COVID-19 in patients with end stage kidney disease at a large community hospital in Eastern Saudi Arabia. A prospective study

Abstract

Objectives: To report the outcome of patients with end stage kidney disease (ESKD) who were diagnosed with COVID-19 at a large community hospital in Eastern Saudi Arabia.Methods: A single center, prospective observational study at Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia. Patients with ESKD who were maintained on dialysis and developed COVID-19 between June 15, 2020 and October 31, 2021 were enrolled. Results:In total, 30 patients with ESKD were diagnosed with severe acute respiratory syndrome coronavirus 2 infection. Twenty two (73%) patients developed the disease prior to COVID-19 vaccine rollout. The median age of the cohort was 63 (55-75) years. Most patients were diabetic (73%), hypertensive (97%) and had a median body mass index of 28 kg/m 2 . Twenty seven (90%) patients required admission, 16 (52%) patients developed pneumonia, and 5 (17%) patients required mechanical ventilation. Patients who developed pneumonia were older, and the majority had diabetes mellitus and coronary artery disease. Five patients died with a total mortality of 17%. Conclusion:Patients with ESKD who developed COVID-19 had a poor outcome with high mortality compared to the general population. Presence of diabetes mellitus, coronary artery disease and older age were associated with a higher risk of severe disease. There was a sharp decline in the number of positive cases following implementation of the vaccination program.

COVID-19 among Hospitalized Chronic Hemodialysis Patients: Clinical Features and Predictors of Mortality

“…In this study, half of the patients had mild symptoms, and the remaining half developed pneumonia. Age, diabetes and coronary artery disease were predictors of the development of pneumonia [13]. In our current study, an overall mortality rate of 26.5% (27.6% among symptomatic patients) was observed.…”

“…Therefore, each country (and maybe each region within a country) may need to study their patients' risks as well as various factors affecting their outcomes, especially with the evolving knowledge about COVID-19 and its episodes of outbreaks. Data about COVID-19 among chronic HD patients in Saudi Arabia are limited [11][12][13]. Table 3 summarizes the currently available data about the outcomes of COVID-19 among chronic dialysis patients in Saudi Arabia.…”

“…In another study from the southwest region of Saudi Arabia, Hakami et al reported a mortality rate of 19.8% among chronic HD patients with COVID-19 and found that age, heart disease, lymphocytopenia, neutrophilia, D-Dimer, ferritin, blood urea nitrogen, and aspartate transaminase level were the predictors of mortality [12]. Alkhunaizi et al looked at ESRD patients who developed COVID-19 in the eastern region and found an overall mortality rate of 17%, which increased to 30% among those who developed pneumonia [13]. In this study, half of the patients had mild symptoms, and the remaining half developed pneumonia.…”

“…In fact, some data suggests that the rate of mortality from COVID-19 infection among dialysis patients is affected by geographical and temporal patterns observed within the same country [10]. Data about the clinical features and outcomes of hemodialysis patients with COVID-19 in Saudi Arabia are limited [11][12][13]. Identifying and understanding risk rates and factors are important when planning and implementing interventions, such as the COVID-19 vaccination.…”