SARS-CoV-2 Seropositivity Rates in Patients and Clinical Staff in New York City Dialysis Facilities: Association With the General Population

Thwin, Ohnmar; Grobe, Nadja; Silva, Leticia M Tapia; Ye, Xiaoling; Zhang, Hanjie; Wang, Yuedong; Kotanko, Peter

doi:10.1016/j.xkme.2021.02.010

Cited by 3 publications

(3 citation statements)

References 4 publications

(4 reference statements)

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“…plays a significant role in the spread of COVID-19 among in-center hemodialysis patients. This conclusion is supported by a different line of research that investigated the presence of SARS-CoV-2 antibodies in the general population in New York City neighborhoods and hemodialysis patients who dwelled in those areas [6]. This study showed a strong association between seropositivity rates in the general population and dialysis patients, supporting the notion that COVID-19 infection in in-center maintenance HD patients can primarily be attributed to community-acquired infection.…”

Section: Plos Onesupporting

confidence: 58%

Network analysis of spread of SARS-CoV-2 within dialysis clinics: A multi-center network analysis

Duan,

Wang,

Kotanko

et al. 2024

PLoS ONE

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Background In-center hemodialysis entails repeated interactions between patients and clinic staff, potentially facilitating the spread of COVID-19. We examined if in-center hemodialysis is associated with the spread of SARS-CoV-2 between patients. Methods Our retrospective analysis comprised all patients receiving hemodialysis in four New York City clinics between March 12th, 2020, and August 31st, 2022. Treatment-level clinic ID, dialysis shift, dialysis machine station, and date of COVID-19 diagnosis by RT-PCR were documented. To estimate the donor-to-potential recipient exposure (“donor” being the COVID-19 positive patient denoted as “COV-Pos”; “potential recipient” being other susceptible patients in the same shift), we obtained the spatial coordinates of each dialysis station, calculated the Euclidean distances between stations and weighted the exposure by proximity between them. For each donor, we estimated the donor-to-potential recipient exposure of all potential recipients dialyzed in the same shift and accumulated the exposure over time within the ‘COV-Pos infectious period’ as cumulative exposures. The ‘COV-Pos infectious period’ started 5 days before COVID-19 diagnosis date. We deployed network analysis to assess these interactions and summarized the donor-to-potential recipient exposure in 193 network diagrams. We fitted mixed effects logistic regression models to test whether more donor-to-potential recipient exposure conferred a higher risk of SARS-CoV-2 infection. Results Out of 978 patients, 193 (19.7%) tested positive for COVID-19 and had contact with other patients during the COV-Pos infectious period. Network diagrams showed no evidence that more exposed patients would have had a higher chance of infection. This finding was corroborated by logistic mixed effect regression (donor-to-potential recipient exposure OR: 0.63; 95% CI 0.32 to 1.17, p = 0.163). Separate analyses according to vaccination led to materially identical results. Conclusions Transmission of SARS-CoV-2 between in-center hemodialysis patients is unlikely. This finding supports the effectiveness of non-pharmaceutical interventions, such as universal masking and other procedures to control spread of COVID-19.

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Section: Plos Onesupporting

confidence: 58%

Network analysis of spread of SARS-CoV-2 within dialysis clinics: A multi-center network analysis

Duan,

Wang,

Kotanko

et al. 2024

PLoS ONE

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“…The same hypothesis was evoked by Anand et al in a US nationwide comparative study which found that residents of neighborhoods with high population density presented a ten times higher risk of seropositivity compared with residents of lowest density areas [ 12 ]. Another US study showed that seroprevalence in the general and hemodialysis population are similar [ 15 ]. Since the early pandemic, epidemiological studies suggested that SARS-CoV-2 basic reproduction number (R0) increases linearly with population density [ 16 ] and this was why clusters were observed in crowded and confined spaces, mass gatherings, and populous metropolitan areas [ 17 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of SARS-CoV-2 antibodies in hemodialysis patients in Senegal: a multicenter cross-sectional study

et al. 2021

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Background Hemodialysis patients are among high-risk groups for COVID-19. Africa is the continent with the lowest number of cases in the general population but we have little information about the disease burden in dialysis patients. Objectives This study aimed to describe the seroprevalence of SARS-CoV-2 antibodies in the hemodialysis population of Senegal. Patients and methods We conducted a multicenter cross-sectional survey, between June and September 2020 involving 10 public dialysis units randomly selected in eight regions of Senegal. After seeking their consent, we included 303 patients aged ≥ 18 years and hemodialysis for ≥ 3 months. Clinical symptoms and biological parameters were collected from medical records. Patients’ blood samples were tested with Abbott SARS-CoV-2 Ig G assay using an Architect system. Statistical tests were performed with STATA 12.0. Results Seroprevalence of SARS-CoV-2 antibodies was 21.1% (95% CI = 16.7–26.1%). We noticed a wide variability in SARS-CoV-2 seroprevalence between regions ranging from 5.6 to 51.7%. Among the 38 patients who underwent nasal swab testing, only six had a PCR-confirmed infection and all of them did seroconvert. Suggestive clinical symptoms were reported by 28.1% of seropositive patients and the majority of them presented asymptomatic disease. After multivariate analysis, a previous contact with a confirmed case and living in a high population density region were associated with the presence of SARS-CoV-2 antibodies. Conclusion This study presents to our knowledge the first seroprevalence data in African hemodialysis patients. Compared to data from other continents, we found a higher proportion of patients with SARS-CoV-2 antibodies but a lower lethality rate.

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“…(6)(7)(8)10,13,14,15) Centres in India, Iran, South Africa, and Turkey have reported SARS-CoV-2 infection rates between 7 -47% amongst their dialysis patients, with fatality rates of 2 -38%. (3)(4)(5)11,12,24) While infection rates in LMICs were generally higher than in HICs, differences may reflect the community infection burden at that time rather than within centre transmission, (6,8,25,26) although outbreaks within centres have been reported globally. (6,7) Centre layout, including available side rooms for isolation, and patient factors have also been associated with the risk of infection.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

The Global Impact of the COVID-19 Pandemic on In-Center Hemodialysis Services: An ISN-Dialysis Outcomes Practice Patterns Study Survey

Aylward

Bieber

Guedes

et al. 2022

Kidney International Reports

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Introduction To assess the impact of the COVID-19 pandemic impact on haemodialysis centres, The Dialysis Outcomes and Practice Patterns Study and International Society of Nephrology (ISN) collaborated on a web-survey of centres. Methods A combined approach of random sampling and open invitation was used between March 2020 and March 2021. Responses were obtained from 412 centres in 78 countries and all 10 ISN regions. Results In 8 regions, rates of SARS-CoV-2 infection were <20% in most centres, but in North East Asia and Newly Independent States and Russia rates were ≥20% and ≥30%, respectively. Mortality was ≥10% in most centres in 8 regions, though lower in North America and Caribbean and North East Asia. Diagnostic testing was not available in 33%, 37%, and 61% of centres in Latin America, Africa, and East and Central Europe, respectively. Surgical masks were widely available, but severe shortages of particulate-air filter masks were reported in Latin America (18%) and Africa (30%). Rates of infection in staff ranged from 0% in 90% of centres in North East Asia to ≥50% in 63% of centres in the Middle East and 68% of centres in Newly Independent States and Russia. In most centres <10% of staff died, but in Africa and South Asia 2% and 6% of centres reported ≥50% mortality, respectively. Conclusion There has been wide global variation in SARS-CoV-2 infection rates amongst haemodialysis patients and staff, PPE availability, and testing, and the ways in which services have been redesigned in response to the pandemic.

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SARS-CoV-2 Seropositivity Rates in Patients and Clinical Staff in New York City Dialysis Facilities: Association With the General Population

Cited by 3 publications

References 4 publications

Network analysis of spread of SARS-CoV-2 within dialysis clinics: A multi-center network analysis

Network analysis of spread of SARS-CoV-2 within dialysis clinics: A multi-center network analysis

Prevalence of SARS-CoV-2 antibodies in hemodialysis patients in Senegal: a multicenter cross-sectional study

The Global Impact of the COVID-19 Pandemic on In-Center Hemodialysis Services: An ISN-Dialysis Outcomes Practice Patterns Study Survey

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