Abstract: TH-PO1156
Four-Year Impact of the COVID-19 Pandemic on Mortality and Hospitalization Trends among Patients on Maintenance Dialysis from a National US Dialysis Provider
Session Information
- COVID-19
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Coronavirus (COVID-19)
- 000 Coronavirus (COVID-19)
Authors
- Shieu, Monica, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Li, Nien Chen, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Manley, Harold, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Harford, Antonia, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Hsu, Caroline M., Tufts Medical Center, Boston, Massachusetts, United States
- Weiner, Daniel E., Tufts Medical Center, Boston, Massachusetts, United States
- Miskulin, Dana, Tufts Medical Center, Boston, Massachusetts, United States
- Johnson, Doug, Dialysis Clinic Inc, Nashville, Tennessee, United States
- Lacson, Eduardo K., Dialysis Clinic Inc, Nashville, Tennessee, United States
Background
Longitudinal trends in mortality and hospitalization rates during the COVID-19 pandemic period (2020-2023) vs. prior two years (2018-2019) among patients receiving maintenance dialysis from a national provider were described.
Methods
Adult maintenance dialysis patients at Dialysis Clinic, Inc. between 1/1/2018 to 12/31/2023 were included. Hospitalization stays over two midnights and death events were obtained from electronic medical record. COVID-19 hospitalization and death were defined as within 30 days and 90 days of a COVID-19 diagnosis, respectively.
Results
The study included 41,257 patients. All-cause mortality among prevalent patients receiving dialysis decreased by 15.4%, from 16.9 to 14.3 (per 1000 person-months) between 2018-2023, with a spike in 03/2020 when the pandemic started. Mortality peaked that winter (19.4 per 1000 person-months) until the availability of COVID-19 vaccines in early 2021 (Fig 1a). All-cause hospitalization rates decreased between 2018-2023. There was a sudden drop in hospitalization rates when the pandemic began (1.61 from 01/2018 to 1.18 03/2020 and 1.01 from 04/2020 per person-year); these rates never recovered to the overall rates observed prior to the pandemic (Fig 1b).
Conclusion
The pandemic has impacted mortality and hospitalization rates among patients on maintenance dialysis, with a drastic increase in all-cause mortality vs. a sudden drop in all-cause hospitalization when the pandemic started. All-cause mortality and hospitalization rates, 2018-2021, are lower than the rates in 2023 USRDS. The profound impact of vaccination in reducing severe outcomes from COVID-19 is evident. Strategies to maintain updated vaccination status to prevent COVID-19-related hospitalization and death in this high-risk population are warranted.