ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-OR07

COVID-19 Pandemic Effect on Mortality of Hemodialysis Patients

Session Information

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