A killer in disguise? - Impact of the COVID-19 pandemic on the health care of patients on kidney replacement therapy in Austria

Author: Tüchler, D. (1,2,3,5,6)
Co-Author: Kerschbaum, J. (2,4), Mayer, G. (2), Wiesholzer, M. (3,5,6), Walochnik, J. (1)

Affiliations:
(1) Center for Pathophysiology, Infectiology and Immunology (Institute of Specific Prophylaxis and Tropical Medicine), Medical University of Vienna
(2) Department of Internal Medicine IV – Nephrology and Hypertension, Medical University of Innsbruck
(3) Department of Internal Medicine 1, University Hospital of St. Pölten
(4) Department of Internal Medicine 1, Regional Hospital of Horn
(5) Karl Landsteiner Institute for Nephrology and Hematooncology
(6) Karl Landsteiner University of Health Sciences

The COVID-19 pandemic may have disproportionately affected patients with end-stage renal disease (ESRD), including those on dialysis and kidney transplant recipients. Yet, the full impact on mortality and health care in infected and non-infected patients in Austria remains unclear. Preliminary data of the Austrian Dialysis and Transplant Registry (OEDTR) from 01.03.2020 to 12.02.2021, show COVID–19–related case fatality rates of 16.8 % in dialysis patients and 7.1 % in transplant recipients during the first year of the pandemic. This study aims to assess pandemic-related mortality and healthcare outcomes in ESRD patients using OEDTR and Gesundheit Österreich GmbH (GÖG) data. Mortality rates during the pandemic (15.03.2020 – 14.01.2021, and 15.03.2020 – 14.03.2024) will be compared with i) a pre-pandemic reference period (15.03.2015 – 14.03.2019), ii) a reference group consisting of two matched controls for each kidney transplant recipient with SARS-CoV-2 infection and iii) a comparable reference group of the general population. Additional clinical course and treatment data, including length and type of the in-hospital stay, along with the matched control group, will reveal renal function trajectories in transplant recipients. We will evaluate excess mortality among ESRD patients and discriminate between COVID–19–attributable and non-attributable mortality. The data will support future healthcare planning and improve outcomes in this high-risk population during health crises.
Acknowledgement: We gratefully acknowledge the Austrian Science Fund (FWF P35055-B) for its financial support. We also thank all participating centres for their collaboration and our colleagues and supporters, Franziska Engler, Johanna Jobst, Daniela Kaiser-Feistmantl, Philipp Mehrwald, and Anna Repic, for their invaluable assistance. AI-based language tools supported the preparation of this abstract.