MO844COVID-19 PANDEMIC IN DIALYSIS PATIENTS IN SWITZERLAND

Abstract

Background and AimsCOVID-19 is an infectious disease that can result from infection with the novel coronavirus SARS-CoV-2. The disease, was first described in Wuhan at the end of 2019 and the first case in Switzerland was discovered in February 2020. This analysis gives an overview of dialysis patients in Switzerland that were tested COVID-19 positive.MethodAll dialysis centers reported their cases with COVID-19 to the Swiss dialysis registry srrqap. All patients reported to the registry between March 5 (1st dialysis patient with COVID-19) and June 30, 2020 were included in this analysis and comparisons were made with COVID-19-free dialysis patients (from 2019).ResultsOn March 5, 2020, the first dialysis patient was infected with COVID-19 in Ticino. The number of infected dialysis patients increased rapidly over the months of March and April, with the majority of patients in the cantons of Vaud (23.5%), Ticino (22.3%) and Geneva (18.8%) and together making up almost 65% of the COVID-19-infected dialysis patients in Switzerland. COVID-19 cases represented 2.4% of all prevalent patients on dialysis (as of 31.12.2019).Twenty-seven (12 female, 15 male) out of 93 dialysis patients died, which corresponds to a mortality rate of 29%. Mortality was highest in patients from Switzerland (together with the Netherlands), and lowest in Romania with 8.5% (K. Jager and A. Kramer, submitted for publication, 2020).Mortality was associated with advanced age in dialysis patients. In contrast to the general population, male sex, diabetes and hypertension were no major risk factors for mortality in our cohort.ConclusionAlthough dialysis patients from Switzerland in general have a better survival compared to those from other European countries, infection with COVID-19 in Switzerland results in the highest mortality compared to other European countries in this population. In addition, male sex, diabetes and hypertension seem not to be associated risk factors in our dialysis population.MO844 Table 1.Characteristics (given as mean±SD or percentage) in dialysis patients with COVID-19 and COVID-19-free dialysis patientsWith COVID-19 (n=93)Without COVID-19 (n=4619)p-valueAge, years70.0 ± 15.568.9 ± 14.70.103Male gender, %65.665.20.898Body mass index, kg/m227.3 ± 5.425.9 ± 5.70.228Dialysis vintage, years5.5 ± 12.74.0 ± 4.00.624Dialysis duration per week (h)11.4 ± 1.411.5 ± 1.40.749Kt/V1.55 ± 0.391.59 ± 0.410.259Hemoglobin, g/dL10.9 ± 1.411.1 ± 1.40.506Ferritin, ng/mL507 ± 416510 ± 4340.448Calcium, mmol/L2.21 ± 0.192.22 ± 0.190.822Phosphate, mmol/L1.50 ± 0.461.62 ± 0.480.769PTH, ng/L317.6 ± 238.2369.2 ± 328.40.148Comorbidities, n2.9 ± 2.32.6 ± 2.00.047CCI*4.6 ± 2.24.5 ± 2.20.536Hypertension, %88.283.10.209Diabetes Mellitus, %43.537.70.273Iron substitution, %78.872.70.207EPO substitution, %81.279.70.732MO844 Table 2.Characteristics (given as mean±SD or percentage) in dialysis patients with COVID-19 according to their survival statusNon-Survivors, n=25Survivors, n=60rp-valueAge, years80.1 ± 7.465.1 ± 16.60.000Male gender, %52.071.70.081Body mass index, kg/m228.3 ± 6.426.9 ± 4.90.282Dialysis vintage, years3.7 ± 4.14.2 ± 3.40.798Comorbidities, n3.4 ± 1.72.7 ± 2.40.046CCI*4.9 ± 1.94.5 ± 2.30.341Diabetes, %44.043.30.955Hypertension, %76.093.30.024MO844 Figure 1: Probability of death in dialysis patients in Switzerland