The High Mortality and Impact of Vaccination on COVID-19 in Hemodialysis Population in India During the Second Wave

Yadav, Ashok; Sankarasubbaiyan, Suresh; Bg, Mallikarjuna Gowda; Shah, Kamal D.; Jha, Vivekanand

doi:10.1016/j.ekir.2021.08.004

Cited by 11 publications

(9 citation statements)

References 2 publications

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“…In a large retrospective cohort of 15244 HCWs conducted during the delta variant (B.1.617.2) predominant months of March to June 2021 in North India, recipients of 2 doses of Covaxin were found to have higher protection against symptomatic and asymptomatic reinfection [23] . In a cohort of patients on haemodialysis during the months of March to June 2021, patients who received at least one dose of either Covishield or Covaxin had a 46% (95% CI: 17%-62%) lower risk of mortality due to COVID 19 infection on adjusted models [24] .…”

Section: Discussionmentioning

confidence: 99%

Impact of prior vaccination with CovishieldTM and Covaxin® on mortality among symptomatic COVID-19 patients during the second wave of the pandemic in South India during April and May 2021: a cohort study

Abhilash¹,

Mathiyalagan²,

Krishnaraj³

et al. 2022

Vaccine

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Background COVID-19 vaccines were authorised for emergency use to mitigate the impact of the pandemic. This study evaluated the effect of prior vaccination with either Oxford Astra Zeneca’s Covishield TM or Bharath Biotech’s Covaxin® on mortality among symptomatic COVID-19 patients during the second wave of the pandemic in India. Methodology In this cohort study comprising of RT-PCR confirmed symptomatic COVID-19 patients presenting during April and May 2021, the effect of prior vaccination on mortality (primary outcome), need for hospitalization, oxygen therapy, non-invasive ventilation (NIV) and intensive care unit (ICU) admission were assessed and expressed as risk ratio (RR) with 95% confidence intervals (CI). Results The mean (SD) age of the cohort (n=4183) was 46.3 (15.5) years; 17.9% (748/4183) had received at least one dose of Covishield TM and 4.8% (201/4183) had received Covaxin®. Mortality was 0.2% (95% CI: -0.2% - 0.7%), 3.5% (1.9% - 5.2%), 6.2% (0.3% - 12%) and 12.9% (11.8% - 14.1%) among fully vaccinated (>2 weeks after two doses), partially vaccinated (>2 weeks after one dose or <2 weeks after two doses), indeterminate (<2 weeks after one dose) and unvaccinated patients respectively. The difference in mortality among unvaccinated vs. fully vaccinated was 12.7% (95% CI: 11.4% - 13.9%), unvaccinated vs. partially vaccinated was 9.4% (7.4% - 11.4%) and unvaccinated vs. indeterminate vaccinated was 6.8% (0.8% - 12.7%). On adjusted analysis, as compared to unvaccinated patients, at least one dose of vaccine reduced the need for hospitalization (RR: 0.40; 95% CI: 0.35 - 0.47), oxygen (0.33; 0.27 - 0.40), NIV (0.23; 0.17 - 0.32), ICU admission (0.18; 0.12 - 0.27) and mortality (0.18; 0.11 - 0.29). Conclusion Among symptomatic COVID-19 patients, prior vaccination with Covishield TM or Covaxin® impacted the severity of illness and reduced mortality during a period of widespread delta variant circulation. Full vaccination conferred greater protection than partial vaccination.

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Section: Discussionmentioning

confidence: 99%

Impact of prior vaccination with CovishieldTM and Covaxin® on mortality among symptomatic COVID-19 patients during the second wave of the pandemic in South India during April and May 2021: a cohort study

Abhilash¹,

Mathiyalagan²,

Krishnaraj³

et al. 2022

Vaccine

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“…This may be related to the younger age, lower comorbidity burden, and possibly high rates of symptomatic and subclinical infection. Vaccination effectively prevents severe disease and death even after one dose of the vaccine,[ 56 ] thus wider vaccine coverage in patients with kidney disease is needed.…”

Section: Vaccinationmentioning

confidence: 99%

COVID-19: A nephrologists' perspective

Jamale

Thakare

2022

Journal of Postgraduate Medicine

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“…PD is cost saving in most global settings and recommended by professional societies, including the International Society of Nephrology (ISN) [ 3 ]. Further, while patients receiving in-center HD were 5–20 times more likely to be infected with severe acute respiratory syndrome coronavirus 2 compared with the age-matched general population, the risk for PD patients was the same as the general population [ 4–7 ].…”

Section: Introductionmentioning

confidence: 99%

Peritoneal catheter insertion: combating barriers through policy change

Jha

Abrahams

Al-Hwiesh

et al. 2022

Clinical Kidney Journal

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Barriers to accessing home dialysis became a matter of life and death for many patients with kidney failure during the COVID-19 pandemic. Peritoneal Dialysis (PD) is the more commonly used home therapy option. This paper provides a comprehensive analysis of PD catheter insertion procedures as performed around the world today, barriers impacting timely access to the procedure, the impact of COVID-19, and a roadmap of potential policy solutions. To substantiate the analysis, the paper includes a survey of institutions across the world, with questions designed to get a sense of the regulatory frameworks, barriers to conducting the procedure, and impacts of the pandemic on capability and outcomes. Based on our research, we found that improving patient selection processes, determining and implementing correct insertion techniques, creating multidisciplinary teams, providing appropriate trainings, and sharing decision-making among stakeholders will improve access to PD catheter insertion and facilitate greater uptake of home dialysis. Additionally, on a policy level, we recommend efforts to: improve the awareness and feasibility of PD among patients and the health care workforce; enhance and promulgate trainings for clinicians – both surgical and medical – to insert PD catheters; and fund personnel, pathways and physical facilities for PD catheter insertion.

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The High Mortality and Impact of Vaccination on COVID-19 in Hemodialysis Population in India During the Second Wave

Cited by 11 publications

References 2 publications

Impact of prior vaccination with CovishieldTM and Covaxin® on mortality among symptomatic COVID-19 patients during the second wave of the pandemic in South India during April and May 2021: a cohort study

Impact of prior vaccination with CovishieldTM and Covaxin® on mortality among symptomatic COVID-19 patients during the second wave of the pandemic in South India during April and May 2021: a cohort study

COVID-19: A nephrologists' perspective

Peritoneal catheter insertion: combating barriers through policy change

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