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Case Reports
. 2022 Nov;11(4):422-427.
doi: 10.1007/s13730-022-00697-z. Epub 2022 Mar 9.

A case of COVID-19 reinfection in a hemodialysis patient: the role of antibody in SARS-CoV-2 infection

Hiroko Beppu  1 , Toshie Ogawa  2 , Masahiro Ishikane  3 , Tomoko Kawanishi  2 , Tatsuya Fukuda  4   5 , Lubuna Sato  3 , Akihiro Matsunaga  6 , Kenji Maeda  7 , Daisuke Katagiri  8 , Yukihito Ishizaka  6 , Hiroaki Mitsuya  7 , Norio Ohmagari  3 , Fumihiko Yasui  9 , Michinori Kohara  9 , Kan Kikuchi  10 , Sachiko Wakai  2
Affiliations
Case Reports

A case of COVID-19 reinfection in a hemodialysis patient: the role of antibody in SARS-CoV-2 infection

Hiroko Beppu et al. CEN Case Rep. 2022 Nov.

Abstract

Hemodialysis patients are vulnerable to severe and lethal COVID-19, and their protective immunity against COVID-19 is not yet fully understood. Therefore, we report a case of COVID-19 reinfection in a hemodialysis patient 81 days after the first episode and discuss the role of antibodies in SARS-CoV-2 infection. A hemodialysis patient developed asymptomatic COVID-19 due to an outbreak in a hospital on October 29th, 2020. As he was hospitalized and did not develop any symptoms, he was discharged on November 9th. On January 18th, he presented with symptomatic COVID-19 due to close household contact. Then, he developed respiratory failure and was transferred to National Center for Global Health and Medicine if he would need intensive care. He recovered with oxygen inhalation, favipiravir, and steroid treatment, and was discharged on February 12th. To evaluate anti-SARS-CoV-2 antibodies during two hospital stays, we measured immunoglobulin (Ig) G specific for S1 subunit of Spike (S) protein of SARS-CoV-2 (IgG-S1) , IgG specific for the full-length S protein (anti-Spike IgG) and neutralizing antibodies. No seroconversion occurred 5 days after initial infection, the seroconversion of IgG-S1 was observed 10 days after the second infection. Similar to IgG-S1 antibody titer results, anti-Spike IgG and neutralizing antibodies increased from 12 days after the second infection. In conclusion, we experienced a case of COVID-19 reinfection in a hemodialysis patient 81 days after the first episode and showed the kinetics and role of antibodies in SARS-CoV-2 infection. Further studies are needed to understand SARS-CoV-2 reinfection risk in hemodialysis patients and its clinical significance.

Keywords: COVID-19; End-stage renal disease; Hemodialysis; Reinfection; Severe acute respiratory syndrome coronavirus 2 antibodies.

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Conflict of interest statement

All the authors have declared no competing interest.

Figures

Fig. 1
Fig. 1
a Initial axial chest computed tomography images did not show any abnormalities suggesting COVID-19. b Axial chest computed tomography images in the second episode showed moderate ground-glass opacities in bilateral lungs
Fig. 2
Fig. 2
Clinical time course
See this image and copyright information in PMC

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