Goodlad, Cate;
Davenport, Andrew;
(2023)
The changing pattern of COVID-19 infection in haemodialysis and peritoneal dialysis patients.
Artificial Organs
, 47
(7)
pp. 1202-1207.
10.1111/aor.14526.
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Abstract
INTRODUCTION: Following the first wave of COVID-19 there have been several variants. We wished to review the number and severity of infections with the different variants in a population of haemodialysis (HD) and peritoneal dialysis (PD) patients. METHODS: We reviewed the outcomes and results in HD and PD patients testing positive for COVID-19 between March 2020 -August 2022. RESULTS: 795 cases of COVID-19 were recorded in 710 dialysis patients. More HD patients than PD contracted wild type (21.4 vs 6.8%), delta (23.3 vs 6.3%) and omicron (27.7 vs 14.7%), all p<0.01, but no difference with alpha (4.6 vs 6.3%) or beta variants (5.7 vs 6.85). Hospitalisation and death were greatest for alpha followed by wild type, beta, delta and omicron (60.6 vs 57 vs 47.5 vs 21.2 vs 19.3%) respectively, p<0.001. C reactive protein progressively increased from outpatient management to hospitalisation to hospitalisation with critical care or death (14 (4-30) vs 41 (18-101) vs 94 (47-168) mg/L, p<0.001. Despite previous infection and vaccination 85 (12%) patients had 2 or more infections with COVID-19. CONCLUSION: Disease severity declined and survival improved as the virus mutated from wild type and alpha to beta, delta and omicron variants. Whether this related to reduction in viral virulence, vaccination, natural acquired immunity, or introduction of pharmacological treatments remains to be determined. Government lockdowns and enhanced infection control measures reduced the % of HD patients contracting alpha and beta variants to those of PD. Vaccination and prior infection did not prevent re-infection.
| Type: | Article |
|---|---|
| Title: | The changing pattern of COVID-19 infection in haemodialysis and peritoneal dialysis patients |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/aor.14526 |
| Publisher version: | https://doi.org/10.1111/aor.14526 |
| Language: | English |
| Additional information: | © 2023 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
| Keywords: | COVID-19, haemodialysis, hospitalisation, inflammation, peritoneal dialysis, survival |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10167471 |
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