OBJECTIVES:

SARS-CoV-2 is known for its respiratory impact, but also affects other organs such as kidneys. According to the Intensive Care National Audit & Research Centre (ICNARC) report of June 5^th, 26% of critically ill COVID-19 patients required acute renal support (ARS), in comparison to 5-10% of the general critically ill patients. This threefold increase led to challenges in product supply and thereby in care provision. ARS is associated with an increased risk in chronic dialysis dependency, which with scarcity of appropriate therapies could be accelerated. The study aims to perform a high-level calculation on the potential economic impact.

METHODS:

The calculation was based on data from the European Center for Disease Prevention & Control (ECDC) and on critically ill COVID-19 patients (e.g. total patient number, mortality rate). A systematic literature review (SLR) was performed on dialysis dependency caused by ARS. Important to note is that the dynamic nature of the COVID-19 data inquiry should be taken into consideration.

RESULTS:

On June 12^th, 12,023 critically ill COVID-19 patients were reported in Europe. Based on the ICNARC report, 26% required ARS i.e. 3,126 patients. Of those, 62% died leaving 1,188 survivors at risk for chronic dialysis-dependency. The SLR found that 19% become chronic dialysis-dependent, leading to a first conservative estimate of 226 additional patients in the last 3 months. This will already cause an annual rise of ~6.78M EUR in health system expenditure, taking 30,000 EUR as an annual individual dialysis patient cost and is likely to further rise.

CONCLUSIONS:

In the ongoing COVID-19 crisis, long-term effects on the patient population and healthcare system don’t only depend on optimal respiratory support but also other therapy elements such as ARS. Early recognition and additionally increased awareness of the most cost-effective ARS therapy – continuous over intermittent treatment – is crucial to widely prevent chronic dialysis dependency.