The Omicron <scp>COVID</scp>‐19 threat to dialysis patients is dramatically lower than previous variants

Madani, Ayman Kamal Al; Obaidli, Ali Kareem Al; Ahmed, Wasim; Kaabi, Nawal Al; Holt, Stephen G

doi:10.1111/nep.14065

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…Patients undergoing dialysis are categorized as having a high risk of SARS-CoV-2 infection/transmission and are more vulnerable to unfavorable clinical outcomes. Previous studies have shown that the Omicron COVID-19 threat to patients undergoing MHD is lower than that of previous variants (7); however, the present study revealed a higher mortality rate among MHD patients after COVID-19 infection than that of the general population (12.1% and 1.45% to 8%, respectively) (8-10).…”

Section: Discussioncontrasting

confidence: 84%

Risk factors for mortality and antibody responses in chronic hemodialysis patients with coronavirus disease 2019: a single-center experience in China

Song,

Cai,

Xiao

2024

Preprint

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Introduction: This single-center retrospective research aimed to depict the outcomes of coronavirus disease 2019 (COVID-19) in a cohort of patients from China. Methods: We traced the outcomes of 216 MHD patients admitted to the Aerospace Center Hospital of China during a COVID-19 wave . Clinical information was assembled and compared between survivors and non-survivors. Serum immunoglobulin M (IgM) and IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were detected in MHD survivors 90–120 days post-infection. Clinical information was analyzed to find outfactors influencing mortality and antibody responses. Results: Among 216 patients, 207 (95.8%) were evaluated as COVID-19, and 25 (12.1%) passed away within 90 days. Fifty-five (26.6%) patients were needed of hospital admission. Non-survivors had lower levels of hemoglobin and serum albumin, higher levels of alkaline phosphatase, higher white blood cell counts and lower percentage of lymphocytes than survivors. Furthermore, the Clinical Frailty Scale (CFS) scores were higher in non-survivors significantly (p<0.05). Multivariate analysis showed that diabetes (HR 3.98, 95% CI 1.25–12.66, p=0.019), level of frailty according to the CFS (HR 2.10, 95% CI 1.36-3.23, p=0.001) and central venous catheter (CVC) use (hazard ratio [HR] 3.48, 95% confidence interval [CI] 1.18-10.29, p=0.024), had significant impacts on mortality. IgG was positive in 59.5%, and IgM was positive in 3.3% of patients (>1 sample/cutoff) between 90–120 days post-infection. Lower blood C-reactive protein (CRP) levels before the onset of SARS-CoV-2 infection were associated with significantly higher IgG antibody levels at 90-120 days after COVID-19 infection. Discussion: This study identified high mortality rates of SARS-CoV-2 infection among hemodialysis patients. Risk factors associated with mortality include diabetes, frailty, and CVC access. Low level of blood CRP before SARS-CoV-2 infection may predict high antibody responses during convalescence.

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Section: Discussioncontrasting

confidence: 84%

Risk factors for mortality and antibody responses in chronic hemodialysis patients with coronavirus disease 2019: a single-center experience in China

Song,

Cai,

Xiao

2024

Preprint

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“…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%

“…The emergence of the Omicron variant and high vaccination coverage could significantly affect the disease course among patients with ESRD. However, studies on their impacton patients withCOVID-19with ESRDare limited except for a few observations [ 15 , 23 ]. Some laboratory features predict the clinical course of patients with COVID‐19, [ 25 ] although limited data are available for patients with ESRDwho are fully vaccinated against COVID-19.…”

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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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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SARS-CoV-2 Omicron Infections among Vaccinated Maintenance Hemodialysis Patients: Outcomes and Comparison to Delta Variant

Wand,

Drori,

Einbinder

et al. 2024

Nephron

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Background Infections with B.1.1.529 (Omicron) variants of SARS-CoV-2 became predominant worldwide since late 2021, replacing the previously dominant B.1.617.2 variant (Delta). While those variants are highly transmissible and can evade vaccine protection, population studies suggested that outcomes from infection with Omicron variants are better compared with Delta. Data regarding prognosis of maintenance hemodialysis (MHD) patients infected with Omicron vs. Delta variants, however, is scarce. Methods This retrospective cohort study includes all patients with end-stage kidney disease treated with MHD in Meir Medical Center, Kfar-Saba, Israel that were diagnosed with SARS-CoV-2 infection between June 2021 and May 2022. Results Twenty-six subjects were diagnosed with the Delta variant and 71 with Omicron. Despite comparable age between groups and higher mean vaccine doses prior to the infection among Omicron group (p<0.001), SARS-CoV-2 infection severity was significantly worse among MHD infected with the Delta variant: 50% developed severe or critical COVID-19 vs. 5% in the Omicron group (p<0.001). Over half of MHD infected with Omicron (57%) were asymptomatic during their illness. 30-day mortality rate for the whole cohort was 5.2%. It was significantly higher among MHD in the Delta group than in the Omicron group (5/26, 19.2% vs. 0/71, p<0.001), as was 90-day mortality rate (5/26, 19.2% vs. 3/71, 4.2%, p=0.02). Conclusions Infection with the SARS-CoV-2 Delta variant was associated with worse outcomes compared with Omicron, among subjects on MHD. However, despite mild disease among vaccinated MHD patients, infection with Omicron variant was still associated with significant 90-day mortality rate.

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The Omicron COVID‐19 threat to dialysis patients is dramatically lower than previous variants

Cited by 4 publications

References 8 publications

Risk factors for mortality and antibody responses in chronic hemodialysis patients with coronavirus disease 2019: a single-center experience in China

Risk factors for mortality and antibody responses in chronic hemodialysis patients with coronavirus disease 2019: a single-center experience in China

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

SARS-CoV-2 Omicron Infections among Vaccinated Maintenance Hemodialysis Patients: Outcomes and Comparison to Delta Variant

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