Predictors of mortality in hemodialysis patients with COVID-19: A single-center experience

Abstract

Introduction: The COVID-19 pandemic has disproportionately affected patients with preexisting comorbidities, particularly dialysis patients. The aim of this study was to determine predictors of mortality in this population. Methodology: We conducted an observational, retrospective, cohort study collecting data from pre and post-vaccine from the electronic medical records of a single dialysis center at Hygeia International Hospital Tirana, Albania. Results: Of 170 dialysis patients, 52 were diagnosed with COVID-19. The prevalence of COVID-19 infection in our study was 30.5%. The mean age was 61.5 ± 12.3 years and 65.4% were men. The mortality rate in our cohort was 19.2%. Mortality rates were higher in patients with diabetic nephropathy (p < 0.04) and peripheral vascular disease (p < 0.01). Elevated C- reactive protein (CRP) (p < 0.018), high red blood cell distribution width (RDW) (p < 0.03), and low lymphocyte and eosinophil counts, were found to be risk factors for severe COVID-19 disease. ROC analysis identified lymphopenia and eosinopenia as the strongest predictors of mortality. After the vaccine administration, the mortality rate in the vaccinated population was 8%, in contrast to the 66.7% mortality rate that was found in the unvaccinated group (p < 0.001). Conclusions: Our study revealed that risk factors for the development of severe COVID-19 infection were RDW, low lymphocyte and eosinophil counts, elevated levels of CRP. Lymphopenia and eosinopenia were determined as the most important predictors of mortality, in our cohort. Mortality was notably lower among vaccinated patients.

A Study on Mortality Predictors in Hemodialysis Patients Infected with COVID-19: Impact of Vaccination Status

“…Our findings indicate that factors such as gender, primary kidney disease diagnosis, and comorbidities did not exhibit statistical significance in hemodialyzed patients when considering vaccination status and mortality, except for age and cardiomyopathy. In the study by Rista et al, higher mortality rates were observed in patients undergoing dialysis for diabetic nephropathy ( p < 0.04) and peripheral vascular disease ( p < 0.01) [ 34 ], in contrast to Selvaskandan et al, who found no association between obesity, diabetes status, ethnicity, or Charlson Comorbidity Index with COVID-19 severity [ 35 ]. Kikuchi et al, in their study, used multivariate analysis to show a significant increase in mortality with prolonged duration of dialysis, without a difference in gender or primary disease [ 36 ].…”

“…Rista et al, using ROC analysis, identified lymphocytopenia and eosinopenia as robust predictors of mortality. Post-vaccination, the mortality rate in the vaccinated population was 8%, a significant contrast to the 66.7% mortality rate observed in the unvaccinated group ( p < 0.001) [ 34 ]. Similar results were observed in our study.…”