COVID – 19 in Two Dialysis Centers Situated in Two Neighbouring States of the Western Balkans

Abstract

Background: Bosnia and Herzegovina (B&H) and Serbia are developing countries in the Western Balkans that share similar social and political legacy from the former Yugoslavia including the health care system and are not members of European Union. There are very scarce data on COVID – 19 pandemic from this region. Materials and methods: This observational prospective study was conducted in two dialysis and transplant centres in B&H and Serbia, during the COVID – 19 pandemic. We monitored: demographic and epidemiological data, preventive and control measures in dialysis centres, clinical course and outcomes of dialysis and transplanted patients with COVID – 19. Data were collected by filling out an agreed questionnaire and were analysed and compared for two consecutive time periods: February – June 2020 with total number of 767 studied patients, and July – December 2020 with total number of 749 studied patients. Results: For a period of 11 months, from February to December 2020, there were 82 ICHD patients, 11 CAPD patients and 25 kidney transplant patients who tested positive for COVID-19. In the first study period, the incidence of COVID – 19 positive in Tuzla was 1.32% among ICHD patients, and there were no positive CAPD patients, nor patients with kidney graft. The incidence was significantly higher in both centres in the second time period. These data correspond to incidence in general population. Total deaths of COVID-19 positive patients was 0% in Tuzla DC and 45.45% in Niš DC during first, and 16.67% in Tuzla DC and 23.44% in Niš DC during the second period. Conclusion: Very bad overall survival was direct reflection of unpreparedness of our medical systems for such situations, and reminder of importance of preventive measures. Spreading of COVID-19 and similar respiratory infections within DC can be achieved using cheap measures that we have described here. It might also shift fight in more developed countries toward cheaper and simpler preventive measures, which could result in money and lifesaving results.