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COVID-19 in patients undergoing long-term dialysis in Ontario.
Taji, Leena; Thomas, Doneal; Oliver, Matthew J; Ip, Jane; Tang, Yiwen; Yeung, Angie; Cooper, Rebecca; House, Andrew A; McFarlane, Phil; Blake, Peter G.
  • Taji L; Ontario Renal Network (Taji, Thomas, Oliver, Ip, Tang, Yeung, Cooper, McFarlane, Blake), Ontario Health; Department of Medicine (Oliver), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (House, Blake), Western University, London, Ont.; St. Michael's Hospital (McFarlan
  • Thomas D; Ontario Renal Network (Taji, Thomas, Oliver, Ip, Tang, Yeung, Cooper, McFarlane, Blake), Ontario Health; Department of Medicine (Oliver), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (House, Blake), Western University, London, Ont.; St. Michael's Hospital (McFarlan
  • Oliver MJ; Ontario Renal Network (Taji, Thomas, Oliver, Ip, Tang, Yeung, Cooper, McFarlane, Blake), Ontario Health; Department of Medicine (Oliver), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (House, Blake), Western University, London, Ont.; St. Michael's Hospital (McFarlan
  • Ip J; Ontario Renal Network (Taji, Thomas, Oliver, Ip, Tang, Yeung, Cooper, McFarlane, Blake), Ontario Health; Department of Medicine (Oliver), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (House, Blake), Western University, London, Ont.; St. Michael's Hospital (McFarlan
  • Tang Y; Ontario Renal Network (Taji, Thomas, Oliver, Ip, Tang, Yeung, Cooper, McFarlane, Blake), Ontario Health; Department of Medicine (Oliver), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (House, Blake), Western University, London, Ont.; St. Michael's Hospital (McFarlan
  • Yeung A; Ontario Renal Network (Taji, Thomas, Oliver, Ip, Tang, Yeung, Cooper, McFarlane, Blake), Ontario Health; Department of Medicine (Oliver), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (House, Blake), Western University, London, Ont.; St. Michael's Hospital (McFarlan
  • Cooper R; Ontario Renal Network (Taji, Thomas, Oliver, Ip, Tang, Yeung, Cooper, McFarlane, Blake), Ontario Health; Department of Medicine (Oliver), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (House, Blake), Western University, London, Ont.; St. Michael's Hospital (McFarlan
  • House AA; Ontario Renal Network (Taji, Thomas, Oliver, Ip, Tang, Yeung, Cooper, McFarlane, Blake), Ontario Health; Department of Medicine (Oliver), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (House, Blake), Western University, London, Ont.; St. Michael's Hospital (McFarlan
  • McFarlane P; Ontario Renal Network (Taji, Thomas, Oliver, Ip, Tang, Yeung, Cooper, McFarlane, Blake), Ontario Health; Department of Medicine (Oliver), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (House, Blake), Western University, London, Ont.; St. Michael's Hospital (McFarlan
  • Blake PG; Ontario Renal Network (Taji, Thomas, Oliver, Ip, Tang, Yeung, Cooper, McFarlane, Blake), Ontario Health; Department of Medicine (Oliver), University of Toronto, Toronto, Ont.; Schulich School of Medicine and Dentistry (House, Blake), Western University, London, Ont.; St. Michael's Hospital (McFarlan
CMAJ ; 193(8): E278-E284, 2021 Feb 22.
Article in English | MEDLINE | ID: covidwho-1105842
ABSTRACT

BACKGROUND:

Patients undergoing long-term dialysis may be at higher risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and of associated disease and mortality. We aimed to describe the incidence, risk factors and outcomes for infection in these patients in Ontario, Canada.

METHODS:

We used linked data sets to compare disease characteristics and mortality between patients receiving long-term dialysis in Ontario who were diagnosed SARS-CoV-2 positive and those who did not acquire SARS-CoV-2 infection, between Mar. 12 and Aug. 20, 2020. We collected data on SARS-CoV-2 infection prospectively. We evaluated risk factors for infection and death using multivariable logistic regression analyses.

RESULTS:

During the study period, 187 (1.5%) of 12 501 patients undergoing dialysis were diagnosed with SARS-CoV-2 infection. Of those with SARS-CoV-2 infection, 117 (62.6%) were admitted to hospital and the case fatality rate was 28.3%. Significant predictors of infection included in-centre hemodialysis versus home dialysis (odds ratio [OR] 2.54, 95% confidence interval [CI] 1.59-4.05), living in a long-term care residence (OR 7.67, 95% CI 5.30-11.11), living in the Greater Toronto Area (OR 3.27, 95% CI 2.21-4.80), Black ethnicity (OR 3.05, 95% CI 1.95-4.77), Indian subcontinent ethnicity (OR 1.70, 95% CI 1.02-2.81), other non-White ethnicities (OR 2.03, 95% CI 1.38-2.97) and lower income quintiles (OR 1.82, 95% CI 1.15-2.89).

INTERPRETATION:

Patients undergoing long-term dialysis are at increased risk of SARS-CoV-2 infection and death from coronavirus disease 2019. Special attention should be paid to addressing risk factors for infection, and these patients should be prioritized for vaccination.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Renal Dialysis / COVID-19 / Hemodialysis Units, Hospital / Kidney Failure, Chronic Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: CMAJ Journal subject: Medicine Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Renal Dialysis / COVID-19 / Hemodialysis Units, Hospital / Kidney Failure, Chronic Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: CMAJ Journal subject: Medicine Year: 2021 Document Type: Article