Egyptian Retrospective Multicenter Study: The Interrelationship between COVID-19 Infection and Hemodialysis

Abstract

Background: Individuals on dialysis are disproportionately affected by corona virus. It is beneficial to compare the general population's and dialysis population's hospitalisation trends during the COVID-19 pandemic. Objective: To study the clinical presentation of SARS-CoV-2 infection in maintenance hemodialysis patients and identify their clinical sequel and outcomes through comparing the results with non-COVID-19 infection hemodialysis patients, and non-hemodialysis COVID-19 infection patients. Material and Methods: In this retrospective multicenter study 734 Egyptian patients were recruited. The clinical course and outcomes of hemodialysis patients with confirmed COVID, (group I) were compared to non-COVID hemodialysis patients (group II), and non-hemodialysis COVID-19 patients (group III). Results: The most common co-morbidities among group I was hypertension (45%), then diabetes mellitus (28.3%). Fever was the most common symptom (84.4 %) followed by dyspnea (46.9%). The cure rate was 84.4% and mortality was (15.6%). 5.3% of patients needed mechanical ventilation and majority were treated according to Egyptian protocol at home (65.3%). Comparison between (group I) and (group II) revealed that body mass index were significantly higher in group I while comparing investigations of both groups revealed that hemoglobin, hematocrit, leucocytes, platelets, ferritin & C-reactive protein showed statistically significant difference. Unexpectedly, although the need for intensive care admission presented more in group III, mortality significantly increased among group I. Comparing investigations during and after cure there were significant decrease in leucocytes, lymphocytes, and platelets. Conclusion: Obesity, hypertension and diabetes mellitus are important risk factors among hemodialysis patients with COVID-19 infection. Hemoglobin, hematocrit, leucocytes, platelets, ferritin & C-reactive protein are significant investigations for screening of COVID-19 among them, while WBCs, Lymphocytes, and platelets are considerable for follow-up of cure. Unexpectedly the need for ICU admission presented more in non-hemodialysis patients and mortality significantly increased among hemodialysis group with COVID-19.