Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 May;27(5):410-420.
doi: 10.1111/nep.14016. Epub 2022 Jan 6.

The COVID-19 pandemic and access to health care in people with chronic kidney disease: A systematic review and meta-analysis

Danny Deng  1 , Amy Liang  1 , Juanita N Chui  1 , Germaine Wong  2   3   4 , Tess E Cooper  2   3   5
Affiliations
Meta-Analysis

The COVID-19 pandemic and access to health care in people with chronic kidney disease: A systematic review and meta-analysis

Danny Deng et al. Nephrology (Carlton). 2022 May.

Abstract

Aim: This systematic review aims to evaluate the effect of the COVID-19 pandemic on access to health care for patients with CKD.

Methods: MEDLINE and EMBASE databases were searched up to July 2021 (PROSPERO CRD42021230831). Data relevant to access to health care before and during the COVID-19 pandemic were extracted, including outcomes related to access to general nephrology consultations, telehealth, dialysis services and kidney transplantations. Relative and absolute effects were pooled using a random effects model to account for between-study heterogeneity. Risk of bias was assessed using a modified Quality in Prognostic Studies tool. The certainty of the evidence was rated using the GRADE approach.

Results: Twenty-three studies across five WHO regions were identified. Reductions in transplantation surgeries were observed during the COVID-19 pandemic compared with the pre-COVID-19 era (risk ratio = 2.15, 95%CI = 1.51-3.06, I2 = 90%, p < .001). Additionally, six studies reported increased use of telehealth services compared with pre-COVID-19 times. Four studies found reduced access to in-person general nephrology services and six studies reported interruptions to dialysis services during the COVID-19 pandemic.

Conclusion: Our findings suggest COVID-19 pandemic may have led to reductions in access to kidney transplantation, dialysis and in-person nephrology care. Meanwhile, whilst the use of telehealth has emerged as a promising alternate mode of health care delivery, its utility during the pandemic warrants further investigation. This study has highlighted major barriers to accessing care in a highly vulnerable chronic disease group.

Keywords: COVID-19 pandemic; health care access; telemedicine; transplantation.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

REFERENCES

    1. WHO. Coronavirus disease (COVID-19) weekly epidemiological update and weekly operational update; World Health Organization; 2021.
    1. Gansevoort RT, Hilbrands LB. CKD is a key risk factor for COVID-19 mortality. Nat Rev Nephrol. 2020;16(12):705-706.
    1. COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. Br J Surg. 2020;107(11):1440-1449.
    1. Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.
    1. Hayden JA, van der Windt DA, Cartwright JL, Côté P, Bombardier C. Assessing bias in studies of prognostic factors. Ann Intern Med. 2013;158(4):280-286.

LinkOut - more resources