Mo874covid-19 in Hemodialysis Patients: Clinical Particularities and Outcomes

Abstract

Background and Aims Coronavirus disease 2019 (COVID-19) has affected the care and outcomes of patients treated with dialysis worldwide. Patients on hemodialysis (HD) are at extremely high risk to develop COVID-19 because of their multiple co-morbidities and immunosuppression. We report throw this work the experience of our unit of HD with the covid-19 infection and its outcomes on our patients. Method We conducted a prospective study since the beginning of the pandemic. We have collected 26 HD patients reached of COVID 19 disease. Results The sex ratio of our population was equal to 1,36 with female predominance. The mean age of our patients was 61, 31 ±14,17 years. The co-morbidities noted among these patients were respectively hypertension, diabetes, heart diseases and obesity in 19, 17, 10 and 10 cases. The causal nephropathy was respectively diabetic, undetermined, glomerular and interstitial nephropathy in 13, 9, 2 and 2 cases. The major symptoms associated to the COVID 19 were respectively dyspnea, cough, asthenia, fever and chills, digestive manifestations, chest pain in 22, 19, 19, 15, 10, and 6 cases. 7 patients have been exposed to covid-19 infested person. Symptoms appeared within an average of 4,3 ± 2 days. Oxygen saturation was less than 92% in 65% of the cases during hospitalization. 84% of the patients are hospitalized including one among them who required the stay in a resuscitation unit and intubation. The scannographic lesions of covid were estimated to more than 50% in 8 cases and less than 50% in 4 cases. A biological inflammatory syndrome has been noted in all of the patients with a mean CRP at 117+/-127 mg/l and the mean leucocytes count at 10248±6592 elt/mm3. Lymphopenia was noted in 14 cases with lymphocytes count less than 1500 elt/mm3. The ratio of neutrophils / lymphocytes was more than 2,5 in 12 cases. The treatment was based on oxygen, corticosteroids, antibiotics, vitamins and anticoagulation for hospitalized patients (22 patients). The mean number of HD sessions realized per patient during hospitalization was 4 ± 2,3 HD sessions. The perdialytic complications noted were alteration of the state of consciousness in 3 cases and heart failure in 5 cases. The outcomes of our patients were marked by death in 38% and a recovery in 62% of the patients. Thus, the forms observed in our series are respectively moderate, severe, pauci-symptomatic and asymptomatic in 12, 10, 2 and 2 cases. Conclusion We highlight throw this study the severe consequences of COVID-19 on HD patients in whom mortality reached 38%. Until the pandemic is controlled and a vaccine or a treatment are valid, we highlight the importance of the compliance with confinement and develop home dialysis among our population.