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Kidney Week

Abstract: FR-PO1101

Vaccination, Prior Infection, and the Risk of COVID-19 Reinfection Across the Spectrum of CKD

Session Information

  • COVID-19 - II
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Mir, Hamza, The University of New Mexico, Albuquerque, New Mexico, United States
  • Garcia, Pablo, The University of New Mexico, Albuquerque, New Mexico, United States
  • Argyropoulos, Christos, The University of New Mexico, Albuquerque, New Mexico, United States
  • Roumelioti, Maria-Eleni, The University of New Mexico, Albuquerque, New Mexico, United States
Background

Patients with CKD have a higher burden of sequelae due to COVID19 (C19), but little is known about the impact of prior vaccination (vax) & infection (inf) on the risk of reinfection (reinf) across the spectrum of CKD.

Methods

We analyzed C19 inf (ICD10 B97.29, U07.1, U07.2, J12.82, B34.2) & vax data from the TRINETX Health Research Network of electronic medical records from 59 healthcare organizations from inception until June, 1st 2022. eGFR was assessed with the CKDEpi 2021 formula using the most recent creatinine to the first inf or C19 vax. Repeated C19 episodes were analyzed with proportional hazards models using cluster variance methods. Interactions between eGFR & time updated prior number of infections(NI) or vaccinations (NV) were used to answer the primary question. Patients who tested negative for C19 served as controls.

Results

9.5M pts were identified, but 2.4M were eligible for analyses (most pts were excluded due to missing eGFR [Fig]A. Mean age was 56 , 42.4% were male, 9.7% were Hispanic & African Americans were 19.2%. 90.7% of pts were unvaxxed, 2.1%, 4.13% & 2.4% had received 1,2,3 vax. 10.3% of pts had a single C19 inf, 3.2% 2 & <0.1% more than 3 inf. In models adjusting for demographics, region, age, eGFR,and secular trends, there was a statistical significant interaction between CKD stage and NI and NV [Fig]B. While a prior C19 inf reduced the risk of a subsequent reinf for eGFR>30, it increased the risk for those with eGFR≤30. Cumulative NV was protective across all eGFR levels.

Conclusion

Prior C19 inf increases subsequent risk for inf for pts with eGFR <30, even after adjusting for number of vax. Pts with CKD stages 4-5 should strongly consider adhering to nonpharmaceutical interventions & stay up to date with C19 vax to reduce their risk of C19 disease.