Presentation and outcomes of SARS-CoV-2 Omicron variant infection in haemodialysis patients

Chimon, Alice; Ferriere, Elsa; Lammouchi, M.A.; Jouan, Narindra; Michel, P.; Saloum, Kenda; Morand‐Joubert, Laurence; Schnuriger, Aurélie; Leruez‐Ville, Marianne; Fourgeaud, Jacques; Dahmane, Djamal; Bentaarit, Boutheina; Guéry, Bruno; Fessi, H.; Kazdaghli, Hajer; Sounni, Farah; Fearon, Timothée; Boudhabhay, Idris; Pawlotsky, Jean‐Michel; Karoui, Khalil El; Fourati, Slim; Sakhi, Hamza

doi:10.1093/ckj/sfac137

Cited by 5 publications

(4 citation statements)

References 9 publications

(11 reference statements)

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“…Similar to observation among patients withCOVID-19 on HD [ 22 ], the observed mortality rate of 4.7% (5 of 106) among patients with COVID-19 with ESRD in our study was comparatively lower than that among those with ESRDbeforethe Omicron era (22.4%; February 2020 to November 2021) in South Korea [ 32 ]. This pre-Omicron mortality rate is comparable to other reported series among patients with ESRD,which demonstrated a mortality rate of approximately 20–30% [ 33 ].…”

Section: Discussionsupporting

confidence: 89%

“…However, T-cell responses induced by vaccines have acceptable cross-reactivity against variants [ 18 , 19 ] that protect against severe diseases and mortality [ 20 ]. It has been reported that symptoms of the Omicron variant in the general population [ 21 ] and those on HD [ 22 , 23 ] were milder and shorter than those of the previous and wild-type variants.…”

Section: Introductionmentioning

confidence: 99%

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Clinical features of COVID-19 among patients with end-stage renal disease on hemodialysis in the context of high vaccination coverage during the omicron surge period: a retrospective cohort study

Beck,

Song,

Park

et al. 2023

BMC Nephrol

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Background We determined the clinical presentation and outcomes of the Omicron variant of severe acute respiratory syndrome coronavirus 2 infection in hemodialysis patients and identified the risk factors for severe coronavirus disease (COVID-19) and mortality in the context of high vaccination coverage. Methods This was a retrospective cohort study involving hemodialysis patients who were vaccinated against COVID-19 during March–September 2022, when the Omicron variant was predominant, and the COVID-19 vaccination rate was high. The proportion of people with severe COVID-19 or mortality was evaluated using univariate logistic regression. Results Eighty-three (78.3%) patients had asymptomatic/mild symptoms, 10 (9.4%) had moderate symptoms, and 13 (12.3%) had severe symptoms. Six (5.7%) patients required intensive care admission, two (1.9%) required mechanical ventilation, and one (0.9%) was kept on high-flow nasal cannula. Of the five (4.7%) mortality cases, one was directly attributed to COVID-19 and four to pre-existing comorbidities. Risk factors for both severe COVID-19 and mortality were advanced age; number of comorbidities; cardiovascular diseases; increased levels of aspartate transaminase, lactate dehydrogenase, blood urea nitrogen/creatinine ratio, brain natriuretic peptide, and red cell distribution; and decreased levels of hematocrit and albumin. Moreover, the number of COVID-19 vaccinations wasa protective factor against both severe disease and mortality. Conclusions Clinical features of hemodialysis patients during the Omicron surge with high COVID-19 vaccination coverage were significant for low mortality. The risk features for severe COVID-19 or mortality were similar to those in the pre-Omicron period in the context of low vaccination coverage.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Clinical features of COVID-19 among patients with end-stage renal disease on hemodialysis in the context of high vaccination coverage during the omicron surge period: a retrospective cohort study

Beck,

Song,

Park

et al. 2023

BMC Nephrol

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“…Patients with the omicron variant were found to be at risk of critical illness and death, with 7% of the patients infected with the omicron variant dying in the United States and 15% of patients requiring invasive mechanical ventilation [ 10 ]. Chimon et al found that the case fatality rate was 5% and severe forms of infection were observed in 14% of patients, suggesting that hemodialysis patients remain at a high risk of severe complications after SARS-CoV-2 Omicron infection [ 11 ]. During the fifth Omicron wave in Hong Kong, the mortality attributable to COVID-19 in the hemodialysis population was 2.2 deaths per 100 dialysis patients [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and outcomes of maintenance hemodialysis patients with COVID-19 during the Omicron wave of the pandemic in Beijing: a single center retrospective study

Pan,

Li,

Zhang

et al. 2024

BMC Nephrol

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Background The clinical manifestations and prognosis of hemodialysis patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) during the Omicron wave of the pandemic infection were still unclear. This study investigated the clinical characteristics of patients undergoing maintenance hemodialysis (MHD) infected with it. Methods This retrospective single-center study included 151 patients undergoing MHD. Healthcare workers were selected as control group were assessed from December 1, 2022 to March 31, 2023. Clinical data, laboratory test results, treatment protocols, and prognoses were collected and analyzed. Results The study population included 146 patients with MHD, 93 (63.7%) of whom were infected with SARS-CoV-2. The number of non-severe, severe, and critical cases was 84 (90.3%), 4 (4.3%), and 5 (5.3%), respectively. Six patients (6.5%) died during the study period. The main symptoms of SARS-CoV-2 infection, including fever, cough, and fatigue, were less common in patients with MHD than the controls. During SARS-CoV-2 infection, the C-reactive protein (2.9 vs. 11.8 mg/dl, p < 0.0001) and ferritin levels(257.7 vs. 537 ng/l, p < 0.0001) were elevated. The hemoglobin(113vs 111 g/L, p = 0.0001) and albumin levels(39.4 vs. 36.1 g/L, p < 0.0001) decreased. Generally, it took two months for the hemoglobin levels to recover. Positivity rate for SARS-COV-2 serum immunoglobin G (IgG) antibodies and IgG titers were lower in dialysis patients than the controls. Age was positively associated with disease severity, while age and hyponatremia were associated with death. Conclusions Patients with MHD and COVID-19 were primarily classified as non-severe. SARS-CoV-2 infection would soon lead to the increase of inflammation related acute response protein in dialysis patients, and then lead to the decrease of hemoglobin and albumin. About 9.6% in HD patients were severe cases and had poor prognosis. Advanced age and hyponatremia were associated with disease severity and prognosis.

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“…The Omicron variant seemed to result in less severe disease in patients on MHD compared with other variants (Spensley et al, 2022. Chimon et al suggested the importance of surveillance and continuous protection measures to limit SARS-CoV-2 infection to patients on MHD high risk of severe forms of infection compared to non-HD population (Chimon et al, 2022). Combination of the BNT162b2 vaccine and previous infection produced immunity against omicron infection and protection against hospitalization and death .…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of 4 doses of COVID-19 vaccine in patients on maintenance hemodialysis in 5th wave of COVID-19 infection in Myanmar: Do we need 5 doses?

Pyar

Myint

Hla

et al. 2022

IJMSCRS

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Background: Patients on maintenance hemodialysis (MHD) are at high risk of contracting SARS-CoV-2 and developing severe COVID-19 infection because they have low innate immunity as well as poor antibody response to COVID-19 vaccine. This study aimed to assess the effectiveness of 4 doses of COVID-19 vaccine in preventing 5th wave of COVID-19 infections in patients on maintenance hemodialysis in Myanmar. Methods: A hospital-based descriptive study was conducted in July 2022 to November 2022 among patients on MHD who received COVID-19 vaccine 4 doses; last dose was 2 weeks ago. Data were collected by using standardized forms and analysis was done. Results: A total of 61 patients on maintenance hemodialysis ( MHD) who had 4 doses of COVID-19 vaccination more than 2 weeks were included. Nasopharyngeal swab PCR was taken twice a week to all patients (if they did not have symptoms) and it was repeated if they had symptoms suggestive of COVID-19 infection or they had history of contact with patients having COVID-19 infection. Their signs and symptoms were analyzed; chest radiograph and blood tests were taken if indicated. Then, the severity of COVID-19 infection was determined according to WHO criteria and they were given treatment according to hospital guideline. They were followed up till 28 days. The base line characteristics were as follows: mean age was 51.15 ± 12.85 years; male to female ratio was 4:6; mean BMI was 19.93 ± 2.83 kg/m2; 16.4%(10/61) had diabetic nephropathy; 9.8%(6/61) had cerebrovascular accident; 24.6%(15/61) had coronary heart disease; and one fifth of them were current smokers. Sixty six percent had past history of COVID-19 infection; duration from last infection was 404 days. Thirty three percent of cases had shortest duration of hemodialysis (6 months) and 23% were over 3 years. Mean duration from last vaccination was 39 days. Thirty six percent (22/61) had confirmed COVID-19 infection and 64% (39/61) of them were not infected till the end of 5th wave. All infected cases were mild form according to WHO criteria; none of them required oxygen therapy. One case having multiple comorbidities (lymphoma, coronary heart disease, hypertension and malignant cachexia) had sudden death due to pulmonary embolism. Conclusions: The protection rate of four doses of COVID-19 vaccine in patients on MHD was not good as 36% of them were infected in the 5th wave of epidemic in Myanmar. However, all the infected cases were mild form and they did not need oxygen therapy showing that booster vaccination prevented morbidity and mortality. Therefore, the protection rate of four doses of COVID-19 vaccine in patients on MHD was nearly 65%; it reduced the severe form of infection and death. Fifth dose of COVID-19 vaccine is necessary along with personnel protective measures.

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Presentation and outcomes of SARS-CoV-2 Omicron variant infection in haemodialysis patients

Cited by 5 publications

References 9 publications

Clinical features of COVID-19 among patients with end-stage renal disease on hemodialysis in the context of high vaccination coverage during the omicron surge period: a retrospective cohort study

Clinical features of COVID-19 among patients with end-stage renal disease on hemodialysis in the context of high vaccination coverage during the omicron surge period: a retrospective cohort study

Clinical characteristics and outcomes of maintenance hemodialysis patients with COVID-19 during the Omicron wave of the pandemic in Beijing: a single center retrospective study

Effectiveness of 4 doses of COVID-19 vaccine in patients on maintenance hemodialysis in 5th wave of COVID-19 infection in Myanmar: Do we need 5 doses?

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