Abstract
BackgroundInfection with the severe acute respiratory coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic with coronavirus disease 2019 (COVID-19), the disease caused by SARS-CoV-2, overwhelming healthcare systems globally. Preliminary reports suggest a high incidence of infection and mortality with SARS-CoV-2 in patients receiving kidney replacement therapy (KRT). The aims of this study are to report characteristics, rates and outcomes of all patients affected by infection with SARS-CoV-2 undergoing KRT in Scotland.MethodsStudy design was an observational cohort study. Data were linked between the Scottish Renal Registry, Health Protection Scotland and the Scottish Intensive Care Society Audit Group national data sets using a unique patient identifier (Community Health Index (CHI)) for each individual by the Public Health and Intelligence unit of Public Health, Scotland. Descriptive statistics and survival analyses were performed.ResultsDuring the period 1st March 2020 to 31st May 2020, 110 patients receiving KRT tested positive for SARS-CoV-2 amounting to 2% of the prevalent KRT population. Of those affected, 86 were receiving haemodialysis or peritoneal dialysis and 24 had a renal transplant. Patients who tested positive were older and more likely to reside in more deprived postcodes. Mortality was high at 26.7% in the dialysis patients and 29.2% in the transplant patients.ConclusionThe rate of detected SARS-CoV-2 in people receiving KRT in Scotland was relatively low but with a high mortality for those demonstrating infection. Although impossible to confirm, it appears that the measures taken within dialysis units coupled with the national shielding policy, have been effective in protecting this population from infection.
Highlights
Infection with the severe acute respiratory coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic with coronavirus disease 2019 (COVID-19), the disease caused by SARS-CoV-2, overwhelming healthcare systems globally
The rate of detected SARS-CoV-2 in people receiving kidney replacement therapy (KRT) in Scotland was relatively low but with a high mortality for those demonstrating infection. It appears that the measures taken within dialysis units coupled with the national shielding policy, have been effective in protecting this population from infection
Characteristics of SARS-CoV-2 positive patients As of 31st May 2020, 876 patients receiving KRT had been tested for SARS-CoV-2 infection
Summary
Infection with the severe acute respiratory coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic with coronavirus disease 2019 (COVID-19), the disease caused by SARS-CoV-2, overwhelming healthcare systems globally. Preliminary reports suggest a high incidence of infection and mortality with SARS-CoV-2 in patients receiving kidney replacement therapy (KRT). Infection with the severe acute respiratory coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic with COVID-19, the disease caused by SARS-CoV-2, overwhelming healthcare systems globally [1]. Patients receiving kidney replacement therapy (KRT) are a vulnerable population as those receiving dialysis are usually older with significant co-morbidity, have impaired immune responses [3] and require regular attendance at a healthcare facility which further increases their risk of exposure. Patients requiring KRT often have multiple comorbid conditions which are widely documented as increasing the risk of death from COVID-19 such as older age, chronic conditions such as diabetes mellitus and hypertension [12, 13] but may be at additional risk due to the relatively impaired immune response associated with kidney failure
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