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Official publication of the Indian Society of Nephrology
 
ORIGINAL ARTICLE
Ahead of Print

From infection to immunity - Impact of COVID-19 across nine hemodialysis centres in Mumbai


1 Apex Kidney Care; Apex Kidney Foundation; Sushrut Hospital and Research Centre; Bombay Hospital and Research Centre, Mumbai, Maharashtra, India
2 Apex Kidney Care; Apex Kidney Foundation; PD Hinduja Hospital and Research Centre, Mumbai, Maharashtra, India
3 Apex Kidney Care; Apex Kidney Foundation; Bombay Hospital and Research Centre, Mumbai, Maharashtra, India
4 Apex Kidney Care; Apex Kidney Foundation; LH Hiranandani Hospital, Mumbai, Maharashtra, India
5 Apex Kidney Care; Apex Kidney Foundation; Sushrut Hospital and Research Centre, Mumbai, Maharashtra, India
6 University of Pittsburgh Medical Center, Pittsburgh, USA

Correspondence Address:
Viswanath Billa,
Assoc. Professor of Nephrology, Director, Apex Kidney Care, R. No 6, 2 Floor, New Wing, Bombay Hospital, New Marine Lines, Mumbai - 4000020, Maharashtra
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_361_20

Introduction: There are several studies of symptomatic hemodialysis patients with proven COVID-19 infection. However, there is paucity of data on asymptomatic COVID-19 infection in the outpatient hemodialysis population. The true prevalence and transmission of this infection in hemodialysis centres is unknown. This study was conducted across hemodialysis centers by testing all patients and staff for COVID-19 PCR and later for IgG antibody, irrespective of their symptoms. Methods: All 705 hemodialysis patients and 103 dialysis staff across nine centres, were tested for COVID-19 over a period of 54 days of the pandemic, and for COVID IgG antibody of available enrolled staff and patients, after 8 weeks of study termination. Results: The period prevalence of infection in patients and staff was 7.1% and 14.6% respectively. Mortality in patients was 18%, and all staff recovered. Clustering of patients and staff occurred at 3 of 9 centers. Of 26 HIV positive patients, only one contracted the COVID-19 infection and has recovered. Of those infected, seroconversion occurred in 80% of patients and 83% of staff. Seroconversion also occurred in 16% of patients and 37% of staff, who were asymptomatic and COVID PCR negative during the study period. Conclusions: Testing a patient only when symptomatic, identified only 26% (13/50) of infected patients. For every single symptomatic patient who tested positive, there were 3 other asymptomatic infected ones. There was a high seroconversion rates in infected subjects. But antibodies also developed in asymptomatic subjects, indicating silent transmission and antibody generation in this population.


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Indian Journal of Nephrology
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Online since 20th Sept '07