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Kidney Week

Abstract: PO0757

Trajectories of Clinical and Laboratory Characteristics Before COVID-19 Diagnosis in Hemodialysis Patients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Jiao, Yue, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Larkin, John W., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Monaghan, Caitlin, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Winter, Anke, Fresenius Medical Care Deutschland GmbH, EMEA Medical Office, Bad Homburg, Germany
  • Raimann, Jochen G., Renal Research Institute, New York, New York, United States
  • Neri, Luca, Fresenius Medical Care Deutschland GmbH, EMEA Medical Office, Bad Homburg, Germany
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
  • Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Lee, Sangho, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)
  • Usvyat, Len A., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care AG & Co. KGaA, Global Medical Office, Bad Homburg, Germany
Background

The frequency of evaluations in hemodialysis (HD) care affords opportunities to assess profiles that may characterize onset of the 2019 coronavirus disease (COVID-19). We aimed to characterize the trajectories of clinical/laboratory assessments before COVID-19 diagnosis in HD patients.

Methods

We assessed data from HD patients with known COVID-19 dialyzed at Fresenius Kidney Care in the United States between 02 Mar and 09 Apr 2020. We computed mean daily values for 40 variables 90 days before a positive rRT-PCR test (COVID-19+). Nonparametric smoothing splines were used to fit data of individual trajectories and estimate the mean change over time.

Results

There were 1294 HD patients with COVID-19 (mean age 64±14 years, 60% male, 47% white race, 69% had diabetes, and 24% had coronary artery disease). Mean pre-HD body temperature (primarily oral) increased by about 1° Fahrenheit (F) over 10 days before COVID-19+ test and approached 99° F at diagnosis (Fig 1A). Mean interdialytic weight gain decreased by about 0.75 kg (Fig 1B) over 14 days before COVID-19+ test; concurrent decreases of about 20 minutes were seen in HD treatment time. Mean neutrophil-to-lymphocyte ratio had mild increases (Fig 1C), while mean platelet counts decreased by about 40×109/L over 14 days before COVID-19+ test (Fig 1D). Trajectories of many variables (vitals, heparin, hematology, nutrition, bone, anemia) were observed to change before COVID-19+ test, yet alternations were generally minor.

Conclusion

The trajectories of several clinical/laboratory parameters appeared to change before COVID-19 diagnosis in HD patients. Many changes were small and may not be independently useful in identifying onset of COVID-19. Mean pre-HD body temperature before SARS-CoV-2 infection was 97.4° F and should be considered in screening. Findings may have utility in prediction model development. Further comparisons to patients without COVID-19 are needed.

Funding

  • Commercial Support