Outcomes of COVID-19 in peritoneal dialysis patients: A report by the European Renal Association COVID-19 Database. Issue 1 (January 2023)

• Record Type: Journal Article
• Authors: Abrahams, Alferso C; Noordzij, Marlies; Goffin, Eric; Sanchez, J Emilio; Franssen, Casper FM; Vart, Priya; Jager, Kitty J; van Agteren, Madelon; Covic, Adrian; Mitra, Sandip; Basile, Carlo; Konings, Constantijn; Hemmelder, Marc H; Duivenvoorden, Raphaël; Hilbrands, Luuk B; Gansevoort, Ron T
• Is Part Of: Peritoneal dialysis international. Volume 43:Issue 1(2023)
• Page Start: 23
• Page End: 36
• Publication Date: 2023-01
• Subjects: COVID-19 -- functional health status -- mental health status -- peritoneal dialysis -- survival; Peritoneal dialysis -- Periodicals; Continuous ambulatory peritoneal dialysis -- Periodicals; 617.461059
• DOI: 10.1177/08968608221144395
• Languages: English
• ISSNs: 0896-8608

Abstract

Background: The clinical course of COVID-19 in peritoneal dialysis (PD) patients has so far only been analysed in relatively small, often single-centre case series. Therefore, we studied patient- and disease-related characteristics and outcomes of COVID-19 in a larger European cohort of PD patients. Methods: We used data from the European Renal Association COVID-19 Database (ERACODA) on PD and haemodialysis (HD) patients with COVID-19 (presentation between February 2020 and April 2021). Hazard ratios (HR) for mortality at 3 months were calculated using Cox proportional-hazards regression. In addition, we examined functional and mental health status among survivors at this time point as determined by their treating physician. Results: Of 216 PD patients with COVID-19, 80 (37%) were not hospitalised and 136 (63%) were hospitalised, of whom 19 (8.8%) were admitted to an intensive care unit. Mortality at 3 months for these subgroups was 18%, 40%, and 37%, respectively ( p = 0.0031). Compared with HD patients, PD patients had higher mortality (crude HR: 1.49; 95% CI: 1.33–1.66), even when adjusted for patient characteristics and disease severity (adjusted HR: 1.56; 95% CI: 1.39–1.75). Follow-up data on 67 of 146 patients who survived COVID-19 showed functional recovery to pre-COVID-19 levels in 52 (78%) and mental recovery in 58 patients (87%) at 3 months after the COVID-19 diagnosis. Conclusion: The mortality rate in the first 3 months after presentation with COVID-19 is high, especially among PD patients who were hospitalised. PD patients with COVID-19 had a higher mortality risk than HD patients. The majority of surviving patients recovered both functionally and mentally from COVID-19 within 3 months.