Abstract

Abstract Background and Aims Hemodialysis (HD) patients are at high risk for post-COVID conditions and a high mortality rate over a 1-year period after diagnosis of COVID-19, especially in the first 3 months. Evidence shows that vaccinated individuals who experience breakthrough infection are less likely to report post-COVID conditions compared with unvaccinated individuals. Although oxidative stress has been shown to be an important cause of post-COVID conditions, there is a general lack of data on oxidant/antioxidant status in HD patients with post-COVID conditions. The present study aimed to evaluate the oxidant/antioxidant markers in HD patients with post-COVID conditions according to vaccination status. Method A total of 106 HD patients, aged 52.4 ± 10.2 years, and dialysis vintage of 68 (29-134) months, were enrolled in this cross-sectional observational cohort study. Patients were divided into 3 groups according to their vaccination status and the presence of post-COVID conditions. Group 1 consisted of 36 HD patients who had been fully vaccinated against COVID-19 with either Pfizer-BNT-162b2 or Moderna-mRNA-1273 vaccine and had experienced a post-vaccination SARS-CoV-2 infection and had at least 1 post-COVID symptom. Group 2 consisted of 35 fully vaccinated HD patients who had never been infected with COVID-19 (vaccinated control group), and Group 3 included 35 unvaccinated HD patients who had experienced COVID-19 and had post-COVID conditions (unvaccinated control group). Concentrations of malondialdehyde in serum (MDAs) and erythrocytes (MDAe), sulfhydryl groups (SH-groups), serum catalase activity (CTs), serum transferrin and ceruloplasmin levels were determined 3 months after COVID -19 recovery. Data were expressed as a median and interquartile range [Me (Q25-Q75)] and compared with the Kruskal-Wallis test. Results The vaccinated HD patients with post-COVID conditions had the highest concentrations of MDAs and ceruloplasmin, and lower serum levels of CTs and transferrin compared with the vaccinated and unvaccinated control groups (Table 1). Conclusion Our findings suggest a significant oxidative imbalance in HD patients with post-COVID syndrome most likely due to the synergistic effects of the virus and the vaccine. The use of antioxidant supplements might be a possible strategy to treat post-COVID conditions in HD patients.

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