Logo image
Back
Interplay of kidney function and anti-SARS-CoV-2 antibodies in COVID-19 mortality: a prospective cohort study
Journal article   Open access   Peer reviewed

Interplay of kidney function and anti-SARS-CoV-2 antibodies in COVID-19 mortality: a prospective cohort study

Sylvia Mink, Heinz Drexel, Andreas Leiherer, Janne Cadamuro, Wolfgang Hitzl, Emanuel Zitt, Matthias Frick, Patrick Reimann, Christoph H Saely and Peter Fraunberger
Scientific reports, v 15(1), pp 24978-16
10 Jul 2025
DOI: https://doi.org/10.1038/s41598-025-98788-1
PMID: 40640492
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1038/s41598-025-98788-1View
Published, Version of Record (VoR) Open

Abstract

Aged Aged, 80 and over Antibodies, Viral - blood Antibodies, Viral - immunology COVID-19 - immunology COVID-19 - mortality Female Glomerular Filtration Rate Hospital Mortality Humans Male Middle Aged Prospective Studies Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - immunology Renal Insufficiency, Chronic - mortality Risk Factors SARS-CoV-2 - immunology Spike Glycoprotein, Coronavirus - immunology
CKD has been recognized as an independent risk factor for severe disease and death in COVID-19. Given the high variability in humoral responses, their general decrease in strength, quality, and durability with age, and the decline of antibody levels over time, personalized vaccination regimes would ensure optimal protection of patients with CKD. This prospective, multicenter cohort study included 1112 hospitalized COVID-19 patients from five study centers. Anti-SARS-CoV-2-spike antibodies and eGFR were measured on hospital admission. The primary outcome was all-cause in-hospital mortality. Reduced kidney function combined with anti-SARS-CoV-2 spike antibody levels was a stronger predictor of COVID-19 mortality than either parameter separately. After adjusting for potential confounders, patients with an eGFR of 60-89 ml/min, 30-59 ml/min, and < 30 ml/min had 4.5, 8.5, and 8.4 times higher odds of dying if antibody levels were below the Youden index of 182BAU/ml (aOR 4.468, 95%CI 1.599-12.486, p = 0.004; 8.528, 3.190-22.793, p < 0.001; 8.400, 2.571-27.442, p < 0.001). Mortality rates did not differ significantly by renal function in CKD patients with antibody levels > 1200BAU/ml. In patients with impaired kidney function, survival is strongly associated with sufficiently high antibody levels. Additional booster vaccinations should be considered in CKD patients with antibody levels < 1200BAU/ml.

Metrics

1 Record Views
2 citations in Web of Science

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

Source: SDGs in the Output

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Urology & Nephrology
Logo image