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. 2022 May 25;37(6):1140-1151.
doi: 10.1093/ndt/gfac008.

Recovery of dialysis patients with COVID-19: health outcomes 3 months after diagnosis in ERACODA

Marc H Hemmelder  1 , Marlies Noordzij  2 , Priya Vart  2 , Luuk B Hilbrands  3 , Kitty J Jager  4 , Alferso C Abrahams  5 , David Arroyo  6 , Yuri Battaglia  7 , Robert Ekart  8 , Francesca Mallamaci  9 , Sharon-Rose Malloney  10 , Joao Oliveira  11 , Andrzej Rydzewski  12 , Sivakumar Sridharan  13 , Liffert Vogt  14 , Raphaël Duivenvoorden  3 , Ron T Gansevoort  2 , Casper F M Franssen  2 ; ERACODA Collaborators
Collaborators, Affiliations

Recovery of dialysis patients with COVID-19: health outcomes 3 months after diagnosis in ERACODA

Marc H Hemmelder et al. Nephrol Dial Transplant. .

Abstract

Background: Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis.

Methods: We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression.

Results: In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8-6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome.

Conclusions: Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis.

Keywords: COVID-19; dialysis; functional health status; mental health status; survival.

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Figures

FIGURE 1:
FIGURE 1:
Kaplan–Meier curves presenting cumulative 3-month survival probability (in days) among HD patients with COVID-19.
FIGURE 2:
FIGURE 2:
Flow diagram of hospitalization, ICU admission, vital status and residence at 3 months after a COVID-19 diagnosis.
FIGURE 3:
FIGURE 3:
Functional and mental health status in HD patients at 3 months after a COVID-19 diagnosis, as judged by the treating nephrologist.
See this image and copyright information in PMC

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