#2588 IMPACT OF THE COVID-19 PANDEMIC ON THE WELL-BEING OF PATIENTS WITH CHRONIC KIDNEY DISEASE
Authors: Moromizato Takuhiro , Sakaniwa Ryoto , Hashimoto Yorikazu , Iseki Kunitoshi 
Published: June 2023

Abstract

Background and Aims
Coronavirus Disease 2019 (COVID-19) devastatingly impacted well-being, especially among the socioeconomically vulnerable population. The impacts of the pandemic on specific groups of age, sex, race, type of work, and income have been studied. However, the impacts COVID-19 pandemic on well-being of people with diseases have yet to be well evaluated. We conducted a longitudinal survey for outpatients who visited our Nephrology division and asked about their monthly well-being status for two years. Therefore, we aimed to elucidate the impacts of the pandemic especially on the well-being of patients with chronic kidney disease (CKD).

Method
We conducted a monthly survey for 358 outpatients who visited the Nephrology division of Okinawa Prefectural Nanbu Medical Center and Children's Medical Center between February 1st, 2020, and December 31st, 2021. Out of these patients, 257 patients were included in this study. All participants were asked questions about their well-being status with a visual analog scale (0-10) regarding their health, socioeconomic satisfaction, human connections, general anxiety, and satisfaction in receiving treatment. We also collected information about their basal demographics, social situation (living with family, marriage, having children, or caregiving), educational status, income level, the activity of daily life, and active diseases. We used a mixed-effects regression model to assess the impacts of the pandemic on longitudinal changing of well-being scores especially among patients with CKD. We also described trajectories of well-being scores for CKD patients and non-CKD patients to visualize the difference in the impacts of the COVID-19 pandemic on them.

Results
Among the 257 analyzed patients, 43.9% were male, and the mean (± standard deviation) of their age was 58.9 (± 19.9). 25% were unmarried, and 59.5% had full-time job. 47.9% had G3b or higher stage CKD (eGFR&lt;45 ml/min/1.73 m2); 24.5% had diabetes; and 30.7% had collagenous disease. In total, 1,814 answer sheets were collected from the patients. Based on the mixed-effects regression model, especially among female patients with CKD, the pandemic has decreased the well-being regarding their human connections (Fig. 1). Contrarily, male patients with CKD showed an increase in well-being regarding human connections during the pandemic. In female patients with CKD, (1) younger, (2) married, (3) living with a family member, and (4) required caregiving status were associated with lower well-being status regarding human connections. Notably, male patients with CKD had higher well-being status regarding human connections and socioeconomic situation if married and living with family than male patients without CKD.

Conclusion
In patients with CKD, female Japanese patients showed lower well-being score regarding human connections than male patients during the early phase of pandemic. The support and caregiving among families influenced differently for male and female patients with CKD.