David A Jaques, Linard Hoessly, Rebecca Guidotti, Michael Koller, Belen Ponte, Patrice Ambuehl
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Cox proportional hazard model was used with all-cause mortality as the primary outcome.</p><p><strong>Results: </strong>The cohort consisted of 7837 patients from 97 dialysis centres. Median age was 68.6 years with 66.1% men. Crude mortality rates were 11.6% (11.0% to 12.2%) and 14.2% (13.4% to 14.9%) person-years for the pre-COVID-19 era and the COVID-19 era, respectively. In multivariable analysis, SARS-CoV-2 infection was associated with an increased risk of mortality (HR 4.26, 95% CI 3.65 to 4.97, <i>P </i>< .001) while the COVID-19 era itself was not (HR 0.98, 95% CI 0.88 to 1.08, <i>P </i>= .687).</p><p><strong>Conclusions: </strong>The COVID-19 era was not associated with an excess of mortality in the Swiss dialysis population as compared to the pre-COVID-19 era when accounting for the direct effect of SARS-CoV-2 infection. This suggests that control measures established during the pandemic did not have a negative impact on dialysis patients at the national level. 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引用次数: 0
摘要
背景:虽然SARS-CoV-2感染对透析患者有直接的明显后果,但COVID-19大流行也对卫生系统产生了间接影响。因此,我们的目的是确定与前COVID-19时代相比,COVID-19时代本身是否与瑞士透析人群的不良后果相关,同时考虑到SARS-CoV-2感染的直接影响。方法:回顾性纳入2014年1月至2022年12月瑞士透析登记处记录的所有患者。新冠疫情前和新冠疫情时期以2020年1月为截止日期。采用Cox比例风险模型,以全因死亡率为主要结局。结果:该队列包括来自97个透析中心的7837名患者。中位年龄为68.6岁,男性占66.1%。新冠肺炎前期和新冠肺炎时期的粗死亡率分别为11.6%(11.0% ~ 12.2%)和14.2%(13.4% ~ 14.9%)人年。在多变量分析中,SARS-CoV-2感染与死亡风险增加相关(HR 4.26, 95% CI 3.65 ~ 4.97, P = 0.687)。结论:考虑到SARS-CoV-2感染的直接影响,与前COVID-19时代相比,COVID-19时代与瑞士透析人群的死亡率增加无关。这表明,在大流行期间制定的控制措施并未对国家一级的透析患者产生负面影响。这些结果可使卫生政策制定者了解未来大流行的可能性。
Mortality associated with the COVID-19 pandemic in the Swiss dialysis population beyond SARS-CoV-2 infection.
Background: While SARS-CoV-2 infection has direct obvious consequences on patients undergoing dialysis, the COVID-19 pandemic also had an indirect impact on health systems. Therefore, we aimed to determine whether the COVID-19 era itself was associated with adverse consequences in the Swiss dialysis population as compared to the pre-COVID-19 era, while accounting for direct impact of SARS-CoV-2 infection.
Methods: We retrospectively included all patients recorded in the Swiss dialysis registry from January 2014 to December 2022. The pre-COVID-19 era and the COVID-19 era were defined based on the cut-off date of January 2020. Cox proportional hazard model was used with all-cause mortality as the primary outcome.
Results: The cohort consisted of 7837 patients from 97 dialysis centres. Median age was 68.6 years with 66.1% men. Crude mortality rates were 11.6% (11.0% to 12.2%) and 14.2% (13.4% to 14.9%) person-years for the pre-COVID-19 era and the COVID-19 era, respectively. In multivariable analysis, SARS-CoV-2 infection was associated with an increased risk of mortality (HR 4.26, 95% CI 3.65 to 4.97, P < .001) while the COVID-19 era itself was not (HR 0.98, 95% CI 0.88 to 1.08, P = .687).
Conclusions: The COVID-19 era was not associated with an excess of mortality in the Swiss dialysis population as compared to the pre-COVID-19 era when accounting for the direct effect of SARS-CoV-2 infection. This suggests that control measures established during the pandemic did not have a negative impact on dialysis patients at the national level. These results could inform health policy makers in the eventuality of future pandemics.
期刊介绍:
About the Journal
Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.