ABSTRACT
Background: Mortality for COVID-19 in dialysis(HD) and kidney transplant(TX) patients(pts) is 30%. In these pts the immunology of the disease has been poorly explored. Methods: 32 HD or TX pts hospitalized for COVID-19 (COV), of which 13 with benign course(PosCOV) and 19 who died or developed ARDS(NegCOV), 10 controls(HC) and 12 HD/TX without COVID-19(PC), have been included. Lymphocytes subsets, dendritic cells(DC) and monocytes activation (MA) have been explored. Results: COV showed lower counts of CD4+, CD8+, CD56+, CD19+, DC and higher counts of terminally differentiated CD19+ compared to HC and PC;CD4+, CD8+, CD19+ and MA were significantly lower in NegCOV than PosCOV. Compared to HD, TX showed lower CD56+, pDC and MA. Conclusions: The COV group showed immunological alterations compared to HC and PC with deeper alterations of the innate immune system in TX pts with COVID-19.
ABSTRACT
The ability of patients with hematologic malignancies (HM) to develop an effective humoral immune response after COVID-19 is unknown. A prospective study was performed to monitor the immune response to SARS-CoV-2 of patients with follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), chronic lymphoproliferative disorders (CLD), multiple myeloma (MM), or myelodysplastic/myeloproliferative syndromes (MDS/MPN). Antibody (Ab) levels to the SARS-CoV-2 nucleocapsid (N) and spike (S) protein were measured at +1, +3, +6 months after nasal swabs became PCR-negative. Forty-five patients (9 FL, 8 DLBCL, 8 CLD, 10 MM, 10 MDS/MPS) and 18 controls were studied. Mean anti-N and anti-S-Ab levels were similar between HM patients and controls, and shared the same behavior, with anti-N Ab levels declining at +6 months and anti-S-Ab remaining stable. Seroconversion rates were lower in HM patients than in controls. In lymphoma patients mean Ab levels and seroconversion rates were lower than in other HM patients, primarily because all nine patients who had received rituximab within 6 months before COVID-19 failed to produce anti-N and anti-S-Ab. Only one patient requiring hematological treatment after COVID-19 lost seropositivity after 6 months. No reinfections were observed. These results may inform vaccination policies and clinical management of HM patients.