SARS-CoV-2 in Spent Dialysate from Chronic Peritoneal Dialysis Patients with COVID-19

Abstract

Background To date it is unclear whether SARS-CoV-2 is present in spent dialysate from peritoneal dialysis (PD) patients with COVID-19. Our aim was to assess the presence or absence of SARS-CoV-2 in spent dialysate from chronic PD patients with confirmed diagnosis of COVID-19. Methods Spent PD dialysate samples from COVID-19 positive PD patients were collected between March and August 2020. The multiplexed real-time reverse transcriptase-polymerase chain reaction assay contained primer/probe sets specific to different SARS-CoV-2 genomic regions and to bacteriophage MS2 as internal process control for nucleic acid extraction. Demographic and clinical data were obtained from patients' electronic health records. Results A total of 26 spent PD dialysate samples were collected from 11 patients from 10 dialysis centers. Spent PD dialysate samples were collected on average 25±13 days (median 20, range 10 to 45) after onset of symptoms. The temporal distance of PD effluent collection relative to the closest positive nasal swab RT PCR was 15±11 days (median 14; range 1 to 41). All 26 PD effluent samples tested negative at three SARS-CoV-2 genomic regions. Conclusions Our findings indicate the absence of SARS-CoV-2 in spent PD dialysate collected 10 days or later after the onset of COVID-19 symptoms. We cannot rule out presence of SARS-CoV-2 in spent PD dialysate in the early stage of COVID-19.

COVID-19 Vaccination Acceptance and Hesitancy in Dialysis Staff: First Results From New York City

“…Lastly, since spring 2020, clinic staff are actively involved in quality improvement and clinical research projects related to COVID-19. 3,4 We believe that these factors in aggregate contributed to the high vaccination acceptance rate observed by us.…”

Impact of COVID‐19 on maintenance peritoneal dialysis patients and providers: A review

“…Later analysis in a separate study demonstrated negative qRT‐PCR results for the SARS‐CoV‐2 RNA‐dependent RNA polymerase (RdRp) and Envelope (E) genes in a total of 11 PD effluent samplings across three patients with mild to moderate COVID [78]. Since August 2020, a handful of studies across the world supported these findings by similarly reporting an absence of detectable SARS‐CoV‐2 RNA in spent PD effluent [20, 84–87]. Perhaps most convincingly, SARS‐CoV‐2 RNA was undetectable in qRT‐PCR analysis of spent PD dialysate samples from 10 patients with severe COVID‐19 pneumonia; this same paper also reported an absence of infective virions, cytopathic effects in culture, and plaque formation in PD effluent [88].…”

Presence of SARS-CoV-2 Antibodies in Spent Peritoneal Dialysate

“…As reported previously, all PD dialysate samples in Group 3 and Group 4 were tested negative for SARS-CoV-2 viral RNA. 6,7 We had no access to serum SARS-CoV-2 antibody levels in any patient.…”