Kidney Week

Abstract: PO0757

Trajectories of Clinical and Laboratory Characteristics Before COVID-19 Diagnosis in Hemodialysis Patients

Session Information

• COVID-19: Dialysis Patients
  October 22, 2020 | Location: On-Demand
  Abstract Time: 10:00 AM - 12:00 PM

Category: Coronavirus (COVID-19)

• 000 Coronavirus (COVID-19)

Authors

• Jiao, Yue, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

Yue Jiao,

• Larkin, John W., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

John W. Larkin,

• Monaghan, Caitlin, Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

Caitlin Monaghan,

• Winter, Anke, Fresenius Medical Care Deutschland GmbH, EMEA Medical Office, Bad Homburg, Germany

Anke Winter,

• Raimann, Jochen G., Renal Research Institute, New York, New York, United States

Jochen G. Raimann,

• Neri, Luca, Fresenius Medical Care Deutschland GmbH, EMEA Medical Office, Bad Homburg, Germany

Luca Neri,

• Kotanko, Peter, Renal Research Institute, New York, New York, United States

Peter Kotanko,

• Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States

Jeffrey L. Hymes,

• Lee, Sangho, Kyung Hee University Hospital at Gangdong, Seoul, Korea (the Republic of)

Sangho Lee,

• Usvyat, Len A., Fresenius Medical Care, Global Medical Office, Waltham, Massachusetts, United States

Len A. Usvyat,

• Maddux, Franklin W., Fresenius Medical Care AG & Co. KGaA, Global Medical Office, Bad Homburg, Germany

Franklin W. Maddux,

Background

The frequency of evaluations in hemodialysis (HD) care affords opportunities to assess profiles that may characterize onset of the 2019 coronavirus disease (COVID-19). We aimed to characterize the trajectories of clinical/laboratory assessments before COVID-19 diagnosis in HD patients.

Methods

We assessed data from HD patients with known COVID-19 dialyzed at Fresenius Kidney Care in the United States between 02 Mar and 09 Apr 2020. We computed mean daily values for 40 variables 90 days before a positive rRT-PCR test (COVID-19+). Nonparametric smoothing splines were used to fit data of individual trajectories and estimate the mean change over time.

Results

There were 1294 HD patients with COVID-19 (mean age 64±14 years, 60% male, 47% white race, 69% had diabetes, and 24% had coronary artery disease). Mean pre-HD body temperature (primarily oral) increased by about 1^° Fahrenheit (F) over 10 days before COVID-19+ test and approached 99^° F at diagnosis (Fig 1A). Mean interdialytic weight gain decreased by about 0.75 kg (Fig 1B) over 14 days before COVID-19+ test; concurrent decreases of about 20 minutes were seen in HD treatment time. Mean neutrophil-to-lymphocyte ratio had mild increases (Fig 1C), while mean platelet counts decreased by about 40×10⁹/L over 14 days before COVID-19+ test (Fig 1D). Trajectories of many variables (vitals, heparin, hematology, nutrition, bone, anemia) were observed to change before COVID-19+ test, yet alternations were generally minor.

Conclusion

The trajectories of several clinical/laboratory parameters appeared to change before COVID-19 diagnosis in HD patients. Many changes were small and may not be independently useful in identifying onset of COVID-19. Mean pre-HD body temperature before SARS-CoV-2 infection was 97.4^° F and should be considered in screening. Findings may have utility in prediction model development. Further comparisons to patients without COVID-19 are needed.

Funding

• Commercial Support – Fresenius Medical Care