Clinical manifestations of COVID-19 infection in dialysis patients and protective effect of COVID-19 vaccine

Abstract

Background and objective COVID-19 infection poses a special challenge to patients with dialysis patients. The purpose of this study was to evaluate the clinical manifestations of dialysis patients with COVID-19 and the protective effect of the vaccine. Methods We included 41 studies based on big data, mainly analyzing the clinical symptoms of dialysis patients with COVID-19, the proportion of severe patients before and after vaccination, and the humoral reaction of vaccine in the body. Results 6.1% to 35.7% of dialysis patients with COVID-19 developed respiratory distress symptoms and needed to be admitted to an intensive care unit for mechanical ventilation. The incidence and mortality of COVID-19 in dialysis patients before vaccination were 5.5% and 1.1%, respectively, and decreased to 4.5% and 0.6% in breakthrough infected patients. There was no statistical difference in serum conversion rates between dialysis patients and healthy controls, but the neutralizing antibody titer in the control group was 1922 (IQR 533 to 3186) AU/mL, and the neutralizing antibody titer in dialysis patients significantly decreased to 367 (IQR 171 to 1650) AU/mL ( P =0.046). Conclusions Dialysis is associated with an increased risk of severe COVID-19, and generally has a poor seroconversion response to vaccines. It also confirms the protective effect of vaccines on high-risk populations such as dialysis.

Characteristics and Prognostic Factors of SARS-CoV-2 Omicron Variant Infection in Hemodialysis Patients: A Single-Center Study in China

“…Previous literature has identified several demographic and clinical prognostic factors in HD with COVID-19 [18,[25][26][27][28][29]. Advanced age constitutes not only a risk factor for SARS-CoV-2 infection but also a negative prognostic factor for HD patients with COVID-19 [18]. Our study corroborates these findings, as we identified age as an independent factor for disease progression to critical illness and in-hospital mortality, aligning with previous research [25,30].…”

“…COVID-19 infection poses a challenge to HD patients, with certain demographic and clinical manifestations observed in this unique population. Previous observations of dialysis cases with COVID-19 showed that diabetes and hypertensive nephropathy are the predominant kidney diseases, with most patients being over 50 years old [18]. Similarly, in the current study, chronic nephritis, diabetes, and hypertensive nephropathy accounted for 93.4% of the whole population with an average age exceeding 60 years.…”

“…Especially in those aged over 75 years, the 28-day mortality rate could soar to 31.4% [30]. A recent review comprising 41 studies similarly emphasized the significance of age as a crucial risk factor for dialysis patients [18].…”

“…Previous literature has identified several demographic and clinical prognostic factors in HD with COVID-19 [18, 25‒29]. Advanced age constitutes not only a risk factor for SARS-CoV-2 infection but also a negative prognostic factor for HD patients with COVID-19 [18].…”

Clinical, laboratory, and imaging findings of stage 3-5 chronic kidney disease patients suffering from COVID-19 in Bangladesh: a prospective cross-sectional study

“…Literature suggests that the observed high symptoms and clinical parameters among the patients are likely due to the combined effects of the viral infection and pre-existing kidney disease [10,38]. Fever and cough are common in viral infections; shortness of breath and compromised oxygen saturation result from respiratory involvement, exacerbated by compromised kidney and lung function; and fatigue may be heightened due to the interaction of both conditions are reported in COVID-19 [39,40].…”