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Kidney Week

Abstract: PO0722

COVID-19 Incidence and Outcomes in Hemodialysis Patients in Mexico

Session Information

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 1,201Total n 1,276p
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