Background Systematic reviews have shown a high prevalence of long-term persistent sequelae after COVID-19. The aim of this study was to describe the prevalence and risk factors associated with long‐lasting clinical symptoms (LLCS) in survivors on chronic dialysis at 6 months after the onset of acute COVID-19 infection in the pre-vaccination period. Methods This national cohort study included all French patients on dialysis who had SARS-Cov-2 infection between March and December 2020 and who were alive and still on dialysis 6 months after infection. A form was filled in at 6 months concerning the presence of the following persistent symptoms: extreme fatigue, headache, muscle or weight loss of > 5%, respiratory sequelae, tachycardia, chest pain, joint or muscle pain, persistent anosmia or ageusia, diarrhea, sensory disorders, neuro-cognitive disorders, post-traumatic stress syndrome, depression, and anxiety. Results Complete survey results were available for 1217 patients (25.2% of those included); 216 (17.7%) had some LLCS. Probability of 6-month LLCS was higher in patients who were hospitalized in a medical or intensive care unit: OR 1.64 (95% CI 1.16–2.33) and 5.03 (2.94–8.61), respectively. Younger patients had a lower probability of LLCS. Each year on dialysis, as well as diabetes, overweight or obesity were associated with a higher probability of LLCS by 1.03 (1.01–1.06), 1.53 (1.08–2.17), 1.96 (1.10–3.52) and 2.35 (1.30–4.26), respectively. Conclusions This national study shows that at least one in six patients on dialysis who have COVID-19 will have LLCS. Systematic screening in dialysis patients would allow us to identify those who need more careful prevention and long-term care and to address them towards a rehabilitation pathway.

Background Pregnant women with end-stage renal disease on chronic dialysis are at a high risk of maternal and foetal complications. Over the years, the prognosis of their pregnancies has improved with advances in dialysis treatments and maternal and neonatal care. We conducted this systematic review to examine the recent data on maternal and foetal outcomes in pregnant women with end-stage renal failure on chronic dialysis over the last decade. Methods We made a systematic review of studies on pregnant women on chronic dialysis published between January 1st, 2010, and December 31st, 2020. We searched the following electronic databases: Medline via PubMed, Embase and the Cochrane Library, with search strategies for each database. We checked the titles and abstracts identified by the search equation, and two independent reviewers assessed the articles retrieved. For each study, the two reviewers separately recorded the data from each selected article on a standardised data extraction form. For each article, we recorded relevant general information on the study, patient demographic characteristics, dialysis schedule, pregnancy complications and outcomes, maternal complications, and foetal and neonatal outcomes. Results The literature search yielded 1668 potentially relevant abstracts. After reviewing the titles, abstracts, and full text, we identified 14 studies according to the inclusion criteria. All studies were observational, 9 of them were retrospective and 8 were from the single-centre experience. The total number of women included in these studies was 2364 (range 8 to 2008) and the total number of pregnancies was 2754 (range 8 to 2352). The patients’ ages ranged from 15 to 45 years. Obesity was observed in 808 (34.2%) women and ranged from 1 to 778. Haemodialysis was the predominant modality with 2551 (92.6%) pregnancies and 203 (7.4%) on peritoneal dialysis. Overall, 68 out of 402 (16.9%) spontaneous miscarriages, 21 out of 402 (5.2%) therapeutic abortions and 26 (8.3%) stillbirths among 313 (stillbirths and live births) were recorded. The mean or median gestational age at delivery ranged from 25.2 to 36 weeks. The main maternal complications were preeclampsia 11.9%, hypertension 7.7%, and anaemia 3.9%. Live births represented 287 (71.4%) out of 402 pregnancies, birth weight ranged from 590 g to 3500 g and preterm birth was the main, most common complication in all studies, ranging from 50% to 100%. Intrauterine growth restriction was present in 5.9% and small-for-gestational-age was reported in 18.9% of neonates. There were 22 (7.6%) neonatal deaths among 287 live births and 48 (15.3%) perinatal deaths among 313 total births (stillbirths and live births). Conclusions Presumably, considering the increase in the number of publications and the total number of pregnancies reported therein, the frequency of pregnancy in patients with end-stage chronic kidney disease treated by chronic dialysis has increased. However, the practice of treating pregnant women on dialysis differs significantly among countries. These findings highlight the need to standardise the definition of outcomes and healthcare for pregnant women on dialysis.