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Abstract: PO0742

Accuracy of Lower Temperature Thresholds in Detecting COVID-19 in Hemodialysis Patients

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Goupil, Remi, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Nadeau-Fredette, Annie-Claire, Hopital Maisonneuve-Rosemont, Montreal, Quebec, Canada
  • Beaubien-Souligny, William, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada
  • Madore, Francois, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Suri, Rita, McGill University, Montreal, Quebec, Canada

Group or Team Name

  • for the Réseau Rénal Québécois
Background

Patients receiving in-center hemodialysis (HD) are uniquely vulnerable to COVID-19 yet identifying infected individuals may be challenging. They may not present with typical symptoms and low basal body temperature may impair detection of fever. We studied the accuracy of temperature thresholds in detecting COVID-19 in HD patients.

Methods

We retrospectively studied all patients between March 24-May 14, 2020 from a single HD unit (Hôpital du Sacré-Coeur) in Montreal, Canada, where COVID-19 is highly prevalent. All patients who presented with symptoms or contact exposure were tested by nasopharyngeal swab. Prompted by an outbreak, systematic testing of all HD patients was started on April 18th. Basal temperature was defined as the average pre-dialysis temperature from weeks -1 to -3 before testing. Diagnostic performance was determined for various temperature thresholds defined a priori.

Results

Of 205 in-center HD patients, 34 developed COVID-19 during the study period. Of these, 21 (61%) were hospitalised, 4 (11%) required intensive care and 9 (26%) died. Baseline characteristics are presented in Table 1. Less than a third had typical symptoms. Thresholds of ≥ 37.3 oC and “basal temperature +0.5 oC” had similar moderate sensitivity and high specificity in predicting COVID-19 (Table 2). Combining symptoms and either of these thresholds improved sensitivity to 85%.

Conclusion

Less than one third of HD patients have typical symptoms of COVID-19 or fever >38.0oC. Pre-dialysis temperature >37.3oC or 0.5oC above basal temperature markedly improves sensitivity for detection of COVID-19 in asymptomatic HD patients. A screening strategy combining symptom questionnaires and pre-dialysis temperature monitoring should be used in HD units in regions of high COVID-19 prevalence.