Distribution of SARS-COV-2 positive tests, dialysis stations, and household poverty within cook county, Illinois

Background: End stage renal disease (ESRD) shows higher prevalence in poor urban communities, areas with high SARS-CoV-2 exposure risk This ecological analysis examined the correlation of SARS-CoV-2 positive tests per capita with number of dialysis stations, demographics and income data of the residents within ZIP codes (n=163) in Cook County, Illinois Methods: Data on SARS-CoV-2 positive tests per capita within a ZIP code were merged with ZIP code data on number of dialysis stations (sum of dialysis stations per dialysis center), demographics and household income, during a period from January 21-May 16, 2020 in Cook County (5,231,852 residents) Spearman's rank correlation coefficients were calculated to examine the linear correlation of SARS-CoV-2 positive tests per capita with dialysis stations, demographics and household poverty We mapped SARS-CoV-2 positive tests per capita and total dialysis stations by ZIP code in Cook County Results: Positive tests per capita correlated significantly with number of dialysis stations (r = 0 23;95% CI 0 18, 0 28;P < 0 005), number of households living in poverty (r= 0 58;95% CI 0 54, 0 61;P < 0 005) and percentage of residents reporting Black race (r = 0 34 p < 0 005, CI = 0 30, 0 39) or Hispanic ethnicity (r = 0 60 p < 0 001, CI: 0 57- 0 63) Figure 1 show several areas within Cook County with both high number of SARSCoV- 2 tests per capita and number of dialysis stations Conclusions: SARS-CoV-2 tests per capita correlates positively with number of dialysis stations, and poverty status of that ZIP code These findings highlight the high risk of SARS-CoV-2 exposure for patients with ESRD living in poor urban areas