treat the long-term consequences of COVID in HD patients.

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Long-COVID sequelae are associated with oxidative stress in hemodialysis patients

Stepanova

Korol

Snisar

et al. 2023

Ukr. J. Nephrol. and Dial.

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“…Пацієнти, які лікуються методом гемодіалізу (ГД) належать до групи високого ризику інфікування SARS-CoV-2 [1][2][3]. Необхідність відвідування діалізного центру, літній вік, імуносупресивний стан та тягар коморбідних захворювань обумовлюють високий рівень госпіталізації (від 35% до 88%) та смертності (20% -25%) ГД пацієнтів від коронавірусної хвороби (COVID-19) [2,4,5].…”

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COVID-19 clinical outcomes and risk factors in fully vaccinated hemodialysis patients: A single-center prospective cohort study

Rysyev¹,

Poperechnyi²,

Chernianu³

et al. 2022

Ukr. J. Nephrol. and Dial.

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Hemodialysis patients (HD) are at high risk for coronavirus infection (COVID-19) and associated adverse outcomes compared with the general population. Although vaccination against SARS-CoV-2 has played an important role in stemming the spread of COVID-19 in the general population, the characterization of vaccine efficacy in dialysis patients is based primarily on humoral responses, whereas clinical data are generally not available. The aim of this study was to determine the incidence of COVID-19, clinical outcomes, and risk factors for SARS-CoV-2 infection in fully vaccinated HD patients. Methods. Of 186 HD patients treated at Link-Medital LLC Medical Center (Odesa, Ukraine) between March 2020 and March 2022, 170 patients aged 53.5 (44-63.5) years were enrolled in this prospective observational cohort study and followed up one year after completion of vaccination. Among them were 67 (39.4%) HD patients who were fully vaccinated against COVID-19 with BNT162b2 (Pfizer-BioNTech) or Moderna-mRNA-1273 mRNA vaccines and 103 (60.6%) unvaccinated HD patients. The outcomes assessed were COVID-19 morbidity and severity, hospitalization, and death associated with COVID-19. Results. During the 12-month follow-up, nearly half of 83/170 (48.8%) patients became infected with SARS-CoV-2, including 18/67 (26.7%) vaccinated patients and 65/103 (63.1%) unvaccinated patients (χ2 = 10.8; p = 0.001). The incidence rate of COVID-19 was 27 (95% CI 16, 42) in vaccinated patients at our center and 63 (95% CI 49, 80) per 100 patient-years (p = 0.001) in unvaccinated patients. Cox proportional hazards regression analysis showed that vaccinated HD patients had a statistically significant lower risk of hospitalization [HR = 0.2 (95%CI 0.1;0.4)] and need for oxygen support [HR = 0.19 (95%CI 0.09; 0.38)] compared with unvaccinated patients. Kaplan-Meyer analysis of COVID-19-associated mortality demonstrated a significantly higher survival of vaccinated HD patients compared with unvaccinated (χ2 = 4.6, log-rank p = 0.03). Further multivariate logistic analysis showed that age over 65 years, obesity, low adequacy of HD and duration of more than 5 years, anemia, low levels of parathyroid hormone (PTH) and high-density lipoprotein cholesterol (HDL-C), elevated CRP, arterial hypertension, and other cardiovascular diseases (CVD) significantly increased the risk of SARS-CoV-2 infection in fully vaccinated HD patients. Conclusions. Vaccination against COVID-19 is associated with a reduction in morbidity, hospitalization rates, and mortality in HD patients. Age over 65 years, obesity, low adequacy of HD and its duration of more than 5 years, anemia, low PTH and HDL-C levels, elevated CRP, arterial hypertension, and other CVDs significantly increased the risk of SARS-CoV-2 infection in fully vaccinated HD patients.

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IL-6 and IL-17 may provide a potential link between hypertension and long-COVID sequelae in hemodialysis patients: A multicenter cross-sectional study

Stepanova

Driianska

Rysyev³

et al. 2023

Preprint

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Objective The mechanisms underlying long COVID in patients treated with hemodialysis (HD) are not yet fully understood. We hypothesized that uncontrolled blood pressure (BP) before infection might contribute to the development of long-COVID symptoms in HD patients through upregulation of interleukin (IL)-6 and IL-17 production, possibly associated with severe acute COVID-19. In the present cross-sectional study, we examined serum IL-6 and IL-17 levels at two time points after acute COVID-19 infection taking into account preinfection BP and the presence of long-COVID sequelae in HD patients. Results A total of 80 HD patients aged 56 (44–63.2) years with a dialysis vintage of 4.7 (3.3 − 7.08) years who had experienced COVID-19 at least 5 months before enrollment were included in this cross-sectional study. We found that preinfection uncontrolled BP was associated with long-COVID sequelae in HD patients. Both hypertension and long COVID resulted in elevated IL-6 and IL-17 concentrations, peaking in patients with both conditions and decreasing over time after COVID-19 possibly reflecting Th17-related systemic inflammation during the acute phase of COVID-19.

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Long COVID-19 laboratory findings in hemodialysis patients: Should they be considered post-COVID syndrome?

Cited by 3 publications

References 9 publications

Long-COVID sequelae are associated with oxidative stress in hemodialysis patients

Long-COVID sequelae are associated with oxidative stress in hemodialysis patients

COVID-19 clinical outcomes and risk factors in fully vaccinated hemodialysis patients: A single-center prospective cohort study

IL-6 and IL-17 may provide a potential link between hypertension and long-COVID sequelae in hemodialysis patients: A multicenter cross-sectional study

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