Comparison of Outcomes of In-Centre Haemodialysis Patients between the 1st and 2nd COVID-19 Outbreak in England, Wales, and Northern Ireland: A UK Renal Registry Analysis

Author:

Savino Manuela,Santhakumaran Shalini,Currie Christine S.M.ORCID,Onggo Bhakti S.S.ORCID,Evans Katharine M.,Medcalf James F.,Nitsch Dorothea,Steenkamp Retha

Abstract

<b><i>Introduction:</i></b> This retrospective cohort study compares in-centre haemodialysis (ICHD) patients’ outcomes between the 1st and 2nd waves of the COVID-19 pandemic in England, Wales, and Northern Ireland. <b><i>Methods:</i></b> All people aged ≥18 years receiving ICHD at 31 December 2019, who were still alive and not in receipt of a kidney transplant at 1 March and who had a positive polymerase chain reaction test for SARS-CoV-2 between 1 March 2020 and 31 January 2021, were included. The COVID-19 infections were split into two “waves”: wave 1 from March to August 2020 and wave 2 from September 2020 to January 2021. Cumulative incidence of COVID-19, multivariable Cox models for risk of positivity, median, and 95% credible interval of reproduction number in dialysis units were calculated separately for wave 1 and wave 2. Survival and hazard ratios for mortality were described with age- and sex-adjusted Kaplan-Meier plots and multivariable Cox proportional models. <b><i>Results:</i></b> 4,408 ICHD patients had COVID-19 during the study period. Unadjusted survival at 28 days was similar in both waves (wave 1 75.6% [95% confidence interval [CI]: 73.7–77.5], wave 2 76.3% [95% CI 74.3–78.2]), but death occurred more rapidly after detected infection in wave 1. Long vintage treatment and not being on the transplant waiting list were associated with higher mortality in both waves. <b><i>Conclusions:</i></b> Risk of death of patients on ICHD treatment with COVID-19 remained unchanged between the first and second outbreaks. This highlights that this vulnerable patient group needs to be prioritized for interventions to prevent severe COVID-19, including vaccination, and the implementation of measures to reduce the risk of transmission alone is not sufficient.

Publisher

S. Karger AG

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