Chronic Inflammation Might Protect Hemodialysis Patients From Severe COVID-19.

Hemodialysis patients (HD) are expected to have excess mortality in coronavirus disease 2019 (COVID-19). This was challenged by a recent study reporting HD patients to have comparable mortality and less ICU admissions when hospitalized with COVID-19. An altered immune system due to chronic inflammation might protect HD-patients from severe COVID-19. Therefore, we aimed to describe the peripheral blood immune phenotype in HD-patients and respective controls with COVID-19. Sixty-four patients (31 HD, 33 non-HD) with PCR-confirmed COVID-19 and 16 control patients (10 HD, 6 non-HD) were prospectively included. According to symptoms, COVID-19 patients were categorized as asymptomatic/mild, moderate or severe COVID-19 phenotypes. Cytokine profiling and immune phenotyping was performed. Th1 and Th17 plasma cytokine levels were highly increased in HD patients without COVID-19 and were not significantly regulated during COVID-19. In non-HD COVID-19 patients these cytokines increased significantly with disease severity. While all patients with moderate or severe COVID-19 showed hallmarks of COVID-19 such as decreased CD3 HD patients might be protected from severe COVID-19 due to their chronic inflammatory state with increased CD38

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Copyright © 2022 Prietl, Odler, Kirsch, Artinger, Eigner, Schmaldienst, Pfeifer, Stanzer, Eberl, Raml, Pieber, Rosenkranz, Brodmann, Eller and Eller.

Déclaration de conflit d'intérêts

AE and RR were employed by Joanneum Research Forschungsgesellschaft mbH. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.