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Abstract: PO0051

Excess COVID and Non-COVID Mortality Among Patients with ESKD in 2020

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Johansen, Kirsten L., Hennepin Healthcare, Minneapolis, Minnesota, United States
  • Wetmore, James B., Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Weinhandl, Eric D., Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Gilbertson, David T., Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Peng, Yi, Chronic Disease Research Group, Minneapolis, Minnesota, United States
Background

Patients with ESKD are at high risk of mortality from COVID-19. The extent to which increased mortality in the ESKD population in 2020 was related to COVID-19 vs other causes in the setting of disruption of healthcare delivery is not clear.

Methods

We used the Death Notification Form (CMS-2746) to examine excess all-cause and COVID-related mortality in Jan through Aug of 2020 among the whole ESKD population and by race/ethnicity adjusting for age and comorbidity. We further examined causes of non-COVID-related mortality in 2020 compared with 2017-2019.

Results

All-cause mortality increased by 13.1% during Jan-Aug 2020 compared with mortality during the same period in 2017-2019. Peak overall and excess mortality occurred during Apr (Figure), when 14.7% of all deaths were attributed to COVID-19. COVID-related deaths declined to a nadir of 6.2% of all deaths in June and then increased again in Jul and Aug. Excess mortality was approximately twice as high among Black and Hispanic patients as among whites. Between Feb and Apr, there was substantial excess non-COVID mortality in addition to COVID mortality, whereas most excess mortality during May to Aug was related to COVID-19. There were 4310 excess deaths during Feb-Apr 2020. 1576 (37%) were due to COVID-19, and 517 (12%) were attributed to pneumonia. Thus, approximately half of the excess mortality was not due to COVID-19, including 1635 excess deaths due to cardiac arrest, cause unknown.

Conclusion

Patients with ESKD experienced substantial excess mortality in 2020 relative to prior years that affected Black and Hispanic patients disproportionately. Approximately half of the excess mortality was likely caused by COVID-19. There was also excess mortality in the early phase of the pandemic that was not attributed to COVID-19.

Number of overall and COVID-related deaths in 2020 vs 2017-2019

Funding

  • NIDDK Support