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Kidney Week

Abstract: PO0743

Assessment of a Laboratory-Based SARS-CoV-2 Antibody Test Among Hemodialysis Patients: A Quality Improvement Initiative

Session Information

Category: Coronavirus (COVID-19)

  • No subcategory defined

Authors

  • Cohen, Dena E., Davita Clinical Research, Minneapolis, Minnesota, United States
  • Marlowe, Gilbert, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Contreras, Gabriel, University of Miami, Coral Gables, Florida, United States
  • Sosa, Marie A., University of Miami, Coral Gables, Florida, United States
  • Munoz Mendoza, Jair, University of Miami, Coral Gables, Florida, United States
  • Lenz, Oliver, University of Miami, Coral Gables, Florida, United States
  • Mithani, Zain, University of Miami, Coral Gables, Florida, United States
  • Posada, Jorge L., Kendall Regional Medical Center, Miami, Florida, United States
  • Fernandez-Bombino, Julio A., Hialeah Hospital, Hialeah, Florida, United States
  • Garcia-Mayol, Luis, Kendall Regional Medical Center, Miami, Florida, United States
  • Lemont, Michael T., Kidney and Hypertension Specialists, Miami, Florida, United States
  • Miles, Anne Marie V., Kidney and Hypertension Specialists, Miami, Florida, United States
  • Zeig, Steven, Memorial Healthcare System, Hollywood, Florida, United States
  • Teixeiro, Pura M., University of Miami, Coral Gables, Florida, United States
  • Queija, Nery, University of Miami, Coral Gables, Florida, United States
  • Jeanty, Jean S., University of Miami, Coral Gables, Florida, United States
  • Swanzy, Katie, DaVita Inc, Denver, Colorado, United States
  • Palecek, Misha Jan, DaVita Inc, Denver, Colorado, United States
  • Krishnan, Mahesh, DaVita Inc, Denver, Colorado, United States
  • Giullian, Jeffrey A., DaVita Inc, Denver, Colorado, United States
  • Brunelli, Steven M., Davita Clinical Research, Minneapolis, Minnesota, United States
Background

The coronavirus disease 2019 (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Assessment of newly developed anti-SARS-CoV-2 antibody tests in hemodialysis patients is needed.

Methods

As part of a quality improvement (QI) initiative, nasopharyngeal swabs and predialysis blood samples were collected on the same day from adults receiving routine dialysis care at clinics managed by a large dialysis organization in the Miami, Florida, region (April 23-30, 2020). Polymerase chain reaction (PCR) tests for SARS-CoV-2 (Fulgent Genetics, Temple City, California) and chemiluminescence immunoassays (Diazyme Laboratories, Inc, Poway, California) were performed according to manufacturer protocols. For antibody tests (IgM and IgG), a reading of >1 arbitrary unit/mL was scored as positive.

Results

Of 715 participants in the QI initiative, 38 had symptoms consistent with COVID-19 prior to or during the initiative. Among these, COVID-19 was confirmed in 14 and ruled out in 20, with 4 being inconclusive. Among the 34 patients with known COVID-19 status, the sensitivity and specificity of the antibody test were 57.1% and 85.0%, respectively, when both IgM and IgG were considered. The remaining 677 patients had no record of symptoms consistent with COVID-19 or any known exposure. Of these, 38 (5.6%) tested positive for anti-SARS-CoV-2 antibodies; none of the antibody-positive patients with available PCR results (N=33) tested positive for SARS-CoV-2.

Conclusion

The operational characteristics of the laboratory-based antibody test make it sufficient to rule in, but not rule out, SARS-CoV-2 infection in the appropriate clinical circumstance. A substantial proportion of dialysis patients may have had asymptomatic SARS-CoV-2 infection.