ABSTRACT
Background: The COVID-19 pandemic has had far-reaching implications in terms of physical and mental health ramifications, and minority communities have been disproportionately impacted;particularly, prevalence of depression increased. Throughout the pandemic, ESKD patients have continued thrice-weekly in-center hemodialysis sessions or home therapies. We explored whether there was an increase in depression prevalence after the start of the pandemic in our urban predominantly Black ESKD population. Method(s): We used data from social worker-administered PHQ-2 questionnaire depression screenings (required by Centers for Medicare & Medicaid Services) in eligible patients treated at four Emory University affiliated in-center dialysis units and three home dialysis units from 2018-2019 (pre-pandemic) to 2020-2021 (pandemic). Excluded from this study were patients with no assessments or incomplete assessments. Data were analyzed using chi-square tests comparing the prevalence of depression in pre-pandemic versus pandemic period. Result(s): In 2021, 91.5% of our patients were Black. There were 2433 in-center patient depression scores and 586 home dialysis patient depression scores. Excluded from the study were 1045 patients in the in-center and 214 patients in the home population. Of the 2433 patient scores analyzed in the in-center group, 1289 were pre-pandemic and 1144 were in the pandemic period. 155 (12%) in-center patient scores in the prepandemic period were classified as depressed while 128 (11.2%) in-center patient scores during the pandemic were classified as depressed (two-sided p-value 0.5272). Of the 586 home dialysis patient scores, 325 were pre-pandemic and 261 in the pandemic period. 71 (21.8%) patient scores in the pre-pandemic period had a positive depression screening while 29 (11.1%) patient scores during the pandemic period had depression (two-sided p-value 0.0006). Conclusion(s): We did not observe an increase in depression prevalence during the COVID-19 pandemic in in-center dialysis patients, and surprisingly observed a statistically significant decrease in depression among our home dialysis patients. The decrease in depression in our home dialysis patients during the pandemic may reflect being at home is a protective mechanism, and this observation should be further investigated.