Long-term effect of COVID-19 infection on hemodialysis patients: Should we follow hemodialysis patients more closely?

Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, hemodialysis patients constitute one of the most vulnerable patient populations as they have more significant comorbidities and need to visit healthcare settings frequently even under pandemic conditions. It was also largely demonstrated that hemodialysis patients have high mortality rates with severe to fatal disease due to COVID-19 during their initial hospitalization. Even though the functional decline and fatigue after severe infections are not novel entity, some long-term effects of COVID-19 has drawn attention with its prolonged effects even after discharge. A recent prospective, observational study of Carriazo et al provided the first evidence to compare long-term mortality rates of hemodialysis patients with and without COVID-19. Carriazo et al stated a hazard ratio of 3.00 for the mortality rates of hemodialysis patients over a one-year follow-up period after the COVID-19 diagnosis. They emphasized that the high mortality rates of hemodialysis patients with COVID-19 are not limited to the initial hospitalization period but also continue after discharge, especially the first three months. In the light of this study, it can be recommended that hemodialysis patients with COVID-19 should be monitored closely and continuously and hemodialysis patients should be prioritized for a vaccination against COVID-19 with close follow-up for their antibody levels.

Phosphate and IL-10 concentration as predictors of long-covid in hemodialysis patients: A Brazilian study

“…Chronic kidney disease (CKD) has emerged as an independent risk factor for the severeness of COVID-19 illness (1,(3)(4)(5). Such adverse condition appears to be related with impaired immune function, low-grade chronic inflammation, cardiovascular diseases, frailty, and endothelial dysfunction, which are enhanced according to the severity of CKD, especially in patients undergoing maintenance hemodialysis (HD) (6)(7)(8). The Centre for the Mathematical Modeling of Infectious Diseases COVID-19 working group (1) suggested CKD as an important risk factor for severe COVID-19.…”

“…Carriazo et al (7) showed that the increased mortality rate persists during the one-year after COVID-19 diagnosis in HD patients. Therefore, it is recommended that patients undergoing HD that were infected with COVID-19 should be monitored continuously to avoid future complications, especially in the first three months (8).…”

“…Post-COVID symptoms mostly reported are fatigue, fever, shortness of breath, cough, body aches, heart palpitations, neurological symptoms, diarrhea, stomach pain, and body aches (13). Noteworthy, subjects with underlying health conditions, including HD patients are likely to develop long-COVID (8,(11)(12)(13)(14). Considering the global interest on how COVID-19 symptoms might persist in HD patients, as well as possible targets to avoid this condition, we performed an exploratory post-hoc study from the trial U1111-1237-8231 (15) with two specific aims: i) to characterize COVID-19 infection and long COVID symptoms from our Cohort of 178 Brazilians HD patients.…”

COVID-19 and Lipid Disorders

“…This is in contrast to hemodialysis patients. They are a more vulnerable population for COVID-19-related disease and mortality [9,10].…”

Kidney replacement therapy patients with COVID-19 in the vaccine era: what do we need to know?

“…[ 2 ] also reports the efficacy of a booster vaccine in the HD population, evident by the fact that almost half and most of the HD patients infected in the fifth and sixth waves, respectively, were unvaccinated. However, it is also important to acknowledge that mortality from COVID-19 in HD patients is not limited to the initial hospitalization period, as an increased risk may extend for up to 1 year after the infection, with the highest risk observed in the first 3 months [ 11 , 12 ]. Considering the increasing number of KRT patients worldwide, vaccination is a key element for protection against COVID-19, as the availability of vaccines decreased the number of COVID-19 cases dramatically in this population [ 2 ].…”