COVID-19 Antibodies and Outcomes Among Outpatient Maintenance Hemodialysis Patients

Background: Maintenance hemodialysis patients are particularly vulnerable to infection and hospitalization with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Due to immunocompromise and clustering in outpatient dialysis units, the seroprevalence of COVID-19 antibodies in this population is unknown and has significant implications for public health. Little is also known about their risk factors for hospitalization. Methods: Three outpatient maintenance hemodialysis units affiliated with a major teaching hospital in the New York area were studied. We determined rates of SARS-CoV-2 nasopharyngeal real-time reverse transcriptase polymerase chain reaction (RT-PCR) positivity, SARS-CoV-2 IgG seropositivity, hospitalization, and mortality. Results: Of 367 patients, 28.3% had either SARS-CoV-2 seropositivity or PCR positivity. Prevalence across the three units was 6.7%, 32.3%, and 69.6%. Those who were either antibody or PCR positive were significantly younger (65 vs 69 years, p=0.046), and had higher prevalence of black race (43.3% vs 29.7%, p = 0.001) and Hispanic ethnicity (31.7% vs 11.8%, p