Interim analysis of the cosa registry: COVID-19 patients treated with the seraph® 100 microbind® affinity filter

Background: How the COVID-19 pandemic altered ESKD incidence, dialysis initiation, and preemptive kidney transplantation is unknown. Methods: Using Centers for Medicare & Medicaid Services data, we investigated the incidence of ESKD, dialysis initiation, and preemptive kidney transplantation by week during the first half of 2020. Using Poisson regression, we compared findings in 2020 to a forecast of 2020, had 2017-2019 historical trends continued, overall and by strata of age and race. Results: Mean weekly counts of patients with new ESKD are shown in the Figure. Incidence of ESKD dropped dramatically in 2020 compared with the expected incidence, particularly during epidemiologic weeks 15-18 (April;incidence rate ratio [IRR] 0.75, 95% CI 0.73-0.78), before approaching pre-pandemic levels in weeks 23-26 (June;IRR 0.93, 0.90-0.95). Across age groups, the decrease was most pronounced during weeks 15-18 among individuals aged ≥75 years (IRR 0.69, 0.66-0.73, compared with individuals aged 45-64 years, IRR 0.80, 0.77-0.84). In terms of race, the decrease was least notable among non-Hispanic Blacks (IRR 0.85, 0.81-0.89) and was most pronounced in non-Hispanic Whites (IRR 0.72, 0.69-0.74) and Hispanics (IRR 0.73, 0.69-0.78). Dialysis initiation reached a nadir during weeks 15-18 (IRR 0.76, 0.74-0.78), and preemptive kidney transplantation decreased even more strikingly during this period (IRR 0.56, 0.46-0.67). Conclusions: During the first wave of the COVID-19 pandemic in 2020, the number of patients starting treatment for ESKD fell to a level not observed since 2011. Changes in ESKD incidence and utilization of treatment modalities may reflect differential access to care.