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Abstract: TH-PO922

SARS-CoV-2 Infections and Mortality in Dialysis Patients: A Multicenter Prospective Trial

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Kamalanabhaiah, Sahana R., Philipps-Universitat Marburg Fachbereich Medizin, Marburg, Hessen, Germany
  • Ostermaier, Claudia, Philipps-Universitat Marburg Fachbereich Medizin, Marburg, Hessen, Germany
  • Dahmen, Lotte Louise, Philipps-Universitat Marburg Fachbereich Medizin, Marburg, Hessen, Germany
  • Haas, Christian Stefan, Philipps-Universitat Marburg Fachbereich Medizin, Marburg, Hessen, Germany
  • Hoyer, Joachim, Philipps-Universitat Marburg Fachbereich Medizin, Marburg, Hessen, Germany
  • Keller, Christian, Philipps-Universitat Marburg Fachbereich Medizin, Marburg, Hessen, Germany
Background

Dialysis patients are at great risk for contracting COVID-19 during the pandemic. In need to appear at their dialysis centers on a regular basis they have limited options to self-isolate. They are forced to be in close contact with ambulance or taxi drivers, co-patients and health care workers, setting them at risk of acquiring COVID-19. Disease severity and mortality in dialysis patients seem to be higher than in the general population. The objective of this study was to assess incidence and mortality of SARS-CoV-2 infections in this cohort.

Methods

Repetitive PCR testing and antibody blood sampling was performed in a prospective, multicenter study in chronic hemodialysis patients in 12 dialysis centers in central Germany, starting April 2020. Basic data was assessed, means of transportation and kind of residence were evaluated, specifically with regard to risk for infection. COVID-19 associated symptoms were logged, fatalities were counted during the ongoing pandemic with its particular waves of virus variants.

Results

874 patients at a medium age of 69.8±14.2 yrs (62.1% ♂) participated in the study. Taxi or ambulance were the means of transportation in 86.5%, 7.6% lived in a nursing home; 8.8% acquired COVID-19. Demographic data did not differ between diseased and healthy patients except for residency. The odds ratio to get COVID-19 was significantly higher in dialysis patients living in nursing homes compared to those in home care (OR 3.76, 95%CI 2.05-6.87). Like in the general population, the highest infection rate was observed with the alpha variant, whereas the delta variant did not affect the dialysis centers. Omicron on the other hand was highly present. Mortality was highest during the alpha variant wave (29.1%), but was lower in delta (14.2%) and lowest in omicron infections (0.3%). Overall infections and mortality in dialysis patients decreased with immunization status, either through prior infection or vaccination in nursing homes. Of note, mortality in this cohort was barely impacted by COVID-19 associated death.

Conclusion

COVID-19 immunization in hemodialysis patients is very effective preventing spreading the virus from nursing homes to dialysis centers. General morbiditiy status in dialysis patients seems to be more relevant to outcome than intercurrent infections with COVID-19.