COVID-19 incidence and outcomes among patients with kidney replacement therapy

Abstract

Background: We aimed to investigate the incidence, fatality, and associated factors in patients with hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT) hospitalized for coronavirus disease 2019 (COVID-19) infection and reimbursed from the National Health Security Office (NHSO). Methods: The retrospective cohort analysis was conducted from an electronic-claimed database, and COVID-19 vaccination status was evaluated in patients with HD, PD, and KT from January 2020 to December 2021. There were 85,305 patients reimbursed for HD, PD, and KT by the NHSO. The rates of COVID-19 infection, COVID-19 vaccination, comorbidities, fatalities, and the cost of treatment were evaluated. Results: COVID-19 infection was observed in 1,799 of 36,982 HD cases (4.9%), 1,531 of 45,453 PD cases (3.4%), and 95 of 2,870 KT cases (3.3%). Patients receiving COVID-19 vaccinations were most common in the KT group, followed by those with HD and PD (76.93% vs. 70.65% vs. 51.34%, respectively). KT patients had a lower fatality rate compared to those with PD and HD (8.42% vs. 18.41% vs. 21.40%, respectively). Advanced age, diabetes, cardiovascular diseases, and COVID-19 vaccination status were associated with fatality. The adjusted odds ratios of fatality after receiving one or two doses of vaccines were 0.7 (95% confidence interval [CI], 0.6–0.9) and 0.3 (95% CI, 0.2–0.4), respectively. The cost of treatment was highest in patients with HD, followed by PD and KT. Conclusion: The incidence of COVID-19 infection was higher in patients with HD than in those with PD or KT. COVID-19 vaccination following the national health policy should be encouraged for these patients to prevent fatality.

Comparative analysis of the incidence and mortality of COVID-19 in Korean end-stage kidney disease patients: hemodialysis, peritoneal dialysis, and transplantation

“…This study did not find significant differences in the risk of death from COVID-19 between HD and PD patients. In Thailand, HD patients tended to have a higher mortality rate compared with PD patients, but the difference was not significant [14]. Although the PD group was likelier to stay at home and maintain social distancing, age and comorbidities may have impacted patient mortality more than the dialysis modality.…”

“…A United States study of 28,503 randomly selected patients from approximately 1,300 dialysis facilities found a SARS-CoV-2 seroprevalence of 9.3%, with an estimated seropositivity of 9.2% in the adult population of the United States at the same time [13]. Meanwhile, a nationwide cohort study in Thailand reported that the overall incidence of COVID-19 infection in patients with kidney replacement therapy (HD, PD, and KT) was 4% which is similar to the rate of 3.4% for the general population [14]. In this study, the COVID-19 infection rates for HD and PD patients were 1.3% and 1.2%, respectively, similar to the 1.22% infection rate for the general population in Korea reported by the Korea Disease Control and Prevention Agency [15].…”

“…A recent COVID-19 surveillance report on renal in the United Kingdom found that cumulative COVID-19 cases were also higher in HD patients treated in centers than in HD patients treated at home (40.4% vs. 14.4%) [26]. The Thailand national cohort also showed that patients with HD had a higher chance of COVID-19 infection than those with PD [14]. Similarly to other studies, we found that the incidence of COVID-19 was lower in patients with PD than in patients with HD.…”

COVID-19 infection in patients with end-stage kidney disease undergoing renal replacement therapies in Korea

“…Over the past 4 years since the outbreak began, many studies have been conducted on COVID-19. However, Korean data comparing the incidence and outcomes of COVID-19 based on RRT modality in patients with kidney failure are lacking [8,9]. Here, we aimed to analyze COVID-19 incidence and COVID-19-related hospitalization and mortality rate based on RRT modality in patients with ESKD.…”