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Abstract: TH-PO1091

Dynamic Changes of Cycle Threshold Values and Chest CT Quantification in a Prospective Cohort of Hemodialysis Patients with SARS-CoV-2 Omicron Variant

Session Information

  • COVID-19 - I
    November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Li, Ze, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Xing, Haifan, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
  • Fan, Ying, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
Background

Hemodialysis patients are at high risk of severe forms of SARS-CoV-2 infection due to their impaired immunity. Earlier warning and intervention may help to avoid adverse outcome. We aim to study the clinical characteristics, dynamic changes of cycle threshold (Ct) values and chest CT quantification in hemodialysis patients with SARS-CoV-2 Omicron variant and to explore the risk factors affecting the outcome in these patients.

Methods

We performed a single center, prospective study in Shanghai sixth People’s hospital, a designated hemodialysis center. Clinical information, laboratory results, dynamic Ct values and AI based chest CT quantitative parameters were collected. Primary endpoint was defined as death or ICU admission. Patients were prospectively followed up from the first day of admission until they reached the endpoint or were discharged from hospital. Patients were divided into mild group and severe group according to the exposure to outcome or not. All aforementioned data were compared and analyzed and generalized estimating equation (GEE) was used to identify risk factors from the cohort.

Results

A total of 161 hemodialysis patients with SARS-CoV-2 Omicron variant were included and followed up (median 62 days), among which 31 patients reached the endpoint. Compared to mild group, severe group had a lower Ct value in Day 4. Ct values of the two groups tended to be equal after Day 4. In CT quantitative parameters, severe group had higher thin-section CT scores (TSS), higher percentage of ground glass opacity (GGO) volume (PGV) and higher percentage of consolidation volume (PCV). Both PGV and PCV values got faster growth from Day 0 to Day 4 in severe group than those in mild group, which kept continuously increasing at Day 7 in patients with poor outcome. Multivariate GEE showed age, PCV and phosphorus were independent risk factors for death or ICU admission in hemodialysis patients with Omicron variant, while albumin and lymphocyte count were protecting factors.

Conclusion

Our new findings suggest early and dynamic monitoring of Ct values and AI based chest CT quantitative parameters could be helpful to assess the survival and outcome in hemodialysis patients with SARS-CoV 2 Omicron variant. Optimizing dialysis strategies and improving nutritional status are important in these patients.

Funding

  • Government Support – Non-U.S.