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Kidney Week

Abstract: PO0754

Rates of Asymptomatic Carriage and Antibody Positivity for SARS-CoV-2 in a Large Haemodialysis Cohort

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Mccafferty, Kieran, Barts Health NHS Trust, London, London, United Kingdom
  • Davari, Maria, Barts Health NHS Trust, London, London, United Kingdom
  • Price, Katherine, Barts Health NHS Trust, London, London, United Kingdom
  • Rajakariar, Ravindra, Barts Health NHS Trust, London, London, United Kingdom
  • Cove-smith, Andrea, Barts Health NHS Trust, London, London, United Kingdom
  • Forbes, Suzanne H., Barts Health NHS Trust, London, London, United Kingdom
Background

Haemodialysis patients represent a unique challenge in the COVID-19 pandemic, balancing infection risk while safely providing life-sustaining haemodialysis. Asymptomatic infection rates in haemodialysis patients are unknown.

Aims:
1 - To define rates of asymptomatic swab positivity in a cohort of prevalent haemodialysis patients
2 - To define rates of antibody positivity in patients known to have been historically swab positive
3 - To define rates of antibody positivity in patients without prior symptoms or clinical suspicion of COVID-19

Methods

A programme of COVID-19 screening using a validated nasopharyngeal PCR analysis was carried out across a prevalent cohort of 1253 haemodialysis patients. Concurrently all patients were offered antibody testing for Anti-SARS-CoV-2 IgG/IgM (Roche) and a total of 848 tests were completed.

Results

1 – Routine screening over a 4 week period from 4/5/20 to 1/6/20 confirmed 7 cases of asymptomatic swab positivity (0.6%).
2 – In our cohort there were 197 confirmed swab positive cases of COVID, and of the 153 survivors 124 were antibody positive (81%). 10 patients were highly clinically suspicious of COVID and managed as such; of those 3 were antibody positive (30%).
3 – Of the remaining swab negative patients who had antibody testing (n=710) 82 were antibody positive (11.5%).

Conclusion

In a large inner-city London haemodialysis where the population prevalence of COVID has been high, we demonstrate
1 – low asymptomatic rates of virus carriage at this later stage in the pandemic
2 – significant proportions of swab positive patients seroconverting to be antibody positive
2 – suggestion that 11.5% of patients had previous been asymptomatic carriers and had seroconverted to be antibody positive