Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study

Kazmi, Samia; Alam, Ashar; Salman, Beena; Saeed, Faiza; Memon, Shoukat; Chughtai, Javeria; Ahmed, Sibtain; Tariq, Sobia; Imtiaz, Salman

doi:10.2147/ijnrd.s310035

Cited by 8 publications

(7 citation statements)

References 23 publications

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“…Mortality in the HD group (11.1%) was higher than in the control group (5.5%); however, they had fewer initial symptoms. HD mortality in this study was lower than that reported by Kazmi et al in Pakistan (25.6%) (19) and also Turgutalp et al in Turkey (16.3%) (18). This could result in the faster diagnosis of patients as well as faster treatment; however, fewer samples can be effective.…”

Section: Discussioncontrasting

confidence: 58%

Clinical and Para-clinical Findings of COVID19 in Hemodialysis Patients Compared to Control Group: A Case-Control Study

et al. 2022

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Background: Following the global outbreak of severe acute respiratory syndrome coronavirus 2 in different communities, hemodialysis patients have not been spared by this viral infection. Objectives: This study evaluated the clinical symptoms laboratory and imaging findings in patients undergoing hemodialysis and compared these characteristics with the control group. Methods: The study was performed on 72 patients with positive COVID-19 polymerase chain reaction test, of whom 36 cases had end-stage renal disease undergoing hemodialysis and the remaining had no history of kidney diseases. After matching the two groups in terms of age, sex, and other underlying diseases, the clinical, laboratory, and chest computed tomography (CT) scan findings were compared between the case and control groups. Results: The mean age of dialysis patients was 42.52 ± 12.10 years and 48.58 ± 17.35 years in the control group. The study results revealed that hemodialysis patients had less fever, cough, and shortness of breath than the control group (P-value < 0.05). Hemoglobin, lymphocyte, and platelet counts were significantly lower in hemodialysis patients in comparison to the control group (P-value < 0.05). C-reactive protein was significantly higher in patients undergoing hemodialysis (P-value = 0.01), and ground-glass opacification was observed more in patients undergoing hemodialysis compared to controls, but this difference was not statically significant (P = 0.07). Conclusions: Hemodialysis patients had fewer initial clinical symptoms but more abnormalities in laboratory findings and ground-glass opacities on chest CT scans and a higher mortality rate.

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Section: Discussioncontrasting

confidence: 58%

Clinical and Para-clinical Findings of COVID19 in Hemodialysis Patients Compared to Control Group: A Case-Control Study

et al. 2022

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“…Initially considered a panacea for COVID-19, the drug was later found benign in only improving recovery times and shortening hospital stays, as evident by the two largest clinical trials conducted to date on Remdesivir, (Solidarity trial [ 14 ] and the ACTT-1 [ 15 ]). In contrast, a prospective double-blind trial conducted in China found no difference between Remdesivir and the placebo in early recovery [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, its use is not recommended for severe COVID-19 infection patients who require high oxygen support. In this cohort, a lower mortality rate (8.43%) was experienced compared to Chinese dialysis cohorts (14–31%) [ 47 ], Spanish dialysis units (23%) [ 48 ], and French dialysis units (24%) [ 28 ]. The reason was that the patients in this study had fewer comorbid conditions and the hospital, especially the ICU, was not overburdened.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Remdesivir in COVID-19 Positive Dialysis Patients

et al. 2022

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(1) Background: Immune compromised hemodialysis patients are more likely to develop COVID-19 infections, which increase the risk of mortality. The benefits of Remdesivir, despite less literature support on its effectiveness in dialysis patients due to renal toxicity, can outweigh the risks if prescribed early. The aim of this study was to evaluate the efficacy of Remdesivir on the 30-day in-hospital clinical outcome of hemodialysis population with COVID-19 infection and safety endpoints of adverse events. (2) Study design: A prospective quasi-experimental study design was used in the study. (3) Methods: The sample population consisted of 83 dialysis patients with COVID-19 who were administered Remdesivir at a dose of 100 mg before hemodialysis, as per hospital protocol. After the treatment with Remdesivir, we assessed the outcomes across two endpoints, namely primary (surviving vs. dying) as well as clinical and biochemical changes (ferritin, liver function test, C-reactive protein, oxygen requirements, and lactate dehydrogenase levels) and secondary (adverse effects, such as diarrhea, rise in ALT). In Kaplan–Meier analysis, the survival probabilities were compared between patients who received Remdesivir within 48 h of diagnosis and those who received it after 48 h. Cox regression analysis was employed to determine the predictors of outcome. (4) Results: Of the 83 patients, 91.5% survived and 8.4% died. Remdesivir administration did not reduce the death rate overall. Hospital stays were shorter (p = 0.03) and a nasopharyngeal swab for COVID-19 was negative earlier (p = 0.001) in survivors who had received Remdesivir within 48 h of diagnosis compared to those who had received Remdesivir after 48 h. The only variables linked to the 30-day mortality were serum CRP (p = 0.028) and TLC (p = 0.013). No major adverse consequences were observed with Remdesivir. (5) Conclusions: Remdesivir has the potential to shorten the recovery time for dialysis patients if taken within 48 h of onset of symptoms, without any adverse effects.

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“…14 Kazmi et al found that hypoalbuminemia, leukocytosis, lymphopenia, and elevated LDH were associated with mortality in ESRD patients with COVID-19, with percentages of 81.8%, 72.7%, 100%, and 100%, respectively. 16 Rastad et al showed that COVID-19 patients with ESRD had an in-hospital mortality rate of 37.8% compared to 11.9% for those without ESRD. In the ESRD subgroup, individuals who died were older and likely presented with altered mental status or oxygen saturation <93%.…”

Section: Introductionmentioning

confidence: 99%

A multicenter study of severity and prognosis of symptomatic COVID‐19 in end‐stage renal disease and non‐dialysis patients in East of Iran

Mohsenzadeh,

Ziaee,

Salehiniya

et al. 2024

Immunity Inflam & Disease

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ObjectivesThis study aimed to assess the severity and related factors of symptomatic COVID‐19 in end‐stage renal disease (ESRD) patients from several centers in Eastern Iran.MethodsIn this retrospective cohort study, after obtaining ethical approval, 410 patients diagnosed with COVID‐19 were included for analysis. Patients were categorized into two groups based on their dialysis status: the dialysis group (ESRD patients undergoing hemodialysis) and the non‐dialysis group (those without chronic dialysis). Demographic information, clinical symptoms, laboratory tests at admission, length of hospitalization, ICU admission, need for mechanical ventilation, and mortality data were extracted from their medical records and entered into researcher‐developed checklists.ResultsIn this multicenter study, 104 dialysis patients with a mean age of 64.81 ± 16.04 were compared to 316 non‐dialysis patients with a mean age of 60.92 ± 17.89. Patients were similar in terms of age and gender, but a higher percentage of the dialysis group was aged over 65 years (p = .008). Altered consciousness, dyspnea, headache, myalgia, anorexia, and cough were statistically significantly more common in the dialysis group when evaluating clinical symptoms (p < .05). The dialysis group had significantly higher levels of white blood cell (WBC), potassium, calcium, urea, creatinine, blood pH, INR, ALT, ESR, and CRP, and lower levels of red blood cell, Hb, platelets, sodium, and LDH compared to the non‐dialysis group. Profoundly altered consciousness was more common among deceased patients (p < .001), and this group had higher WBC counts, urea levels, AST, ALT (p < .05), and lower blood pH (p = .001).ConclusionBased on the results of this study, it is plausible to suggest a hypothesis of greater severity and worse prognosis of COVID‐19 in ESRD patients. Underlying comorbidities, such as liver disorders or more severe clinical symptoms like altered consciousness, may also be indicative of a worse prognosis in dialysis patients with COVID‐19.

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Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study

Cited by 8 publications

References 23 publications

Clinical and Para-clinical Findings of COVID19 in Hemodialysis Patients Compared to Control Group: A Case-Control Study

Clinical and Para-clinical Findings of COVID19 in Hemodialysis Patients Compared to Control Group: A Case-Control Study

Efficacy and Safety of Remdesivir in COVID-19 Positive Dialysis Patients

A multicenter study of severity and prognosis of symptomatic COVID‐19 in end‐stage renal disease and non‐dialysis patients in East of Iran

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