Study: Sudden decrease in hospitalization rates were seen at start of COVID-19 pandemic
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Key takeaways:
- Researchers found all-cause mortality decreased by 15.4% from 2018 to 2023.
- There was a reduction in mortality beginning in 2021 with the availability of COVID-19 vaccines.
SAN DIEGO — Researchers reported a sudden decrease in all-cause hospitalization at the beginning of the COVID-19 pandemic, but there was an increase in all-cause mortality in patients on maintenance dialysis.
Monica Shieu, MS, PhD, of Dialysis Clinic Inc. in Nashville, Tennessee, and colleagues, studied the 4-year impact of the COVID-19 pandemic on the mortality and hospitalization trends in patients on maintenance dialysis, which was presented during a poster session at ASN Kidney Week, here
“While unadjusted all-cause hospitalization and mortality rates from 2018 to 2021 in [the] Dialysis Clinic Inc. cohort are lower than the corresponding national rates reported to date by the [United States Renal Data System] USRDS, the trends are similar. Therefore, subsequent trends in rates observed for 2022 and 2023 may be generalizable to the national dialysis population,” Shieu told Healio.
Shieu and colleagues studied all-cause mortality and all-cause hospitalization rates from 2020 to 2023 as compared with 2018 to 2019 among 41,257 adults on maintenance dialysis at Dialysis Clinic Inc. Researchers defined hospitalization as that occurring within 30 days of COVID-19 diagnosis, and death was defined as occurring within 90 days of COVID-19 diagnosis.
Researchers found all-cause mortality decreased by 15.4% from 2018 to 2023, however, there was a sharp increase in all-cause mortality in March 2020. Results showed mortality peaked the following winter until early 2021.
“Introduction of SARS-CoV-2 vaccines was associated with a marked decline in mortality by early 2021. While COVID-19-related mortality has become uncommon in 2022 to 2023, COVID-19-associated hospitalization persisted in this population. Therefore, we need to maintain updated vaccine status in [end-stage renal disease] ESRD patients to further decrease COVID-19 morbidity,” Shieu said.
Researchers found all-cause hospitalization rates decreased between 2018 and 2023. There was a marked decrease in hospitalization rates at the start of the COVID-19 pandemic, with 1.18 per person-year in March 2020 to 1.01 per person-year in April 2020.
“The non-COVID-19-associated hospitalization and mortality rates have declined since 2020, and both have remained below pre-COVID-19 levels up to the end of the study period in 2023,” Shieu said.
Shieu said future research is warranted on the clinical factors and practices implemented during the COVID-19 pandemic which may have impacted non-COVID-19-related hospitalization and mortality rates.
“We need to maintain updated vaccine status in ESRD patients to further decrease COVID-19 hospitalization and keep COVID-19-associated mortality rates down,” Shieu said.
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Shieu M, et al. Abstract TH-PO1156. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
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