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Abstract: PO0052

Associations of Dialysis Modality and Setting with Incidence of COVID-19 Diagnosis and Hospitalization

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Weinhandl, Eric D., Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States
  • Gilbertson, David T., Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States
  • Wetmore, James B., Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States
  • Johansen, Kirsten L., Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States
Background

The novel coronavirus 2019 (COVID-19) pandemic has resulted in substantial morbidity and mortality among patients undergoing maintenance dialysis. Patients performing home hemodialysis (HHD) or peritoneal dialysis (PD) may be able to minimize exposure to the community, thus lowering risk of COVID-19 infection. We assessed whether HHD and PD were associated with lower risks of COVID-19 infection and hospitalization, compared to in-facility hemodialysis (IHD).

Methods

We analyzed Medicare Parts A and B claims accrued during 2020. For each epidemiologic week from week 12 (beginning March 15) to week 37 (September 6), we identified patients with a Medicare-covered outpatient dialysis treatment during the preceding 7 days. We stratified patients into cohorts of IHD, HHD, and PD; we limited the IHD cohort to patients without residency in a skilled nursing facility during the 28 days preceding the epidemiologic week. During each week, we estimated the incidence of COVID-19 infection and COVID-19 hospitalization, per Medicare claims with ICD-10-CM diagnosis code U07.1. Using logistic regression with adjustment for demography, comorbidity, and state, we estimated odds ratios of outcomes during weeks 12-22, 23-33, and 34-37.

Results

Incidence of COVID-19 infection (figure) and COVID-19 hospitalization peaked twice: during weeks 14-16 and weeks 29-30. During weeks 12-22, adjusted odds ratios (AORs) of COVID-19 infection for HHD versus IHD and PD versus IHD were 0.55 (95% CI, 0.43-0.71) and 0.52 (0.46-0.58), respectively. During weeks 23-33, corresponding AORs were 0.63 (0.50-0.78) and 0.63 (0.57-0.69).

Conclusion

Both home dialysis modalities were associated with similarly lower risks of COVID-19 infection and hospitalization. Nephrologists and dialysis provider should consider counseling patients about potentially lower risk of infectious respiratory disease with home dialysis.

Funding

  • NIDDK Support