COVID-19 in hemodialysis patients

Frolova, N.F.; Kim, I.G.; Ушакова, А. И.; Usatiuk, S.S.; Artyukhina, L.Yu.; Iskhakov, R. T.; Varyasin, V.V.; Sinyavkin, D.O.; Diakova, E.N.; Loss, K.E. Loss; Chervinko, V.I.; Volodina, E.V.; Tomilina, Natalia; Kryukov, E.V.; Zubkin, M.L.

doi:10.33029/2305-3496-2021-10-1-14-23

Infectious diseases: News, Opinions, Training

2021

DOI: 10.33029/2305-3496-2021-10-1-14-23

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COVID-19 in hemodialysis patients

N.F. Frolova¹,

I.G. Kim²,

А. И. Ушакова³

et al.

Abstract: Журнал для непрерывного медицинского образования врачей COVID-19 у больных, получающих лечение программным гемодиализом ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ 1 Государственное бюджетное учреждение здравоохранения города Москвы «Городская клиническая больница № 52 Департамента здравоохранения города Москвы», 123182, г. Москва, Российская Федерация 2 Федеральное бюджетное учреждение науки «Московский научноисследовательский институт эпидемиологии и микробиологии им. Г.Н. Габричевского» Федеральной службы по надзору в сфере … Show more

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COVID-19 in haemodialysis patients: result analysis of the first year of the pandemic

Zubkin

Frolova

Kim

et al. 2021

Terapevticheskii arkhiv

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Background. Present concepts of the novel coronavirus infection prognosis in haemodialysis (HD) patients are rather controversial. There is little information on therapy efficiency and safety in such patients. We studied COVID-19 course specifics, prognostic factors associated with fatal outcomes, therapy efficiency and its transformation at different stages of the pandemic first year. Materials and methods. Single-centre retrospective uncontrolled study included 653 COVID-19 HD-patients treated at Moscow City Nephrology Centre from April 1 to December 31, 2020. Results. This period mortality rate was 21.0%. Independent predictors of COVID-19 unfavourable outcome in HD patients were pulmonary lesion extension (CT grades 34), high comorbidity index, and mechanical ventilation. Approaches to COVID-19 treatment modified significantly at different periods. Immunomodulatory drugs (monoclonal antibodies to IL-6, corticosteroids) were used largely at later stages. With tocilizumab administration, mortality was 15.1%, tocilizumab together with dexamethasone 13.3%; without them 37.8% (р0,001). Tocilizumab administration in the first 3 days after hospitalization of patients with CT grades 12 was associated with more favourable outcomes: 1 out of 29 died vs 6 out of 20 (tocilizumab administered at later periods); p0.04. There was no significant difference in death frequency in patients with CT grades 34 depending on tocilizumab administration time. Conclusion. COVID-19 in HD patients can manifest in a severe course with unfavourable outcome. It is urgent to identify reliable disease outcome predictors and develop efficient treatment in this population.

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COVID-19 in haemodialysis patients: result analysis of the first year of the pandemic

Zubkin

Frolova

Kim

et al. 2021

Terapevticheskii arkhiv

Self Cite

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show abstract

The burden of COVID-19 in a heterogeneous population of immunocompromised patients – realities of the postpandemic

Avdeev,

Chulanov,

Alexeeva

et al. 2023

Terapevticheskii arkhiv

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On July 3, 2023, an interdisciplinary Council of Experts The burden of COVID-19 in a heterogeneous population of immunocompromised patients post-pandemic realities was held in Moscow with leading experts in pulmonology, rheumatology, hematology, oncology, nephrology, allergology-immunology, transplantation, and infectious diseases. The aim of the meeting was to discuss the current clinical and epidemiologic situation related to COVID-19, the relevance of disease prevention strategies for high-risk patients. The experts addressed the following issues: 1) the disease burden of COVID-19 in 2023 for patients with immunodeficiency in different therapeutic areas; 2) the place of passive immunization with monoclonal antibodies as a method of COVID-19 prophylaxis among immunocompromised patients; 3) prerequisites for the inclusion of passive immunization of immunocompromised patients into routine clinical practice.

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Analysis of the course and outcomes of COVID-19 at different stages of the pandemic in hemodialysis patients

Frolova,

Kim,

Chervinko

et al. 2024

jour

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The purpose of this study was a comparative analysis of the characteristics of the course and outcomes of COVID-19 in HD patients at different stages of the pandemic, focusing on the of the use of immunomodulatory therapy.Materials and methods. The retrospective study included 897 HD patients with COVID-19 (mean age 60.7 years, M 58.5%) who were hospitalized at Moscow City Hospital № 52. Group 1 (n=720) consisted of patients infected between the end of March 2020 and April 2021, group 2 (n=177) included patients hospitalized in May-December 2021. Each of group was divided into 2 subgroups based on treatment approaches. Subgroup 1a (n=231) included patients of the initial period of the pandemic who did not receive adequate immunomodulatory therapy, while Subgroup 1b (n=489) included patients of the late stage, were treated with IL-6 receptor blockers and corticosteroids. In group 2, 108 patients in Subgroup 2a received similar therapy, while 69 patients in Subgroup 2b were treated with neutralizing monoclonal antibodies in the early stages of the disease.Results. Mortality rates in Group 1 and Group 2 was 20.1% and 14.7%, respectively (p<0.09). The incidence of unfavorable outcome was highest in Subgroup 1a and lowest in Subgroup 2b (31.2% vs 5.8%, p<0.01). Mortality in Subgroups 1b and 2a was comparable (14.9% and 20.4%), despite more severe initial lung damage according to CT data in Subgroup 2a. In these patients, immunomodulators was more frequently combined with therapeutic plasma exchange (TPE). Independent risk factors for an unfavorable outcome were the progression of pulmonary pathology, with the transformation of stages CT 1-2 to CT 3-4, and a high comorbidity index.Conclusions. The use of immunomodulatory drugs imprtoved the effectiveness of COVID-19 treatment in patients with CKD5D. In severe cases, the most favorable outcomes were achieved with a combination of immunobiological drugs, corticosteroids, and TPE. An even more significant reduction in mortality was observed following the introduction of neutralizing monoclonal antibodies into clinical practice. Independent predictors of unfavorable outcome of COVID-19 in HD patients were a high comorbidity index and the progression of CT 1-2 into CT 3-4.

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COVID-19 in hemodialysis patients

Cited by 3 publications

References 1 publication

COVID-19 in haemodialysis patients: result analysis of the first year of the pandemic

COVID-19 in haemodialysis patients: result analysis of the first year of the pandemic

The burden of COVID-19 in a heterogeneous population of immunocompromised patients – realities of the postpandemic

Analysis of the course and outcomes of COVID-19 at different stages of the pandemic in hemodialysis patients

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