Of 400 dialysis patients with the Vall d’Hebron University Hospital as reference in Barcelona, Spain, 21 contracted the coronavirus disease 2019 (COVID-19) and the mortality rate in this center was 24%, according to the opening presentation at the ERA-EDTA Congress conference.

In Spain, approximately 0.5% of the population had contracted COVID-19. The high death rate among infected dialysis patients was also verified in an analysis of the Spanish COVID-19 Dialysis/Transplantation Registry, which included a total of 1572 end-stage renal disease patients, including 998 hemodialysis (HD) patients, 51 peritoneal dialysis (PD) patients, and 523 kidney transplant patients.

The mortality rate among HD patients was more than 27% for all of Spain, but was more than 23% for kidney transplants. In addition, PD patients had a significantly lower mortality rate of 15%, but the number is small in proportion, making it difficult for the study authors to make a statistically valid statement about this patient group.

The high mortality rate among dialysis patients was confirmed in a study that monitored the course of disease in 36 HD patients between March 12 and April 10 in Hospital Gregorio Marañón in Madrid. The study analyzed predictors of mortality and concluded that there are 3 factors that significantly influence the mortality rate among COVID-19-positive dialysis patients. These factors include the number of years on dialysis, lymphopenia, and elevated LDH levels.

"These patients need special protection. Many studies have shown that even people without symptoms or with asymptomatic symptoms can carry and pass on the virus. In dialysis units, therefore, we cannot rely on always being able to detect infected patients and to isolate them in time,” said Maria Jose Soler Romeo, MD, in a press release. “To protect our highly vulnerable patients, it is essential that all the patients and staff be tested on a regular basis in order to minimize the risk of infection in COVID-19 outbreaks. We must continually remind ourselves that, of four coronavirus-positive dialysis patients, one will not survive. Outbreaks in dialysis units must therefore be prevented at all costs.”

REFERENCE
COVID-19 mortality alarmingly high in dialysis patients. EurekAlert! https://www.eurekalert.org/pub_releases/2020-06/e-cma060520.php. Published June 5, 2020. Accessed June 8, 2020.