#3968 differences in mental health status during covid-19 pandemic between in-center hemodialysis and peritoneal dialysis patients

Abstract Background and Aims Results from previous studies suggest that mental health of dialysis patients was unaffected during the first wave of the COVID-19 pandemic. However, the location of dialysis treatment might have had a different impact on patients during the ongoing COVID-19 pandemic, especially at time of restrictions. Studies comparing the mental health of ICHD and PD patients during the pandemic are scarce. Therefore, we aimed to assess whether dialysis modality differently affected the mental health of patients during the COVID-19 pandemic. Method This study used data of patients participating in the Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes (DOMESTICO). We conducted repeated cross-sectional analyses between ICHD and PD patients from the start of the COVID-19 pandemic in March 2020 until August 2021. For this, we divided the study period into six periods of three months. The year before the pandemic was used as reference period. Mental health-related quality of life (HRQOL) was assessed using the mental component summary (MCS) score of the 12-item Short Form (SF-12) health survey. The presence of mental symptoms was determined using the Dialysis Symptom Index (DSI). Both questionnaires were provided at start of dialysis, at 3 months, 6 months and each 6 months thereafter. Patients were included for analysis if a questionnaire was available in at least one period. MCS scores and the prevalence of mental symptoms between ICHD and PD patients were compared with Student's t-test and Chi-square test, respectively. Moreover, we performed multivariable regression analyses to adjust for possible confounders. Results For this analysis, 1274 patients (968 ICHD and 306 PD) were included. Mean age was 65±14 and 64±14 years, respectively. Most patients were male (ICHD: 68%, PD: 61%). Before the pandemic ICHD patients reported similar MCS scores, yet more often reported feeling nervous (32% vs. 22%, P = .03) and sad (40% vs. 29%, P = .03). During the pandemic, mean MCS scores also did not differ between ICHD and PD patients. In contrast, ICHD patients more often reported feeling nervous during period 3 (27% vs 15%, P = .04), feeling irritable and anxious during period 3 (31% vs 18%, P = .03, 26% vs. 9%, P = .002, resp.) and period 4 (34% vs 22%, P = .04, 22% vs 11%, P = .03, resp.), and feeling sad in period 4 (38% vs 26%, P = .04) and period 5 (37% vs 22%, P = .009). In a multivariable regression analysis, these differences persisted after correction for several confounders. Conclusion ICHD patients experienced more mental symptoms compared to PD patients in the period September 2020 to June 2021, which corresponds with the second lockdown of the COVID-19 pandemic. This higher prevalence of specific mental symptoms in ICHD patients was not reflected by a decrease in mental HRQoL.