2019 novel coronavirus disease in hemodialysis (HD) patients: Report from one HD center in Wuhan, China

Yiqiong Ma; Bo Diao; Xifeng Lv; Jili Zhu; Wei Liang; Lei Liu; Wenduo Bu; Huiling Cheng; Sihao Zhang; Lianhua Yang; Ming Shi; Guohua Ding; Bo Shen; Huiming Wang

During the outbreak of SARS in 2003, it was observed that the severity and mortality of HD patients infected with SARS-CoV were similar to other infected population, but the duration of shedding virus through stool or breath was significantly longer than other patients [18] . Considering the high biological similarity between therefore tested the frequency of immune cells in the PBMCs of patients with and without SARS-CoV-2 infection and the level of cytokines in the body of patients. The results showed that compared with the general population, the T cells, Th cells, killer T cells, as well as NK cells was reduced remarkably in PBMCs of HD patients, irrespective of SARS-CoV-2 infection. In addition, the serum level of serial cytokines of IL-4, IL-6, TNF-α in SARS-CoV-2 infected HD patients remain relatively lower in comparison with non-HD patients with SARS-CoV-2 infection. This indicates that the impaired immune system seems to be unable to mount effective cellular immune response upon the invasion of SARS-CoV-2, thus results in no cytokine storm and no severe organs damage. In the current clinical guidelines and practice for COVID-19 therapy, glucocorticoids are regularly recommended and usually prescribed, for the purpose of inhibiting the overactive immune response and reducing the cytokine storm [6, 11] . However, with regard to the management of COVID-19 in HD patients, we suggest the administration of glucocorticoids should be prudent since the immune system in HD patients have already been suppressed [19] [20] [21] . . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.