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. 2020 Dec 9;2(2):263-269.
doi: 10.34067/KID.0006292020. eCollection 2021 Feb 25.

COVID-19 Antibodies and Outcomes among Outpatient Maintenance Hemodialysis Patients

Minesh Khatri  1 , Shahidul Islam  2 , Paula Dutka  1 , John Carson  1 , James Drakakis  1 , Louis Imbriano  1 , Imran Jawaid  1 , Tapan Mehta  1 , Nobuyuki Miyawaki  1 , Elain Wu  1 , Stephen Yang  1 , Nicole Ali  3 , Jasmin Divers  2 , Candace Grant  1 , Naveed Masani  1
Affiliations

COVID-19 Antibodies and Outcomes among Outpatient Maintenance Hemodialysis Patients

Minesh Khatri et al. Kidney360. .

Abstract

Background: Patients on maintenance hemodialysis are particularly vulnerable to infection and hospitalization from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to immunocompromised patients and the clustering that occurs in outpatient dialysis units, the seroprevalence of COVID-19 antibodies in this population is unknown and has significant implications for public health. Also, little is known about their risk factors for hospitalization.

Methods: Three outpatient maintenance hemodialysis units affiliated with a major teaching hospital in the New York area were studied. We determined rates of SARS-CoV-2 positivity via nasopharyngeal, real-time, reverse-transcriptase PCR (RT-PCR); SARS-CoV-2 IgG seropositivity; hospitalization; and mortality.

Results: Of 367 patients, 28% had either SARS-CoV-2 seropositivity or PCR positivity. Prevalence across the three respective units was 7%, 32%, and 70%. Those who were either antibody or PCR positive were significantly younger (65 versus 69 years, P=0.05), and had a higher prevalence of Black race (43% versus 30%, P=0.001) and Hispanic ethnicity (32% versus 12%, P<0.001) compared with those who tested negative. Higher positivity rates were also observed among those who took taxis and ambulettes to and from dialysis, compared with those who used personal transportation. Antibodies were detected in all of the patients with a positive PCR result who underwent serologic testing. Of those that were seropositive, 32% were asymptomatic. The hospitalization rate on the basis of either antibody or PCR positivity was 35%, with a hospital mortality rate of 33%. Aside from COPD, no other variables were more prevalent in patients who were hospitalized.

Conclusions: We observed significant differences in rates of COVID-19 infection within three outpatient dialysis units, with universal seroconversion. Among patients with ESKD, rates of asymptomatic infection appear to be high, as do hospitalization and mortality rates.

Keywords: COVID-19; SARS-CoV-2; antibodies; dialysis; end stage renal disease; hemodialysis; outpatients.

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Conflict of interest statement

N. Ali reports receiving honoraria from CareDx. J. Divers reports receiving honoraria from the National Institutes of Health and Oak Ridge Associated Universities. P. Dutka reports receiving research funding from Akebia, Bayer, GlaxoSmithKline, and Novo Nordisk; being on the editorial board of the Nephrology Nursing Journal; and having consultancy agreements with, receiving honoraria from, and being on a speakers bureau for Rockwell Medical. C. Grant reports receiving research funding from Novo Nordisk. N. Masani reports having ownership interest in AbbVie, Bristol Meyers Squibb, General Electric, and Siemens; receiving research funding from Cara Therapeutics, GlaxoSmithKline, and Novo Nordisk; being a scientific advisor for, or member of, Rockwell Medical; and being a member of Renal Physicians Association. All remaining authors have nothing to disclose.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Derivation of study cohort. HD, hemodialysis; PD, peritoneal dialysis.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention : People at higher risk for severe illness, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-.... Accessed August 1, 2020
    1. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, Wu Y, Zhang L, Yu Z, Fang M, Yu T, Wang Y, Pan S, Zou X, Yuan S, Shang Y: Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study. Lancet Respir Med 8: 475–481, 2020. 10.1016/S2213-2600(20)30079-5 - DOI - PMC - PubMed
    1. Mikami T, Miyashita H, Yamada T, Harrington M, Steinberg D, Dunn A, Siau E: Risk factors for mortality in patients with COVID-19 in New York city [published online ahead of print June 30, 2020]. J Gen Intern Med - PMC - PubMed
    1. Tonelli M, Wiebe N, Culleton B, House A, Rabbat C, Fok M, McAlister F, Garg AX: Chronic kidney disease and mortality risk: A systematic review. J Am Soc Nephrol 17: 2034–2047, 2006. 10.1681/ASN.2005101085 - DOI - PubMed
    1. Sarnak MJ, Jaber BL: Mortality caused by sepsis in patients with end-stage renal disease compared with the general population. Kidney Int 58: 1758–1764, 2000. 10.1111/j.1523-1755.2000.00337.x - DOI - PubMed