Kidney disease is a recognised risk factor for poor COVID-19 outcomes. Up to 30 June 2020, the UK Renal Registry (UKRR) collected data for 2,385 in-centre haemodialysis (ICHD) patients with COVID-19 in England and Wales. Overall unadjusted survival at 1 week after date of positive COVID-19 test was 87.5% (95% CI 86.1–88.8%); mortality increased with age, treatment vintage and there was borderline evidence of Asian ethnicity (HR 1.16, 95% CI 0.94–1.44) being associated with higher mortality. Compared to the general population, the relative risk of mortality for ICHD patients with COVID-19 was 45.4 and highest in younger adults. This retrospective cohort study based on UKRR data supports efforts to protect this vulnerable patient group.

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Background The COVID-19 pandemic is placing a significant strain on healthcare. We conducted a national survey of the UK nephrology workforce to understand its impacts on their working lives. Methods An online questionnaire incorporating the Maslach Burnout Inventory Score was distributed between 31st March and 1st May 2021, with a focus on COVID-19 and long COVID incidence, vaccine uptake, burnout, and working patterns. Data were analysed qualitatively and quantitatively; multivariable logistic regression was used to identify associations. Results 423 responses were received. 29% had contracted COVID-19, more common among doctors and nurses (OR 2.18, 95%CI 1.13–4.22), and those under the age of 55 (OR 2.60, 95%CI 1.38–4.90). 36% of those who contracted COVID-19 had symptoms of long COVID, more common among ethnicities other than White British (OR 2.57, 95% CI 1.09–6.05). 57% had evidence of burnout, more common amongst younger respondents (OR 1.92, 95% CI 1.10–3.35) and those with long COVID (OR 10.31, 95% CI 1.32–80.70). 59% with reconfigured job plans continue to work more hours. More of those working full-time wished to retire early. 59% experienced remote working, with a majority preference to continue this in the future. 95% had received one dose of a COVID-19 vaccine; 86% had received two doses by May 2021. Conclusions Burnout and long COVID is prevalent with impacts on working lives. Some groups more at risk. Vaccination uptake is high, and remote and flexible working were well received. Institutional interventions are needed to prevent workforce attrition.

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Background Chronic kidney disease (CKD) is a recognised risk factor of poor outcomes from COVID-19. Methods This retrospective cohort study used the UK Renal Registry (UKRR) database of people on kidney replacement therapy (KRT) at the end of 2019 in England and who tested positive for SARS-CoV-2 between 01/03/2020 and 31/08/2020, to analyse incidence and outcomes of COVID-19 among different KRT modalities. Comparisons with 2015-2019 mortality data were used to estimate excess deaths. Results 2,783 individuals on KRT tested positive for SARS-CoV-2. Patients from more deprived areas (most deprived vs least deprived HR 1.20, 95% CI 1.04-1.39) and those with diabetes compared to those without (HR 1.51, 95% CI 1.39-1.64) were more likely to test positive. Approximately 25% of in-centre haemodialysis and transplanted patients died within 28 days of testing positive, compared to 36% of those on home therapies. Mortality was higher in those aged ≥80 years compared to those aged 60-79 years (OR 1.71, 95% CI 1.34-2.19) and much lower in those listed for transplantation compared to those not listed (OR 0.56, 95% CI 0.40-0.80). Overall, excess mortality in 2020 for people on KRT was 36% higher than the 2015-2019 average. Excess deaths peaked in April 2020 at the height of the pandemic and were characterised by wide ethnic and regional disparities. Conclusions The impact of COVID-19 on the English KRT population highlights their extreme vulnerability and emphasises the need to protect and prioritise this group for vaccination. COVID-19 has widened underlying inequalities in people with kidney disease making interventions that address health inequalities a priority.