Worldwide Early Impact of COVID-19 on Dialysis Patients and Staff and Lessons Learned: A DOPPS Roundtable Discussion

Abstract

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The COVID-19 Pandemic Identifies Significant Global Inequities in Hemodialysis Care in Low and Lower-Middle Income Countries—An ISN/DOPPS Survey

“…Mortality of HD patients from COVID-19 was subjectively reported but is in line with published literature. [7][8][9][10][11][12][13] In summary, although many global imbalances in dialysis care pre-date the pandemic, striking and unacceptable inequities related to the care of HD patients were identified comparing countries with different income categories. Different restriction to COVID-19 diagnostic testing, availability of PPE for staff, access to ICU care and mechanical ventilation, and poor psychological support for staff during the pandemic clearly exemplify the fragility in HD service delivery across income categories.…”

“…6 The mortality related to Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) infections in patients with kidney failure receiving kidney replacement therapies (dialysis and kidney transplantation) has been significantly higher than the mortality in the general population, ranging from 10-41%. [7][8][9][10][11][12][13] The risk of COVID-19 infection is particularly high in the HD population, due to the need for frequent visits to healthcare settings for treatments, inability to maintain social distancing during transportation and dialysis sessions in some dialysis units. 6,7,14,15 Intrinsically fragile health care systems, lack of diagnostic testing for SARS-CoV-2, low staff numbers with high rates of staff sickness during the pandemic and shortage of personal protective equipment (PPE) have challenged LLMIC since the beginning of the pandemic.…”

Poor neutralization and rapid decay of antibodies to SARS-CoV-2 variants in vaccinated dialysis patients

“…Infection by SARS-CoV-2, the causative agent of the Coronavirus disease-2019 (COVID-19), has posed a new threat for CKD patients, who were found to have a greater risk of severe COVID-19 course [ 3 , 4 ]. Early reports indicated a case fatality ranging from 10 to 30% in patients on hemodialysis (HD) [ 5 – 10 ].…”

Poor neutralization and rapid decay of antibodies to SARS-CoV-2 variants in vaccinated dialysis patients

“…Infection by SARS-CoV-2, the causative agent of the Coronavirus disease-2019 (COVID- 19), has posed a new threat for CKD patients, who were found to have a greater risk of severe COVID-19 course 3,4 . Early reports indicated a case fatality ranging from 10 to 30% in patients on hemodialysis [5][6][7][8][9][10] .…”