Pos-599 Extended-Hours Hemodialysis With Liberalized Diet Is Associated With Reduced Risk of Non-Cardiovascular Mortality in Elderly Dialysis Patients

Abstract

Introduction: Since the emergence of the COVID-19 pandemic, patients with SARS-CoV-2 infection have been seen to have various presentations and outcomes. Several recent studies had explored the differences in characteristics and outcomes of COVID-19 in the different patient population, and some with renal complications. There is, however, no systematic review of ESRD patients with hemodialysis who are infected with SARS-CoV-2. We performed a systematic review to evaluate the prevalence and case fatality rate (CFR) of COVID-19 infection in ESRD patients with hemodialysis. Methods: Systematic search was conducted using PubMed, Embase, Scopus, Web of Science, and CENTRAL for observational studies of COVID-19 infection in hemodialysis patients with prevalence or case fatality outcomes in the English language up to June 30, 2020. The meta-analysis was done using a random-effects model. Outcomes were prevalence and CFR with 95% confidence intervals. Also, global COVID-19 data were retrieved for estimating the prevalence and CFR of the general population as referencing points. Results: Of 3,272 potential studies, 14 studies were included in the meta-analysis (13,883 patients in 7 countries). Seven studies (13,172 patients in five countries) contained prevalence data whereas ten studies (2,626 patients in 7 countries) had case-fatality data. The pooled prevalence of COVID-19 in HD patients was 6.8% (95% CI 4.9 -9.1%) which was significantly higher than the global average prevalence (0.1%, 95% CI 0.1-0.1%). The overall case fatality rate in hemodialysis patients was 17.8% (95% CI 10.8 -24.9%) which was significantly higher than the global average CFR (5.0%, 95% CI 5.0 -5.0%). Conclusions: The prevalence and case fatality rate of SARS-CoV-2 infection in hemodialysis patients across the globe are significantly higher than the global average.