#3106 Dynamic impact of the COVID-19 pandemic on health-related quality of life and symptom burden in Dutch dialysis patients

Abstract Background and Aims : Dialysis patients faced a high risk of COVID-19 during the pandemic, but data on health-related quality of life (HR-QoL) were limited to early pandemic phases and inconclusive. These insights, however, are needed to evaluate the impact of public health interventions on vulnerable patient populations. We therefore studied the HR-QoL and symptom burden of dialysis patients in both early and later phases of the COVID-19 pandemic, and explored effects of lockdowns, COVID-19 infections and vaccinations. Method The Dutch Dialysis Registry routinely collects the HR-QoL and symptom burden of dialysis patients. The SF-12 health survey measures the HR-QoL by calculating physical (PCS) and mental (MCS) component summary scores (0–100, higher scores indicate better HR-QoL). The Dialysis Symptom Index captures 30 symptoms in a sum of symptom burden (0–120, higher scores indicate higher burden). The HR-QoL and symptom burden from pandemic periods were compared with a pre-pandemic period (Fig. 1), using mixed models and negative binomial regression. We explored mediation by adjusting for COVID-19 infections and vaccinations, evaluating percentual changes of effect estimates. Results 22,355 questionnaires from 5,495 patients were analyzed. In the pre-pandemic period, mean PCS and MCS scores were 36 ± 10 and 48 ± 10 and the median symptom burden was 17 [IQR: 9–28]. PCS scores improved during the first lockdown (+1.12 [95% CI: 0.47, 1.77]) but worsened in the Omicron period (−0.59 [−1.05, −0.14]) (Fig. 2). MCS scores worsened during Delta (−1.25 [−1.77, −0.73]) and Omicron periods (−1.46 [−1.97, −0.96]). The symptom burden improved during the first (−11.7% [−18.2, −4.7]) and the second (−6.9% [−12.0, −1.5]) lockdown. COVID-19 infections and vaccinations explained most of the lower PCS scores observed during Delta (77%) and Omicron periods (56%). Conclusion The HR-QoL and symptom burden of the Dutch dialysis population fluctuated throughout the COVID-19 pandemic. Outcomes improved during lockdowns but worsened with the emergence of new COVID-19 variants and relaxation of protective measures. In future pandemics, vulnerable populations may benefit from the sustained implementation and promotion of mitigating interventions, such as vaccination, personal protective measures, and rehabilitation, particularly when nationwide regulations are released.