COVID-19 Management in New York City Kidney Transplant Recipients: Before and After the Apex

Background: It is reported that patients of BAME origin are at greater risk of infection and death due to COVID-19 We describe outcomes in an inner city, ethnically diverse in-centre haemodialysis (HD) population during the pandemic Methods: A total of 1253 patient electronic records were analysed retrospectively 207 infections were recorded -197 patients tested positive for Sars-Cov-2 on validated nasopharyngeal PCR analysis and 10 patients included due to high clinical suspicion Ethnicity data is self-reported All COVID-19 positive patients were isolated for subsequent dialysis sessions Whole-cohort screening confirmed the rates of infection Results: Overall rate of infection amongst the group was 16 5% (n=207), hospitalisation 7 5% (n=94) and death 3 5% (n=44) Within COVID-19 infections, hospitalization rate was 45% and mortality 21% Seven patients received critical care and two were intubated Ethnicity data are shown in table 1: There was no significant difference in rates of COVID infection between ethnic groups The risk of infection in BAME patients was not significantly greater than in white patients (p=0 24, OR 0 79, 95%CI 0 55-1 14) The mean age of those who died from COVID did not differ from the entire cohort (62 vs 63 2 years) Males made up the majority of both the baseline cohort (61 2%) and those infected with COVID (58 5%) 71% of those who died were male Body mass index did not differ between the group as a whole and those infected with COVID Rates of diabetes mellitus did not differ significantly between those infected with COVID and those who died Conclusions: We have defined COVID infections and outcomes within a real-life, large haemodialysis population Hospitalisation and mortality rates were high, and patients self-reporting as black or Asian were over-represented in the infected group compared to the baseline prevalent HD population Higher rates of death were observed in black and asian groups but conclusions are limited by small numbers Larger collaborative studies are required to expand on these findings