COVID-19 in hemodialysis patients

AbstractObjective. Evaluation of clinical observation, the course, the risk factors, and treatment options for SARS-CoV-2 infection in hemodialysis patients with end-stage chronic kidney disease.

Material and methods. The retrospective, single-center, uncontrolled study involved 231 patients (132 M/99 W) aged 61.7±14.7 years with COVID-19 diagnosed. The SPSS software package was used for statistical analysis.

Results. 72 (31.2%) of patients died, 68 (94.4%) of them had ARDS as the main cause of death. Comparative analysis in groups with favorable and unfavorable outcomes of the disease showed that age (68.1±13.2 years vs 58.7±14.5 years, p<0.0001) and the comorbidity index (8.8±2.2 vs 6.2±2.6, p<0.0001) were significantly higher in those who have died compared to survivors. According to CT data, they were more likely to have 3rd or 4th-degree lung damage (72.2 vs 36.5%, p<0.0001), and the minimum oxygen saturation index: 67.6±12.8 and 87.8±10.9%, respectively (p<0.0001). Comorbidity index and the need for invasive ventilation were independent predictors of the fatal outcome of COVID-19. Early administration of monoclonal antibodies to IL-6 (in the first 3 days after hospitalization) in patients with a low prevalence of the pulmonary process (CT stage 1-2) was associated with a significantly lower frequency of fatal outcome.

Conclusions. SARS-CoV-2 infection in HD patients is characterized by a high rate of mortality. Predictors of severe disease in this population are comorbidity index and the need for invasive ventilation.

Keywords:hemodialysis, COVID-19, SARS-CoV-2

Funding. The study had no financial support.

Conflict of interests. The authors declare no conflict of interests.

Contribution. Research concept and design - Zubkin M.L., Frolova N.F., Kim I.G., Kryukov E.V., Chervinko V.I., Tomilina N.A.; collection and processing of material - Ushakova A.I., Usatyuk S.S., Artyukhina L.Yu. Iskhakov R.T., Varyasin V.V., Sinyavkin D.O., Diakova E.N., Loss K.E., Volodina E.V.; statistical data processing - Kim I.G.; text writing - Zubkin M.L., Kryukov E.V., Frolova N.F.; editing - Zubkin M.L., Kim I.G., Kryukov E.V.; approval of the final version of the article - Zubkin M.L., Kryukov E.V., Frolova N.F., responsibility for the integrity of all parts of the article - Frolova N.F., Zubkin M.L.

For citation: Frolova N.F., Kim I.G., Ushakova A.I., Usatiuk S.S., Artyukhina L.Yu., Iskhakov R.T., Varyasin V.V., Sinyavkin D.O., Diakova E.N., Loss K.E., Chervinko V.I., Volodina E.V., Tomilina N.A., Kryukov E.V., Zubkin M.L. COVID-19 in hemodialysis patients. Infektsionnye bolezni: novosti, mneniya, obuchenie [Infectious Diseases: News, Opinions, Training]. 2021; 10 (1): 14-23. DOI: https://doi.org/10.33029/2305-3496-2021-10-1-14-23 (in Russian)

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CHIEF EDITOR
Aleksandr V. Gorelov
Academician of the Russian Academy of Sciences, MD, Head of Infection Diseases and Epidemiology Department of the Scientific and Educational Institute of Clinical Medicine named after N.A. Semashko ofRussian University of Medicine, Ministry of Health of the Russian Federation, Professor of the Department of Childhood Diseases, Clinical Institute of Children's Health named after N.F. Filatov, Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation, Deputy Director for Research, Central Research Institute of Epidemiology, Rospotrebnadzor (Moscow, Russian Federation)

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