Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients
<b>Background/Objectives:</b> Hemodialysis (HD) patients with advanced chronic kidney disease (CKD) are highly vulnerable to complications from SARS-CoV-2 infection. Anemia management in this population is complex, particularly due to erythropoietin resistance, which may be exacerbated b...
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MDPI AG
2025-02-01
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| Series: | Geriatrics |
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| Online Access: | https://www.mdpi.com/2308-3417/10/2/33 |
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| author | Guido Gembillo Luca Soraci Luigi Peritore Rossella Siligato Vincenzo Labbozzetta Alfio Edoardo Giuffrida Felicia Cuzzola Claudia Spinella Adolfo Romeo Vincenzo Calabrese Alberto Montesanto Andrea Corsonello Domenico Santoro |
| author_facet | Guido Gembillo Luca Soraci Luigi Peritore Rossella Siligato Vincenzo Labbozzetta Alfio Edoardo Giuffrida Felicia Cuzzola Claudia Spinella Adolfo Romeo Vincenzo Calabrese Alberto Montesanto Andrea Corsonello Domenico Santoro |
| author_sort | Guido Gembillo |
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| description | <b>Background/Objectives:</b> Hemodialysis (HD) patients with advanced chronic kidney disease (CKD) are highly vulnerable to complications from SARS-CoV-2 infection. Anemia management in this population is complex, particularly due to erythropoietin resistance, which may be exacerbated by COVID-19-related inflammation. To this aim, in this small-scale retrospective study, we investigated trends in the erythropoietin resistance index (ERI) over time in patients with and without SARS-CoV-2 infection. <b>Methods:</b> This single-center retrospective study included 25 HD patients, divided into two groups: 15 with a history of SARS-CoV-2 infection (CoV2 group) and 10 without (nonCoV2 group). The ERI was assessed over four visits, with 70–100-day intervals between them. Linear mixed models were used to evaluate factors associated with ERI changes. <b>Results:</b> Patients in the CoV2 group exhibited significantly higher ERI increases between T1 (baseline) and T2 (post-infection) compared to the nonCoV2 group (median ΔERI: +4.65 vs. −0.27, <i>p</i> < 0.001). During the T2–T4 recovery period, CoV2 patients demonstrated a delayed but substantial decline in the ERI, converging to baseline levels by T4. Male sex and hemoglobin levels were negatively associated with the ERI. <b>Conclusions:</b> SARS-CoV-2 infection induces transient but significant erythropoietin resistance in HD patients, likely due to inflammation and disrupted erythropoiesis. Tailored anemia management strategies, including the potential use of hypoxia-inducible factor stabilizers, are warranted. Larger, multicenter studies are needed to validate these findings and improve treatment protocols. |
| format | Article |
| id | doaj-art-3aadefacc13e4e139b6274ece6dd39b6 |
| institution | OA Journals |
| issn | 2308-3417 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
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| series | Geriatrics |
| spelling | doaj-art-3aadefacc13e4e139b6274ece6dd39b62025-08-20T02:18:16ZengMDPI AGGeriatrics2308-34172025-02-011023310.3390/geriatrics10020033Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis PatientsGuido Gembillo0Luca Soraci1Luigi Peritore2Rossella Siligato3Vincenzo Labbozzetta4Alfio Edoardo Giuffrida5Felicia Cuzzola6Claudia Spinella7Adolfo Romeo8Vincenzo Calabrese9Alberto Montesanto10Andrea Corsonello11Domenico Santoro12Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyUnit of Geriatric Medicine, Italian National Research Center on Aging (IRCCS INRCA), 87100 Cosenza, ItalyUnit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyNephrology Unit, University Hospital of Ferrara, 44121 Ferrara, ItalyUnit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyUnit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyUnit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyUnit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyUnit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyUnit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, ItalyDepartment of Biology, Ecology and Earth Sciences, University of Calabria, 87036 Arcavacata di Rende, ItalyUnit of Geriatric Medicine, Italian National Research Center on Aging (IRCCS INRCA), 87100 Cosenza, ItalyUnit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy<b>Background/Objectives:</b> Hemodialysis (HD) patients with advanced chronic kidney disease (CKD) are highly vulnerable to complications from SARS-CoV-2 infection. Anemia management in this population is complex, particularly due to erythropoietin resistance, which may be exacerbated by COVID-19-related inflammation. To this aim, in this small-scale retrospective study, we investigated trends in the erythropoietin resistance index (ERI) over time in patients with and without SARS-CoV-2 infection. <b>Methods:</b> This single-center retrospective study included 25 HD patients, divided into two groups: 15 with a history of SARS-CoV-2 infection (CoV2 group) and 10 without (nonCoV2 group). The ERI was assessed over four visits, with 70–100-day intervals between them. Linear mixed models were used to evaluate factors associated with ERI changes. <b>Results:</b> Patients in the CoV2 group exhibited significantly higher ERI increases between T1 (baseline) and T2 (post-infection) compared to the nonCoV2 group (median ΔERI: +4.65 vs. −0.27, <i>p</i> < 0.001). During the T2–T4 recovery period, CoV2 patients demonstrated a delayed but substantial decline in the ERI, converging to baseline levels by T4. Male sex and hemoglobin levels were negatively associated with the ERI. <b>Conclusions:</b> SARS-CoV-2 infection induces transient but significant erythropoietin resistance in HD patients, likely due to inflammation and disrupted erythropoiesis. Tailored anemia management strategies, including the potential use of hypoxia-inducible factor stabilizers, are warranted. Larger, multicenter studies are needed to validate these findings and improve treatment protocols.https://www.mdpi.com/2308-3417/10/2/33Sars-CoV-2COVID-19hemodialysisrenal replacement therapiesanemiakidney failure |
| spellingShingle | Guido Gembillo Luca Soraci Luigi Peritore Rossella Siligato Vincenzo Labbozzetta Alfio Edoardo Giuffrida Felicia Cuzzola Claudia Spinella Adolfo Romeo Vincenzo Calabrese Alberto Montesanto Andrea Corsonello Domenico Santoro Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients Geriatrics Sars-CoV-2 COVID-19 hemodialysis renal replacement therapies anemia kidney failure |
| title | Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients |
| title_full | Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients |
| title_fullStr | Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients |
| title_full_unstemmed | Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients |
| title_short | Impact of SARS-CoV-2 Infection on Erythropoietin Resistance Index in Hemodialysis Patients |
| title_sort | impact of sars cov 2 infection on erythropoietin resistance index in hemodialysis patients |
| topic | Sars-CoV-2 COVID-19 hemodialysis renal replacement therapies anemia kidney failure |
| url | https://www.mdpi.com/2308-3417/10/2/33 |
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