Clinical characteristics and analysis of risk factors for disease progression in patients on maintenance hemodialysis infected with SARS-CoV-2 omicron variant

Abstract

Objective:To summarize the clinical characteristics of patients on maintenance hemodialysis (MHD) with the novel coronavirus omicron variant and explore the risk factors for severe cases. Methods:We retrospectively analyzed the data of 158 patients on MHD from Zhongnan Hospital of Wuhan University between December 7, 2022 and January 31, 2023. We collected clinical data, described clinical characteristics, and analyzed the relationships between these factors and critical illness using univariate and multivariate logistic regression analyses. Results: The median age of the 158 patients was 63 (interquartile range: 52–71) years, and 128 (63.7%) were men. Fever (62.7%) and cough (60.1%) were the two most common symptoms. Hypertension (80.4%) was the most common comorbidity, followed by diabetes (31.0%), cardiovascular disease (22.8%), and cerebrovascular disease (15.2%). Unvaccinated patients constituted the majority of the enrolled patients (88.6%, 140/158), whereas only a small proportion (11.4%, 18/158) had been vaccinated (including fully vaccinated and partially vaccinated patients). Multivariate logistic regression analysis indicated that an elevated C-reactive protein (CRP) level (odds ratio [OR]: 1.03, 95% confidence interval [CI], 1.014–1.046], p<0.001) and a decreased platelet count (OR: 0.986, 95% CI, 0.986 (0.976–0.997), p=0.013) during hospitalization were risk factors for the severe group. Conclusions:This study demonstrated a high mortality rate among patients on MHD infected with omicron variant. Furthermore, advanced age, increased CRP levels, and decreased platelet count were predictors of critical illness.