• CMAJ · Feb 2021

    COVID-19 in patients undergoing long-term dialysis in Ontario.

    • Leena Taji, Doneal Thomas, Matthew J Oliver, Jane Ip, Yiwen Tang, Angie Yeung, Rebecca Cooper, Andrew A House, Phil McFarlane, and Peter G Blake.
    • 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 (McFarlane), Toronto, Ont.
    • CMAJ. 2021 Feb 22; 193 (8): E278E284E278-E284.

    BackgroundPatients 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.MethodsWe 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.ResultsDuring 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).InterpretationPatients 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.© 2021 Joule Inc. or its licensors.

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