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
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
Introduction: this retrospective cohort study compares in-centre haemodialysis (ICHD) patients’ outcomes between the 1st and 2nd wave of the COVID-19 pandemic in England, Wales and Northern Ireland.
Methods: all people aged ≥18 years receiving ICHD at 31/12/2019, who were still alive and not in receipt of a kidney transplant at 1 March and who had a positive polymerase chain reaction (PCR) test for SARS-CoV-2 between 01/03/2020 and 31/01/2021 were included. The COVID-19 infections were split into two ‘waves’: wave1 from March to August 2020, and wave2 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 wave1 and wave2. Survival and hazard ratios for mortality were described with age and sex adjusted Kaplan Meier plots and multivariable Cox proportional models.
Results : 4,408 ICHD patients had COVID-19 during the study period. Unadjusted survival at 28 days was similar in both waves [wave1 75.6% (95% CI 73.7-77.5), wave2 76.3% (95% CI 74.3-78.2)], but death occurred more rapidly after detected infection in wave1. Long vintage treatment and not being on the transplant waiting list were associated with higher mortality in both waves.
Conclusions: 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 prioritised for interventions to prevent severe COVID-19, including vaccination, and the implementation of measures to reduce the risk of transmission alone is not sufficient.
COVID-19, Dialysis, End-stage kidney disease, Haemodialysis, Wave 1 and wave 2
469-480
Savino, Manuela
58303cc2-af76-47df-b895-3d82b6351bc9
Santhakumaran, Shalini
16559d03-d93c-4260-afe9-12a5a18f3d81
Currie, Christine
dcfd0972-1b42-4fac-8a67-0258cfdeb55a
Onggo, Bhakti Stephan
8e9a2ea5-140a-44c0-9c17-e9cf93662f80
Evans, Katharine M.
50bd1013-6fb5-4056-b140-224fd656a381
Metcalf, James F.
238cdd13-a8f2-4430-8d5d-adc060f9247a
Nitsch, Dorothea
2c762df5-7ed0-401a-a759-5d39b8d92e4e
Steenkamp, Retha
57994df9-d520-4a35-9f74-0dd0856b7ba9
1 September 2022
Savino, Manuela
58303cc2-af76-47df-b895-3d82b6351bc9
Santhakumaran, Shalini
16559d03-d93c-4260-afe9-12a5a18f3d81
Currie, Christine
dcfd0972-1b42-4fac-8a67-0258cfdeb55a
Onggo, Bhakti Stephan
8e9a2ea5-140a-44c0-9c17-e9cf93662f80
Evans, Katharine M.
50bd1013-6fb5-4056-b140-224fd656a381
Metcalf, James F.
238cdd13-a8f2-4430-8d5d-adc060f9247a
Nitsch, Dorothea
2c762df5-7ed0-401a-a759-5d39b8d92e4e
Steenkamp, Retha
57994df9-d520-4a35-9f74-0dd0856b7ba9
Savino, Manuela, Santhakumaran, Shalini, Currie, Christine, Onggo, Bhakti Stephan, Evans, Katharine M., Metcalf, James F., Nitsch, Dorothea and Steenkamp, Retha
(2022)
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.
Nephron, 146 (5), .
(doi:10.1159/000523731).
Abstract
Introduction: this retrospective cohort study compares in-centre haemodialysis (ICHD) patients’ outcomes between the 1st and 2nd wave of the COVID-19 pandemic in England, Wales and Northern Ireland.
Methods: all people aged ≥18 years receiving ICHD at 31/12/2019, who were still alive and not in receipt of a kidney transplant at 1 March and who had a positive polymerase chain reaction (PCR) test for SARS-CoV-2 between 01/03/2020 and 31/01/2021 were included. The COVID-19 infections were split into two ‘waves’: wave1 from March to August 2020, and wave2 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 wave1 and wave2. Survival and hazard ratios for mortality were described with age and sex adjusted Kaplan Meier plots and multivariable Cox proportional models.
Results : 4,408 ICHD patients had COVID-19 during the study period. Unadjusted survival at 28 days was similar in both waves [wave1 75.6% (95% CI 73.7-77.5), wave2 76.3% (95% CI 74.3-78.2)], but death occurred more rapidly after detected infection in wave1. Long vintage treatment and not being on the transplant waiting list were associated with higher mortality in both waves.
Conclusions: 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 prioritised for interventions to prevent severe COVID-19, including vaccination, and the implementation of measures to reduce the risk of transmission alone is not sufficient.
Text
Nephron2022PaperTablesFigures
- Accepted Manuscript
More information
Accepted/In Press date: 18 February 2022
e-pub ahead of print date: 30 March 2022
Published date: 1 September 2022
Additional Information:
© 2022 S. Karger AG, Basel.
Keywords:
COVID-19, Dialysis, End-stage kidney disease, Haemodialysis, Wave 1 and wave 2
Identifiers
Local EPrints ID: 455979
URI: http://eprints.soton.ac.uk/id/eprint/455979
ISSN: 1660-8151
PURE UUID: 3f19114d-40da-435a-8e53-0ad5f67fe9a2
Catalogue record
Date deposited: 11 Apr 2022 17:07
Last modified: 17 Mar 2024 03:54
Export record
Altmetrics
Contributors
Author:
Manuela Savino
Author:
Shalini Santhakumaran
Author:
Katharine M. Evans
Author:
James F. Metcalf
Author:
Dorothea Nitsch
Author:
Retha Steenkamp
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics
