Renin-angiotensin-system blockers and IgG antibodies in end-stage renal disease hemodialysis-receiving patients diagnosed with COVID-19 infection

Saudi Med J. 2023 Sep;44(9):875-881. doi: 10.15537/smj.2023.44.9.20230129.

Abstract

Objectives: To evaluate the prevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections among patients receiving in-center hemodialysis (ICHD), the relationship between the IgG antibody levels against the virus and SARS-CoV-2-associated symptoms, hemodialysis adequacy, and the antihypertensives used in order to control blood pressure.

Methods: A prospective observational study was carried out at a tertiary care center, King Fahad Kidney Center, Riyadh, Kingdom of Saudi Arabia, between November 2020 and January 2021. A total of 214 ICHD patients with end-stage renal disease (ESRD) were included, and the levels of their anti-SARS-CoV-2 IgG antibodies were assessed after obtaining their informed consent.

Results: Our tests indicated that 15% of the patients in the study's population had detectable SARS-CoV-2 IgG antibodies, with more than half of them (53%) being asymptomatic. We also found that ESRD patients on angiotensin converting enzyme inhibitors or angiotensin receptor blockers (ACEIs/ARBs) had higher levels of SARS-CoV-2 IgG antibodies than patients not receiving this group of medications.

Conclusion: More studies are required to assess whether patients with a SARS-CoV-2 infection that do not have an indication for being prescribed ACEIs/ARBs would benefit from receiving these medications.

Keywords: ACEI; ARBS; COVID19; IgG antibody; IgM antibody; end-stage renal disease; in-center hemodialysis; real-time polymerase chain reaction.

Publication types

  • Observational Study

MeSH terms

  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Angiotensins
  • Antibodies, Viral
  • COVID-19*
  • Humans
  • Immunoglobulin G
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / therapy
  • Renal Dialysis
  • Renin
  • SARS-CoV-2

Substances

  • Immunoglobulin G
  • Renin
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Antibodies, Viral
  • Angiotensins