Abstract: SA-OR07
COVID-19 Pandemic Effect on Mortality of Hemodialysis Patients
Session Information
- COVID-19 and Kidney Diseases: Mechanisms and Management
November 05, 2022 | Location: W230, Orange County Convention Center‚ West Building
Abstract Time: 05:24 PM - 05:33 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Zhang, Yan, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Neri, Luca, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
- Carioni, Paola, Fresenius Medical Care Italia SpA, Palazzo Pignano, Lombardia, Italy
- Arkossy, Otto, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Stauss-Grabo, Manuela, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Laukhuf, Frank M., Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
- Stuard, Stefano, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
- Winter, Anke, Fresenius Medical Care Deutschland GmbH, Bad Homburg, Hessen, Germany
Background
COVID-19 was associated with significant excess mortality among dialysis patients. We aimed to assess mortality risk of patients with confirmed COVID-19 infection (COVID-19+) versus other hemodialysis (HD) patients, and its relation to COVID-19 pandemic in general population (GP).
Methods
We included 63,216 HD patients treated in 2019-2020 at NephroCare centers of 23 countries from European Clinical Database (EuCliD®). Mortality risk per calendar month in 2020 was estimated separately for COVID-19+ and other HD patients using Cox regression models, with COVID-19 status as a time-varying covariate and patients per month in 2019 as reference. The correlation between monthly mortality risk and numbers of COVID-19 cases and deaths in GP were evaluated.
Results
Monthly treated patients were 42,000-43,000 (Fig1). In line with two waves of pandemic in GP, two fluctuations of mortality risk were observed for both COVID-19+ and other HD patients (Fig1). Mortality risk of COVID-19+ patients persisted at much higher levels across 2020, with adjusted hazard ratios (HR)>6.5, whereas mortality risk of other HD patients elevated slightly (HRs<1.5) and mainly during the pandemic peak period (Fig1). Correlation of mortality risk with pandemic in GP were higher for other HD patients (spearman correlation coefficients [ρ] of HRs with the numbers of COVID-19 cases/deaths in GP, 0.77/0.44) than for COVID-19+ HD patients (ρ, -0.10/0.42).
Conclusion
COVID-19 pandemic had direct and indirect impact on mortality of HD patients. Potential reasons of increased mortality in patients without confirmed COVID-19 diagnosis could be undertesting or healthcare system capacity constraints. Quantifying the magnitude of pandemics on patients with/without confirmed disease may benefit dialysis clinics to manage patients during critical events.
Funding
- Commercial Support –