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Abstract: TH-PO952

Management and Course of the SARS-CoV-2 Pandemic in a German Dialysis Network

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Krueger, Thilo, DaVita Clinical Research Deutschland GmbH, Düsseldorf, NRW, Germany
  • Kleophas, Werner, DaVita Clinical Research Deutschland GmbH, Düsseldorf, NRW, Germany
Background

The global Covid-19 pandemic is a particular risk for dialysis patients, the Covid-associated mortality of dialysis patients is known to be higher than that of the general population. From the DaVita network, we present the course of SARS-CoV-2 infections from 65 German centers with around 3,300 active dialysis patients and approximately 1,500 employees.

Methods

To reduce the risk of infection, a triage system was introduced, regulating how dialysis patients are treated in the centers. The triage is based on items like clinical symptoms, swab results and contact with confirmed positive individuals and determines further dialysis in isolation. Point-of-care antigen tests were introduced early and routinely used as a screening measure for both dialysis patients and medical staff. Further to general hygiene measures, a traffic light system was implemented depending on the local incidence rate. This provided for further measures such as a ban on visits, cohort isolation, area care and isolated trips to dialysis. The local vaccination status was also recorded in this system.

Results

In general, the course of incidences among patients reflects that of the general population. We recorded the peak incidence of SARS-CoV-2 at the end of 2021. The cumulative total number of patients who tested positive is currently 1545 cases, which corresponds to a rate of around 48% of patients (officially 30.4% in Germany as of April 2022. With regard to the infection rate per center, there are marked differences within the network, ranging from 1% to 65%. The mortality rate from SARS-CoV-2 among dialysis patients who tested positive was 10.2% as of April 2022 (158/1545; currently around 0.5% across Germany). Since 2021, a significantly reduced Covid-associated mortality rate was noticed decreasing continuously from around 23% in August 2021 to 1.5% in April 2022. The infection rate of the staff was around 37.1% (587/1583) in the network. The rate of dialysis patients with at least three vaccinations is currently at 84.9%.

Conclusion

In summary, the measures taken were able to effectively control for the occurrence of infection within the network. The higher incidence rate of Covid infections amongst patients may be due to more frequent routine testing than in the general population. The markedly decreasing Covid-associated mortality is possibly due to vaccinations and the milder omicron variant.