Risk factors and prognosis for coronavirus disease 2019 among 131 hemodialysis patients during the Omicron variant epidemic

Abstract

The present study evaluated the presentations and outcomes of coronavirus disease 2019 (COVID-19) among patients undergoing maintenance hemodialysis (MHD) and the impact of the Omicron BF.7 variant. Adult patients (age ≥ 18 years), who underwent MHD (dialysis vintage ≥ 3 months) at the Hemodialysis Center at Beijing Tsinghua Changgung Hospital between December 2022 and January 2023, were included based on predefined eligibility criteria. Clinical and laboratory characteristics were retrospectively collected. Among 131 patients who underwent MHD (10.7% vaccination rate), 106 (80.9%) tested positive for COVID-19. The prevalence of asymptomatic, mild, moderate, and severe COVID-19 was 8.5%, 58.5%, 17%, and 16%, respectively. Among the 97 patients with symptoms, 23 (23.7%) were hospitalized and six (5.7%) died. Fever was experienced by 74.2% of patients and respiratory symptoms were the most common (81.4%). Residual symptoms persisted in 20.9% of patients one month after the onset of COVID-19. COVID-19-positive hemodialysis patients were more likely to experience weight loss and exhibit reduced albumin levels compared to those without COVID-19 ( p < .05). Compared with the asymptomatic group, patients with symptoms were younger, and exhibited higher interleukin-6 levels and lower post-infection phosphate levels ( p < .05). Age, dialysis vintage, comorbidities, and inflammatory factors were positively associated with disease severity, while baseline albumin and hemoglobulin levels were associated with death ( p < .05). In conclusion, COVID-19 was prevalent among patients undergoing MHD, even during the Omicron variant epidemic. Age, nutritional status, comorbidities, and inflammatory factors were associated with disease severity and prognosis.

Clinical characteristics and outcomes of maintenance hemodialysis patients with COVID-19 during the Omicron wave of the pandemic in Beijing: a single center retrospective study

“…Bao et al found that in 102 hemodialysis patients, 12 (11.8%) died [ 13 ]. Wen found that the mortality was 5.7% which was similar with our study [ 14 ]. The omicron variant was associated with less severe disease than the delta variant but still resulted in substantial morbidity and mortality, especially among hemodialysis patients.…”

“…Similar to the previous studies, older patients tended to show a poorer prognosis [ 14 , 20 ]. Several previous studies have found that hyponatremia was associated with an increased death risk in MHD patients [ 21 – 23 ].…”

Clinical Characteristics of 427 Unvaccinated Chinese Adult Patients with Maintenance Hemodialysis Infected with the SARS-CoV-2 Omicron Variant: A Retrospective Study

“…Type I respiratory failure was present in all severe/critical illness cases, even requiring mechanical ventilation, and hypoxemia serves as a rapid diagnostic indicator for severe/critical illness cases of COVID-19 infection. [36] Few reported studies have used the ORF1ab and N genes as predictive indicators of disease severity, with most studies indicating age, fever, and hypoxemia as strong predictive indicators for disease progression, [37] thereby aligning with observations in this study. A prediction model was established to predict and identify the probability of critical classification of MHD patients at an early stage, thereby allowing for earlier interventional treatment.…”

The outcome and related risk factors of unvaccinated patients with end-stage kidney disease during the Omicron pandemic: a multicentre retrospective study

“… 7 17 18 Similarly, low prealbumin levels, which indicate malnutrition and poor overall health status, have been previously associated with adverse outcomes in various diseases. 17 Recognising these risk factors in the context of HD patients with SARS-CoV-2 infection delivers significant insights for risk stratification and possible interventions in this susceptible population. These findings emphasise the importance of targeted monitoring and management strategies in this high-risk population.…”