COVID-19 Infection in ESKD: Findings from a Prospective Disease Surveillance Program at Dialysis Facilities in New York City and Long Island

COVID-19 Among US Dialysis Patients: Risk Factors and Outcomes From a National Dialysis Provider

“…Similar to other studies, 17,19 about 60% of COVID-positive dialysis patients have been hospitalized, translating to a need for adequate resource planning for in-hospital dialysis equipment, consumables, and staffing to minimize strain, particularly given the associated system strain with the high incidence of acute kidney injury requiring dialysis among critically ill COVID-19 patients. With admissions averaging eleven days' duration in an already-frail J o u r n a l P r e -p r o o f population, a number of patients may be expected to need rehabilitation; therefore coordination among hospitals, dialysis centers, rehabilitation facilities and long-term care facilities is critical to avoid medical errors and readmissions.…”

“…Lastly, this study and others demonstrate that mortality exceeds 20% among maintenance dialysis patients. [17][18][19]28,29 Therefore discussions around advance care planning should be considered to avoid aggressive medical therapy when it is incongruent with one's life goals and values; this is particularly true of those with advanced age and with other indicators of frailty, which were associated with mortality in our study. The appropriate planning for and implementation of palliative care and hospice is critical in this population, particularly with the devastating impact of acute illnesses like COVID-19.…”

“…[9][10][11][12] Studies in China, Italy, the UK, New York, and southern California show that maintenance dialysis patients with COVID-19 experience higher mortality and more severe disease compared to the general population. [13][14][15][16][17][18][19] In the latest United States Renal Data Systems Annual Report, approximately 524,000 patients were receiving dialysis in the country as of 2017, constituting a large at-risk population. 11 By June of 2020, the Centers for Medicare & Medicaid Services reported a COVID-19 prevalence of 3.8% in the dialysis population, 20 but further characterization is needed.…”

Panic in the Pandemic: When Should Kidney Transplant Programs Close?

“…Since infection rates might be higher in ESKD patients, this increase in risk was taken into account. 15,16,17 • In-hospital nosocomial: Spread from medical personnel or undiagnosed patients is a potential source of infection. This is also likely related to the general population incidence as well as hospital resources and practice.…”

Erfahrungen aus dem deutschen COVID-19-Register

“…Auch nach Adjustierung für demographische Angaben und Komorbiditäten bestand das erhöhte Mortalitätsrisiko für Dialysepatienten fort [ 5 ]. Lokale Registerstudien aus Europa oder den USA haben eine Mortalität der SARS-CoV-2-infizierten dialysepflichtigen Patienten von 24–40 % berichtet [ 6 – 10 ]. Eine nationale Registerstudie aus Frankreich beschreibt eine Mortalität von 21 % bei Dialysepatienten mit SARS-CoV-2-Infektion, während die Prävalenz der Erkrankung in den verschiedenen Regionen zwischen 1 und 10 % stark variierte [ 11 ].…”