Abstract: PO0722
COVID-19 Incidence and Outcomes in Hemodialysis Patients in Mexico
Session Information
- COVID-19: Dialysis Patients
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Ardavin Ituarte, Juan M., Medica Santa Carmen, Mexico, Mexico
- Pineirua, Alicia, Medica Santa Carmen, Mexico, Mexico
- Rodriguez, Juan Carlos, Medica Santa Carmen, Mexico, Mexico
Group or Team Name
- Medica Santa Carmen Staff Nephrologists
Background
HD pts are at high risk for COVID-19. High incidence and death rate were reported in China and Europe with more than 20% of asymptomatics. We report incidence, features and outcomes of COVID-19 in HD patients in a network of 8 clinics in Mexico. A protocol was started on Mar 15 with hygiene measures; symptoms triage; separation by age; use of PPE and isolation of suspected cases. We use a more inclusive case definition, different from Mexico Health Ministry`s(SSA). All cases are referred for PCR but most aren`t tested.
Methods
Retrospective analysis of cases (suspect or PCR(+)) from mar 15 to may 22 2020 compared to controls. T-test and Chi2 were used. Hospitalization, IMV and deaths were registered. Overall mortality from mar - may 2020 compared to same period of 2019. We compared the number of cases using our case definition with that using the SSA`s. Incidence of COVID-19 in staff was also analyzed.
Results
Total 1276 pts; Of 102 suspects 25 (24%) had PCR and 16 (64%) were(-). 13 (12%) non-tested were discarded based on alternative dx. 2 pts with (-) PCR were cases based on CT. Total 75 cases (10 (+)PCR, 65 w/o test) were analyzed and compared to controls. No differences in HD vintage, DM, CVD, HD session length, VA, BUN or Kt/V. Less age, fem gender, HTN, more sessions/wk, ACEi/ARB and lower Hb were found in the cases. 7 (9%) hospitalized and 2 (3%) required IMV. There were 6 (8%) deaths, only 1 (1.3%) attributed to COVID-19. Overall mortality minimally higher than that of the same period of 2019 (1.35% vs 1.30%). 31% of cases had only 1 symptom. Only 1 PCR(+) and 14 PCR(-) cases fulfilled SSA`s definition. Among 231 staff members, 31 cases (13.8%), 11 (35%) PCR(+) and 20 non tested.
Conclusion
Incidence of probable or confirmed COVID-19 was 5.9%; probably overestimated suggested by scarce testing and low mortality. ACEi/ARB use more frequent in cases, adjusted for HTN and age. Our protocol helps prevent in-clinic contagion. A more comprehensive probable case definition appears more useful for HD patients.
COVID-19 (Susp / Conf) n 75 ( 5.7%) | Non - COVID-19 n 1,201 | Total n 1,276 | p | |
Mean age (S.E.) | 44.7 (18.8) | 49.7 (17.7) | 49.4 (17.8) | 0.019 |
Female (%) | 45 (60) | 471 (39.2) | 516 (40.4) | <0.001 |
Hypertension (%) | 67 (91.8) | 804 (66.9) | 871 (68.4) | <0.001 |
ACEi/ARB Yes (%) | 45 (60) | 366 (30.5) | 411 (32.2) | <0.001 |
Hemglobin (g/dL) | 9.30 (2.02) | 10.4 (1.96) | 10.3 (1.98) | <0.001 |
Mean sessions per week (S.E.) | 2.80(0.46) | 2.6 (0.67) | 2.6 (0.66) | 0.01 |