In Which Hemodialysis Patients Have Covid-19 Cause Death More Often?
Abstract
Background: We aimed to reveal the frequency, prognosis and factors affecting the prognosis of coronavirus disease 2019 (COVID-19) in hemodialysis patients.
Methods: The frequency, symptoms (fever, throat ache, cough, weakness and diarrhea), laboratory findings (lymphocyte count and ratio, ferritin, c-reactive protein, d-dimer and fibrinogen), duration of hemodialysis, hemodialysis adequacy (determined by KtV Ure) and factors affecting patients who recovered or died of COVID-19 infection in chronic hemodialysis patients (n=730) in 5 different centers were investigated.
Results: COVID-19 infection occurred in 141 of 730 patients in the 13-month period (19.3%), and twenty-nine died (20.5%). While the mean age of those who died was higher than those who recovered, the duration of hemodialysis treatment, gender distribution, and mean Kt/V were not different. The number of comorbidities was higher in patients who died than in those who recovered. Additional diseases such as type 2 diabetes mellitus, coronary artery disease, and heart failure were found at a higher rate in patients who died.
Conclusion: Mortality rates in hemodialysis patients were found to be higher than in the general population, and similar to the general population, death was more common in patients with higher comorbidity and cardiovascular disease compared to patients who recovered. Since cardiovascular diseases are common in chronic hemodialysis patients, death from COVID-19 may be higher.
Keywords
Hemodialysis patients, COVID-19 infection, comorbidity, mortality.
Ethical Statement
This retrospective study was based on anonymized data and, in accordance with institutional and national guidelines, did not require formal ethical approval.
References
- World Health Organization Coronavirus(COVID-19) Dashboard (Oct 28, 2022). https://covid19.who.int
- Dessie ZG, Zewotir T. Mortality-related risk factors of COVID-19: a systematic review and meta-analysis of 42 studies and 423,117 patients. BMC Infect Dis. 2021;21(1):855. Published 2021 Aug 21. doi:10.1186/s12879-021-06536-3
- Bhaskaran K, Bacon S, Evans SJ, et al. Factors associated with deaths due to COVID-19 versus other causes: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform. Lancet Reg Health Eur. 2021;6:100109. doi:10.1016/j.lanepe.2021.100109
- Elezkurtaj S, Greuel S, Ihlow J, et al. Causes of death and comorbidities in hospitalized patients with COVID-19. Sci Rep. 2021;11(1):4263. Published 2021 Feb 19. doi:10.1038/s41598-021-82862-5
- Reis ECD, Rodrigues P, Jesus TR, de Freitas Monteiro EL, Virtuoso Junior JS, Bianchi L. Risk of hospitalization and mortality due to COVID-19 in people with obesity: An analysis of data from a Brazilian state. PLoS One. 2022;17(3):e0263723. Published 2022 Mar 4. doi:10.1371/journal.pone.0263723
- Ghonimi TAL, Alkad MM, Abuhelaiqa EA, et al. Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study. PLoS One. 2021;16(7):e0254246. Published 2021 Jul 22. doi:10.1371/journal.pone.0254246
- Taji L, Thomas D, Oliver MJ, et al. COVID-19 in patients undergoing long-term dialysis in Ontario. CMAJ. 2021;193(8):E278-E284. doi:10.1503/cmaj.202601
- Caplin B, Ashby D, McCafferty K, et al. Risk of COVID-19 Disease, Dialysis Unit Attributes, and Infection Control Strategy among London In-Center Hemodialysis Patients. Clin J Am Soc Nephrol. 2021;16(8):1237-1246. doi:10.2215/CJN.03180321
- Kazmi S, Alam A, Salman B, et al. Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study. Int J Nephrol Renovasc Dis. 2021;14:193-199. Published 2021 Jun 30. doi:10.2147/IJNRD.S310035
- Aoun M, Khalil R, Mahfoud W, et al. Age and multimorbidities as poor prognostic factors for COVID-19 in hemodialysis: a Lebanese national study. BMC Nephrol. 2021;22(1):73. Published 2021 Feb 27. doi:10.1186/s12882-021-02270-9