Abstract TU120: MS#1072 Association of chronic kidney disease with COVID-19 disease severity in the Hispanics/Latinos: the HCHS/SOL study

Abstract

Introduction: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in significant morbidity and mortality. Disparities in COVID-19 severity by Hispanic/Latino ethnicity and comorbidities are known, but differences within Hispanic/Latino populations with different chronic kidney disease (CKD) stages are not well-studied. Objective: Conduct longitudinal analysis of CKD with incident COVID-19 infection and related hospitalization or death in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: CKD at HCHS/SOL Visit 2 (2014-2017) was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m 2 or urine albumin to creatinine ratio (ACR) ≥30 mg/g. CKD stages were defined as Stage 1) (G1) eGFR ≥90 and ACR ≥30, 2) (G2) eGFR 60-89 and ACR ≥30, 3) (G3) eGFR 30-59, 4) (G4) eGFR 15-29, and 5) (G5) eGFR ≤15. A composite COVID-19 outcome between 2020-2023 was defined as adjudicated COVID-19 infection, positive SARS-CoV-2 test, positive immunoglobulin G serology, or COVID-related hospitalization or death. Severe COVID-19 was defined as COVID-related hospitalization or death. Odds ratios (OR) were estimated from logistic regression accounting for age, sex, center, Hispanic background, diabetes, hypertension, cardiovascular disease, and the HCHS/SOL’s complex sampling design. Results: At Visit 2, the mean (standard error) age was 47.6 (0.3) years, and 46% were male. Out of 9673 Hispanic/Latinos, 1188 (12%) had prevalent CKD, including 52% G1, 21% G2, 22% G3, 3% G4, and 1% G5. Overall, 18.9% of those with CKD had evidence of COVID-19, compared to 25.0% of non-CKD participants (p = 0.001). Hispanic/Latinos with CKD had a greater percentage of severe COVID-19 (3.2% versus 2.0%; p=0.01). G1 and G5 had the highest percentage of COVID-19 (21.5%) and severe COVID-19 (6.0%), respectively. CKD was not associated with the composite COVID-19 variable (OR 0.80, 95% confidence interval (CI) 0.63, 1.02) or severe COVID-19 (OR 1.04, 95% CI 0.63, 1.72) in adjusted models. Conclusions: CKD was not associated with COVID-19 severity in Hispanics/Latinos, possibly due to older age and more healthcare utilization.