26 Sep COVID-19: Survey of Dialysis Population Shows Higher Prevalence Among Poor and Minority Patients

MedicalResearch.com Interview with:

Dr. Anand

Shuchi Anand M.D. M.S.
Director of the Center for Tubulointerstitial Kidney Disease
Stanford University

MedicalResearch.com: What is the background for this study?

Response: Seroprevalence (or presence of antibodies in response to SARS CoV-2) is considered by many experts to be the most complete to track the spread of COVID19 in communities. However seroprevalence studies are hard to conduct, because they require going into communities and underdoing random blood draws. Many people—especially racial and ethnic minorities, or people with underlying health conditions, or people with language barriers—may be hard to reach for these types of surveys. Plus outreach into communities is very difficult in light of the COVID19 pandemic.

To mitigate this problem we worked with a random sample of 28,503 patients on hemodialysis, the vast majority of whom are covered by Medicare. They get their blood drawn monthly, as part of their routine care. Furthermore even though we used a random sample, we know that patients on dialysis are more likely to be racial and ethnic minorities, and more likely to come from disadvantaged backgrounds. 

MedicalResearch.com: What are the main findings?

Response: We find that in this sample of patients receiving dialysis and living in 46 states within the U.S., 8% of patients overall have evidence of SARS CoV2 antibody as of July. When standardized to the adults living in the U.S. in general, 9% are estimated to have evidence of SARS CoV2 antibody in July. As of July, the highest seroprevalence existed in the Northeast Region (27.1%) and the lowest in the West (3.5%) of US.

People who identify as Black or Hispanic, or live in neighborhoods (defined by zipcodes) where more than 60% of people identify as Black or Hispanic people had 2-4 fold higher antibody prevalence. People who live in highly population dense neighborhoods, or areas of high poverty also had 2-4 fold higher antibody prevalence.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

1. Surveying seroprevalence (antibodies) in patients on hemodialysis can help to track the spread of COVID19 in the U.S., and in other countries which undertake routine laboratory examinations of patients on dialysis.
2. Understanding seroprevalence, and trends in seroconversion, will be key to studying the effects of any prevention strategies and interventions, even for understanding vaccine effectiveness. 

No disclosures relevant to this work, except as listed in the manuscript

Citation:

Prevalence of SARS-CoV-2 antibodies in a large nationwide sample of patients on dialysis in the USA: a cross-sectional study
Anand, Shuchi et al.
The Lancet, Volume 0, Issue 0

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Last Updated on September 26, 2020 by Marie Benz MD FAAD