Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series - Archive ouverte HAL
Article Dans Une Revue Revue Neurologique Année : 2021

Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series

L. Cleret de Langavant
  • Fonction : Auteur
A. Petit
  • Fonction : Auteur
Q.T.R. Nguyen
  • Fonction : Auteur
T. Gendre
  • Fonction : Auteur
J. Abdelhedi
  • Fonction : Auteur
A. Djellaoui
  • Fonction : Auteur
L. Seddik
  • Fonction : Auteur
L. Lim
  • Fonction : Auteur
F. Faugeras
  • Fonction : Auteur
H. Salhi
  • Fonction : Auteur
A. Wahab
  • Fonction : Auteur
L. Fechtenbaum
  • Fonction : Auteur
A. Dormeuil
  • Fonction : Auteur
H. Hosseini
  • Fonction : Auteur
K. Youssov
  • Fonction : Auteur
G. Fénelon
  • Fonction : Auteur
B. Bapst
  • Fonction : Auteur
P. Brugières
  • Fonction : Auteur
T. Tuilier
  • Fonction : Auteur
E. Kalsoum
  • Fonction : Auteur
M.-B. Matignon
  • Fonction : Auteur
J. Oniszczuk
  • Fonction : Auteur
W. Vindrios
  • Fonction : Auteur
G. Melica
  • Fonction : Auteur
A.-L. Scain
  • Fonction : Auteur
R. Esser
  • Fonction : Auteur
L. Rostain
  • Fonction : Auteur
C. Guillaud
  • Fonction : Auteur
G. Dubos-Lascu
  • Fonction : Auteur
N. Saada
  • Fonction : Auteur
H. Guillet
  • Fonction : Auteur
M. Khellaf
  • Fonction : Auteur
B. Bardel
  • Fonction : Auteur
S.S. Ayache
  • Fonction : Auteur
J.-P. Lefaucheur
  • Fonction : Auteur
J.-M. Pawlotsky
  • Fonction : Auteur
Slim Fourati
  • Fonction : Auteur
A.-C. Bachoud-Lévi
  • Fonction : Auteur

Résumé

Significance Statement The humoral response over time against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is poorly understood. The authors investigated the long-term kinetics of the antibody response to SARS-CoV-2 (specifically, IgG against nucleocapsid and spike antigens), in 83 patients on in-center hemodialysis who recovered from coronavirus disease 2019 (COVID-19). They found that 10% of patients had no initial seroconversion, which was associated with immunocompromised status; in patients with seroconversion, IgG antibodies decayed over time. Factors associated with this decline included older age, female sex, and nonsevere clinical presentation. About 25% of patients had negative IgG antinucleocapsid serology after 6 months, whereas most patients maintained antispike antibodies. By characterizing the evolution of the SARS-CoV-2 antibody response, these findings might help better define future therapeutic and preventive approaches against COVID-19 in patients on hemodialysis. Background The humoral response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the hemodialysis population, including its dynamics over time, remains poorly understood. Methods To analyze initial and long-term humoral responses against SARS-CoV-2 in a hemodialysis population, we retrospectively evaluated findings from SARS-CoV-2 IgG serologic assays targeting the nucleocapsid antigen or spike antigen up to 6 months of follow-up in patients on hemodialysis in the Paris, France, region who had recovered from coronavirus disease 2019 (COVID-19). Results Our analysis included 83 patients (median age 65 years); 59 (71%) were male and 28 (34%) had presented with severe COVID-19. We observed positive initial SARS-CoV-2 IgG antinucleocapsid serology in 74 patients (89%) at a median of 67 days postdiagnosis. By multivariable analysis, immunocompromised status was the only factor significantly associated with lack of an IgG antinucleocapsid antibody response. Follow-up data were available at 6 months postdiagnosis for 60 of 74 patients (81%) with positive initial antinucleocapsid serology, and 15 (25%) of them had negative antinucleocapsid serology at month 6. In total, 14 of 15 sera were tested for antispike antibodies, 3 of 14 (21%) of which were also negative. Overall, 97% of antinucleocapsid-antibody–positive specimens were also antispike-antibody positive. Female sex, age >70 years, and nonsevere clinical presentation were independently associated with faster IgG antinucleocapsid titer decay in multivariable analysis. After adjustment for sex and age >70 years, nonsevere clinical presentation was the only factor associated with faster decay of IgG antispike antibodies. Conclusions This study characterizes evolution of the SARS-CoV-2 antibody response in patients on hemodialysis and identifies factors that are associated with lack of seroconversion and with IgG titer decay.
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hal-04311733 , version 1 (22-07-2024)

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L. Cleret de Langavant, A. Petit, Q.T.R. Nguyen, T. Gendre, J. Abdelhedi, et al.. Clinical description of the broad range of neurological presentations of COVID-19: A retrospective case series. Revue Neurologique, 2021, 177 (3), pp.275-282. ⟨10.1016/j.neurol.2021.01.004⟩. ⟨hal-04311733⟩
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