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. 2023 Sep;42(5):649-659.
doi: 10.23876/j.krcp.22.240. Epub 2023 Sep 27.

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

Siribha Changsirikulchai  1 , Pornpen Sangthawan  2 , Jirayut Janma  1 , Songyos Rajborirug  3 , Thammasin Ingviya  4
Affiliations

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

Siribha Changsirikulchai et al. Kidney Res Clin Pract. 2023 Sep.

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.

Keywords: COVID-19; Dialysis; Kidney transplantation; Peritoneal dialysis; Renal dialysis; Renal replacement therapy.

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Conflict of interest statement

Conflicts of interest

Siribha Changsirikulchai reports receiving a speaker honorarium from Baxter Healthcare and Fresenius Medical Care, as well as a fee paid by the George Institute for Global Health for serving on their clinical advisory board of Ellen Medical Devices. We would also like to report grants from the Health Systems Research Institute outside of the submitted work. Pornpen Sangthawan reports receiving a speaker honorarium from Baxter Healthcare. Thammasin Ingviya reports having research and workshop grant support from the National Institutes of Health (NIH) (grant No. D43TW009522) for research and training on epidemiology related to TB infection. There are no conflicts of interest related to this research.

Figures

Figure 1.
Figure 1.. Percentage of patients with different types of kidney replacement therapy receiving COVID-19 vaccination and becoming infected with COVID-19.
p < 0.001 compared between HD and PD. COVID 19, coronavirus disease 2019; HD, hemodialysis; KT, kidney transplantation; PD, peritoneal dialysis.
None
See this image and copyright information in PMC

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