Article Figures & Data
Figures
- Figure 1.
Cumulative incidence of SARS-CoV-2 infection. Cumulative incidence of SARS-CoV-2 infection in the adult general population (gray bars, y axis left), adult patients on hemodialysis (blue line, y axis right), and adult kidney transplant recipients (red line, y axis right) in the Flemish region from March 2 to May 25, 2020. Implementation of general lockdown (yellow star, March 14), start of routine screening of all nursing home inhabitants (blue triangle, April 8), initial phase of the exit strategy with reopening of commercial activity (purple bar, May 11), and partial reopening of schools and resumption of daily life and gatherings (red crescent, May 18) are shown. Patients on peritoneal dialysis are not shown.
- Figure 2.
All-cause mortality in adult patients on hemodialysis. Periodic all-cause mortality stratified by age group in adult patients on hemodialysis, expressed as percentage of total number of patients on hemodialysis at risk. Mortality in patients with (orange bars) and without (red bars) diagnosis of SARS-CoV-2 infection during the study period (March 2 to May 25; week 10 to week 21) in 2020 was compared with mortality during the same period in 2015–2019 (gray bars).
- Figure 3.
Excess all-cause mortality in adult patients on hemodialysis. All-cause mortality, expressed as percentage of deaths per week from week 1 to week 21, in adult patients on hemodialysis without (red bars) and with (orange bars) diagnosis of SARS-CoV-2 infection in 2020 compared with the mean and 95% confidence limits (blue line and dotted blue lines, respectively) for that week during the period 2015–2019.
- Figure 4.
Excess all-cause mortality in the adult general population. All-cause mortality, expressed as absolute number of deaths per week from week 1 to week 21, in the adult general population without (green bars) and with (orange bars) diagnosis of SARS-CoV-2 infection in 2020 compared with the mean and 95% confidence limits (blue line and dotted blue lines, respectively) of the period 2015–2019.
Tables
- Table 1.
Cumulative incidence of SARS-CoV-2 infection in adult patients on hemodialysis, kidney transplant recipients, and the general population on May 25, 2020: Crude
Population Patients on Hemodialysis Kidney Transplant Recipients General Population Positive/Total % Positive/Total % Positive/Total % Total 228/4297 5.31 46/3293 1.40 30,514/4,797,394 0.64 Age, yr 25–44 5/191 2.62 6/445 1.35 6755/1,647,317 0.41 45–64 38/739 5.14 24/1476 1.63 8950/1,818,562 0.49 65–74 44/917 4.80 11/990 1.11 2963/690,167 0.43 75–84 82/1519 5.40 4/345 1.16 4828/439,557 1.10 85+ 59/931 6.34 1/37 2.70 7018/201,791 3.48 P value across age P=0.26 P=0.78 P<0.001 Sex Men 123/2620 4.69 26/2007 1.30 11,337/2,343,718 0.48 Women 105/1677 6.26 20/1286 1.56 19,177/2,453,676 0.78 P-value men versus women P=0.03 P=0.54 P<0.001 - Table 2.
Cumulative incidence of SARS-CoV-2 infection in adult patients on hemodialysis, kidney transplant recipients, and the general population on May 25, 2020: Age standardized
Population General Population Patients on Hemodialysis Kidney Transplant Recipients % (95% CI) Versus Population % (95% CI) Versus Population Total 0.64% 2.54 (2.23 to 2.89) P<0.001 1.60 (1.18 to 2.11) P<0.001 Men 0.48% 1.98 (1.65 to 2.35) P<0.001 1.24 (0.82 to 1.78) P<0.001 Women 0.78% 3.21 (2.63 to 3.86) P<0.001 2.00 (1.26 to 3.04) P<0.001 Men versus women P<0.001 P=0.03 P=0.55 Population Patients on Hemodialysis, n=4297 Kidney Transplant Recipients, n=3293 COVID-19 Positive, % (No.) COVID-19 Negative, % (No.) P Value COVID-19 Positive, % (No.) COVID-19 Negative, % (No.) P Value Total no. 228 4069 46 3247 Age, yr P=0.26 P=0.78 25–44 2.2 (5) 4.6 (186) 13.0 (6) 13.5 (439) 45–64 16.7 (38) 17.2 (701) 52.2 (24) 44.7 (1452) 65–74 19.3 (44) 21.5 (873) 23.9 (11) 30.2 (979) 75–84 36.0 (82) 35.3 (1437) 8.7 (4) 10.5 (341) 85+ 25.9 (59) 21.4 (872) 2.2 (1) 1.1 (36) Sex P=0.03 P=0.55 Men 53.9 (123) 61.4 (2497) 56.5 (26) 61.0 (1981) Women 46.1 (105) 38.6 (1572) 43.5 (20) 39.0 (1266) Diagnosis ARF 1.3 (3) 2.5 (100) P=0.37 0.0 (0) 0.9 (30) P>0.99 Cardiorenal syndrome 5.7 (13) 7.2 (292) P=0.51 0.0 (0) 0.2 (7) P>0.99 ADPKD 6.1 (14) 5.2 (212) P=0.54 13.0 (6) 19.9 (647) P=0.35 Type 1 diabetes 5.3 (12) 2.0 (83) P=0.004 0.0 (0) 5.7 (184) P=0.11 Type 2 diabetes 25.0 (57) 18.7 (762) P=0.02 4.3 (2) 4.8 (157) P>0.99 Hereditary diseases 2.2 (5) 1.2 (47) P=0.20 4.3 (2) 3.8 (124) P=0.70 Glomerular diseases 8.3 (19) 14.6 (593) P=0.008 37.0 (17) 28.3 (918) P=0.19 Hypertension/RVD 27.2 (62) 23.5 (958) P=0.23 8.7 (4) 8.5 (275) P=0.79 TID 8.8 (20) 9.8 (400) P=0.73 19.6 (9) 14.6 (474) P=0.40 Miscellaneous 2.6 (6) 6.1 (250) P=0.03 0.0 (0) 3.8 (125) P=0.42 Unknown 7.5 (17) 9.1 (372) P=0.48 13.0 (6) 9.4 (306) P=0.44 Comorbid conditions Diabetes mellitus 51.3 (117) 39.8 (1618) P<0.001 10.9 (5) 14.0 (451) P=0.67 CVD 57.2 (123) 55.7 (2053) P=0.31 NA NA BMI≥30 kg/m2 37.3 (81) 28.2 (1047) P=0.002 NA NA Nursing home residence 11.7 (24/205) 4.9 (173/3495) P<0.001 NA NA Total RRT vintage P=0.008 P=0.003 0–6 mo 13.2 (30) 8.2 (333) 2.2 (1) 0.1 (4) 7–12 mo 8.8 (20) 9.5 (387) 0.0 (0) 0.5 (16) 1.0–2.4 yr 21.1 (48) 26.4 (1074) 8.7 (4) 3.1 (100) 2.5–4.9 yr 26.8 (61) 25.9 (1054) 6.5 (3) 10.8 (352) 5.0–9.9 yr 23.7 (54) 18.9 (769) 23.9 (11) 27.4 (891) 10+ yr 6.6 (15) 11.1 (452) 58.7 (27) 58.0 (1884) Hereditary diseases excludes patients with ADPKD. Cardiovascular disease was defined as presence of at least one of the following at the start of RRT: congestive heart failure, ischemic heart disease, peripheral vascular disease, cerebrovascular disease. Total RRT vintage was calculated from the first day of any form of RRT. ADPKD, autosomal dominant polycystic kidney disease; RVD, renal vascular disease; TID, tubulointerstitital disease; CVD, cardiovascular disease; NA, not available; BMI, body mass index.
- Table 4.
Cumulative mortality of SARS-CoV-2 infection in adult patients on hemodialysis, kidney transplant recipients, and the general population on May 25, 2020
PopulationC Patients on Hemodialysis Kidney Transplant Recipients General Population Death/Total % Death/Total % Death/Total % Total 64/216a 29.6 6/43b 14.0 4673/30,514 15.3 Age, yr 25–44 0/5 0.0 0/6 0.0 16/6755 0.2 45–64 6/38 15.8 2/22 9.1 299/8950 3.3 65–74 13/41 31.7 2/11 18.2 589/2963 19.9 75–84 24/77 31.2 2/4 50.0 1277/4828 26.4 85+ 21/55 38.2 0/0 0.0 2492/7018 35.5 P value across age P=0.10 P<0.001 Sex Men 42/117 35.9 2/26 7.7 2100/11,337 18.5 Women 22/99 22.2 4/17 23.5 2573/19,177 13.4 P value men versus women P=0.04 P<0.001 a No final outcome data in 12 patients on hemodialysis.
b No final outcome data in three kidney transplant recipients.
Cause of Death Patients on Hemodialysis Kidney Transplant Recipients COVID-19 Positive, No. (%) COVID-19 Negative, No. (%) P Value COVID-19 Positive, No. (%) COVID-19 Negative, No. (%) P Value Infection 49/64 (76.5) 22/144 (15.3) P<0.001 6/6 (100.0) 1/10 (10.0) P<0.001 Stop therapy 4/64 (6.3) 29/144 (19.1) P=0.01 0/6 (0.0) 0/10 (0.0) — Failure to thrive 1/64 (1.6) 6/144 (4.2) P=0.44 0/6 (0.0) 1/10 (10.0) P>0.99 Sudden death 2/64 (3.1) 24/144 (16.7) P=0.006 0/6 (0.0) 2/10 (20.0) P=0.50 Cardiovascular 3/64 (4.7)a 19/144 (13.2) P=0.09 0/6 (0.0) 1/10 (10.0) P>0.99 Malignancy 1/64 (1.6) 18/144 (12.5) P=0.009 0/6 (0.0) 1/10 (10.0) P>0.99 Miscellaneous 1/64 (1.6) 10/144 (6.9) P=0.18 0/6 (0.0) 2/10 (20.0) P=0.50 Unknown 3/64 (4.7) 16/144 (11.1) P=0.19 0/6 (0.0) 2/10 (20.0) P=0.50 —, not applicable.
↵a Of which two fatal strokes.
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