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In an analysis of patients on hemodialysis in New York City, there were substantial racial/ethnic disparities in COVID-19 rates that were not explained by neighborhood social vulnerability. The findings appear in an upcoming issue of JASN.

The COVID-19 pandemic has disproportionately affected socially disadvantaged groups, typical doses for doxycycline including Black and Hispanic individuals, those with limited English proficiency, and persons of low socioeconomic status. To examine potential racial/ethnic and socioeconomic disparities in COVID-19 in individuals with kidney failure who are undergoing hemodialysis (which puts them at risk of acquiring COVID-19 because they travel several times each week to receive treatment in a congregate setting), Sri Lekha Tummalapalli, MD, MBA, MAS (Weill Cornell Medicine and The Rogosin Institute) and her colleagues analyzed information on 1,378 patients receiving in-center hemodialysis in New York City between March 1, 2020 and August 3, 2020.

A total of 247 patients (17.9%) developed symptomatic COVID-19. Compared with non- Hispanic White patients, non-Hispanic Black patients and Hispanic patients were 1.76-times and 2.66-times more likely to develop symptomatic COVID-19, respectively, after adjustments. “Racial/ethnic disparities in COVID-19 incidence among patients on hemodialysis largely mirrored community transmission patterns, and likely reflect neighborhood spread to this vulnerable population,” said Dr. Tummalapali.

The investigators found that neighborhood-level social vulnerability factors—such as income, education level, languages spoken, and housing crowding—were associated with COVID-19 incidence among non-Hispanic White patients, but these factors did not explain racial/ethnic disparities. Black and Hispanic patients on hemodialysis faced an excess risk of acquiring COVID-19, regardless of the neighborhood they lived in.

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