Institute of Nephrology, Stadtspital Zürich, Zurich, Switzerland.
Service of Nephrology and Hypertension, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland.
Front Public Health. 2022 May 17;10:795701. doi: 10.3389/fpubh.2022.795701. eCollection 2022.
Chronic dialysis patients are classified as patients with increased risk for COVID-19. Knowledge about the incidence and survival of chronic dialysis patients infected with SARS-CoV-2 in Switzerland - a high-income country with high density of relatively small dialysis centers - is scarce. We present the findings regarding incidence, survival and regional differences, compared to those of the general population in Switzerland.
Information on chronic dialysis patients who tested positive for SARS-CoV-2 between February 24, 2020 and February 28, 2022 were reported to the Swiss dialysis registry by all 94 Swiss dialysis centers. Hereafter, these results were linked with clinical characteristics from the Swiss dialysis registry.
Throughout the study period 1,120 out of ~4,700 dialysis patients tested positive for SARS-CoV-2 in Switzerland: 96 cases occurred in the first wave, 472 in the second wave and 5 in between. During the first wave, Italian-speaking Ticino was most severely affected, with a 7-fold higher incidence of dialysis patients compared to the general Swiss population. In the second wave, the majority of cases were found in the French-speaking part of Switzerland, with a 2.5 times higher incidence vs. non-dialysis patients. A total of 123 deaths were recorded in the first two waves, of which COVID-19 was the main cause of death in 100 patients. This corresponds to a highly increased overall mortality rate of 17.5% compared to 1.7% in the general population. Age was identified as the only risk factor for mortality in dialysis patients. During the third, fourth and fifth wave, 61, 43 and 443 cases, respectively, were recorded, resulting in 6 (mortality rate 9.8%), 1 (mortality rate 2.3%) and 13 deaths (mortality rate 2.9%).
Chronic dialysis patients in Switzerland were more likely to be infected by SARS-CoV-2 during the first and second wave than the rest of the population, but an inverse trend was observed during the third, fourth and fifth wave, probably thanks to vaccination. In addition, mortality is significantly increased compared to non-dialysis patients. In Swiss dialysis patients, age is the strongest risk factor for death.
慢性透析患者被归类为 COVID-19 风险增加的患者。在瑞士——一个高收入国家，透析中心密度高且相对较小——有关感染 SARS-CoV-2 的慢性透析患者的发病率和生存率的知识很少。我们报告了与瑞士普通人群相比的发病率、生存率和地区差异。
瑞士所有 94 家透析中心将 2020 年 2 月 24 日至 2022 年 2 月 28 日期间检测出 SARS-CoV-2 阳性的慢性透析患者的信息报告给瑞士透析登记处。此后，这些结果与瑞士透析登记处的临床特征相关联。
在整个研究期间，瑞士约有 4700 名透析患者中有 1120 名检测出 SARS-CoV-2 阳性：96 例发生在第一波，472 例发生在第二波，5 例发生在两者之间。在第一波中，讲意大利语的提契诺州受影响最严重，透析患者的发病率是瑞士普通人群的 7 倍。在第二波中，大多数病例发生在瑞士法语区，与非透析患者相比发病率高出 2.5 倍。在头两波中总共记录了 123 例死亡，其中 COVID-19 是 100 例患者的主要死亡原因。这对应于透析患者的总死亡率比普通人群的 1.7%高出 17.5%。年龄是透析患者死亡的唯一危险因素。在第三、第四和第五波中，分别记录了 61、43 和 443 例，死亡率分别为 9.8%、2.3%和 2.9%。
与其他人群相比，瑞士的慢性透析患者在第一波和第二波中更有可能感染 SARS-CoV-2，但在第三、第四和第五波中观察到相反的趋势，这可能要归功于疫苗接种。此外，与非透析患者相比，死亡率显著增加。在瑞士透析患者中，年龄是死亡的最强危险因素。
