MORTALITY rates from Covid for kidney transplant and dialysis patients had plummetted by March this year, according to a new report.
Statistics tracking the number of confirmed infections against the percentage of patients alive 28 days after testing positive shows a massive increase in survival to between 98-100 per cent by the beginning of this year, in a dramatic shift from the first wave back in 2020.
The report by Public Health Scotland notes "a reduction in deaths following Covid-19 since December 2021" which had coincided with "a number of different factors".
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These include "the emergence of the Omicron variant, administration of third/fourth vaccine, administration of neutralising monoclonal antibodies (nMabs) and/or oral antiviral therapy".
The PHS report adds that it is "likely a combination of these factors has improved patient outcomes".
Monoclonal antibody therapy and/or oral antivirals became available on the NHS this year to certain high-priority patients, including those who had a transplant or who were on dialysis, as soon as they tested positive for Covid - regardless of symptoms.
Both drugs reduce the risk of the infections developing into severe disease.
They are available to a limited group of vulnerable patients considered to be at highest risk of Covid, also including some cancer patients and people with neurological conditions such as multiple sclerosis (MS).
The PHS report shows how case numbers and mortality have changed over time.
In 2020, around 160 kidney dialysis patients in Scotland tested positive for Covid before receiving any dose of vaccine.
They were more likely to be infected that those who had already received a transplant because they were unable to shield at home due to the need to attend hospital three times a week for dialysis.
The mortality rate fluctuated, but in November 2020 nearly half (43%) of those who contracted Covid had died within 28 days. In May 2020, it was 36%.
In January to March 2022, a total of 223 kidney dialysis patients tested positive for Covid of whom 184 had had three vaccine doses.
During this time - when Omicron had become dominant and antivirals were being made available - mortality within 28 days had reduced to 2% in January, and 0% in February and March.
The picture was similar for kidney transplant patients.
In 2020, around 88 kidney transplant patients tested positive for Covid.
In the early stages of the pandemic, in March and April 2020, around 30-40% died within 28 days.
Between January and March 2022, there were 336 confirmed Covid infections in kidney transplant patients, but mortality within 28 days had fallen to 2% in January, 1% in February, and 0% in March.
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Uptake of vaccinations has been high among by dialysis and kidney transplant patients.
By March 27 this year, 90% had had at least three Covid vaccine doses and 46% had received a fourth dose.
Overall, between December 17 and March 27 - the period covering the Omicron BA.1 wave in Scotland - 22% of kidney patients (dialysis and transplant combined) who tested positive for Covid at least 14 days after a third vaccination were hospitalised with the infection, and 4% died.
This was mainly due to infections in December, prior to a major push to increase booster coverage in response to Omicron.
Patients receiving dialysis and those with a kidney transplants have been more vulnerable to Covid due to factors including that dialysis patients are generally older with other health conditions, such as diabetes, and because the medicines taken by transplant patients to suppress their immune system can make vaccines less effective.
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