Abstract: TH-PO930
COVID-19 Infection in Dialysis Patients: Efficacy of Vaccination
Session Information
- COVID-19: Vaccines and Outcomes ESRD/KTR
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Navarrete, Jose E., Emory University, Atlanta, Georgia, United States
- Cobb, Jason, Emory University, Atlanta, Georgia, United States
- Apata, Ibironke W., Emory University, Atlanta, Georgia, United States
- Masud, Tahsin, Emory University, Atlanta, Georgia, United States
- Lea, Janice P., Emory University, Atlanta, Georgia, United States
Background
End stage kidney disease (ESKD) patients are particularly susceptible to poor outcomes from Covid-19 infection (C19). Vaccination has been the cornerstone of mortality prevention. We examine the efficacy of C19 vaccine in ESKD patients.
Methods
All patients dialyzed at Emory dialysis centers from December 1, 2020 until February 2022 represent the study population. Date of completed vaccines series was recorded. Confirmed C19 cases were also registered. Time from vaccination to C19 and from C19 to death was recorded. Mortality risk was compared between vaccinated and unvaccinated patients. Patients that received vaccination after an episode of C19 were excluded from the analysis (n=89).
Results
935 patients received maintenance dialysis during the study period. 68% completed 2 doses of C19 vaccine. 46% of vaccinated patients received a booster dose after 294 days (IQR: 251-273) of completing the primary vaccination series. Non-vaccinated patients were younger (55 vs 60y/o), with shorter dialysis vintage (1.0 vs 2.8 years). The proportion of home and in-center dialysis was similar among vaccinated and unvaccinated patients. The prevalence of diabetes, CHF, PVD, COPD, atrial fibrillation, and previous transplants was also similar. 71 vaccinated patients died during follow up (11%) after 196 days (IQR 122-290), compared to 70 in the non-vaccinated group (24%) after 86 days (IQR 39-166), p<0.001. Adjusting for age, dialysis vintage, diabetes and CHF, ESKD vaccinated patients had a 78% reduction in mortality risk (A). 73 vaccinated patients (11%) acquired C19 after 250 days (IQR 150-288) compared to 48 unvaccinated patients (16%) who acquired C19 after 64 days (IQR 30-215), p<0.001. The mortality odds ratio after C19 infection was 3.9 [CI: 1.3-11.9] for unvaccinated patients 30 days post infection, 4.7 [CI: 1.7-14.2] at 60 days and 4.1 [CI: 1.6-11.5] at 90 days (B).
Conclusion
Vaccination against C-19 infection resulted in a 78% reduction of mortality risk in patients receiving dialysis. Non-vaccinated patients diagnosed with C19 had higher mortality rates than vaccinated patients (OR 4.1 at 90 days post infection).