Korean J Transplant.  2023 Nov;37(Suppl 1):S277. 10.4285/ATW2023.F-8897.

Excess mortality of end-stage renal disease patients during early SARS-Cov-2 pandemic in South Korea

• Jeong JC
• Kim JH
• Jo A
• Kwon EJ
• Yun G
• Lee J

• KMID: 2551906
• DOI: http://doi.org/10.4285/ATW2023.F-8897

Abstract

Background
South Korea used strong public quarantine policies during the early COVID-19 pandemic. With the good public adherence to social distancing, overall mortality of South Korea during early COVID-19 pandemic was reported as similar to the historical trend. However, mortality of end stage renal disease population during COVID-19 pandemic was not reported. This study aimed to whether excess mortality was different by the type of renal replacement modality among end-stage renal disease patients for 2 years of COVID-19 era (2020–2021).
Methods
All-cause death data and population statistics from 2015 to 2021 were obtained. The expected mortality in 2020 January to 2021 December was estimated by quasi-Poisson regression model. Excess mortality was defined as deaths above expected rates (numbers per 100,000 person-years). End stage renal disease patients were classified as hemodialysis, peritoneal dialysis, and kidney transplantation groups.
Results
The observed mortality of end stage renal disease in 2020 to 2021 were 9,790.2 per 100,000 person-years, and the expected mortality was 9,176.9 per 100,000 person-years (95% confidence interval [CI], 9,059.8 to 9,294.1). Excess mortality peaked at the period of Delta variant appearance (2021 August, 2021 December). Hemodialysis patients showed the highest excess mortality of 582.5 (95% CI, 440.5 to 724.4) in overall 2 years period. There were no significant excess in patients mortality among peritoneal dialysis (44.5 per 100,000 person-years; 95% CI, –767.3 to 856.2) or kidney transplant (129.4 per 100,000 person-years; 95% CI, –6.5 to 265.3).
Conclusions
In South Korea, there was no significant excess mortality among kidney transplant recipients or peritoneal dialysis patients during early SARS-Cov-2 pandemic period. However, hemodialysis population experienced excess mortalities. Feasibility of social isolation should be the key issue in public quarantine. Highest excess mortality in hemodialysis patients’ needs attention for future pandemic situation.