Risks factors for virus shedding period of COVID-19 in maintenance hemodialysis patients: a retrospective cohort study

Abstract

Objective This study aimed to describe the clinical features of maintenance hemodialysis (MHD)patients with COVID-19 and potential factors related to the time to return negative RT-PCR in discharged. Methods Retrospective analysis was performed on the clinical data of 90 MHD patients and 134 non-dialysis patients who infected with COVID-19 and admitted to our hospital from 1 April 2022 to 10 June 2022. Results The average age of the MHD patients with COVID-19 was 64.8 ± 12.9 years old and 59.3% patients were males. 12.2% MHD patients with COVID-19 were admitted to ICU and they had higher levels of WBC, neutrophils and procalcitonin(PCT)(P < 0.05) and more symptoms of nausea or vomiting at admission(P = 0.0003). The mean lengths of time from positive to two consecutive negative COVID-19 PCR was 18.15 ± 6.37 days in discharged MHD patients and 11.18 ± 3.52 days in non-dialysis patients(P < 0.0001). Discharged MHD patients with hypertension and DM need obviously longer time to negative than without comorbid disease(21.33 ± 7.03 days vs 16.47 ± 3.6, P = 0.0194). Longer time to negative PCR was associated with lower level of Ct-ORF1ab RNA and Ct-N RNA at admission (R2 = 0.05958, P = 0.0291; R2 = 0.06719, P = 0.0202) in MHD patients. Conclusion MHD patients with COVID-19 had a high probability of admitting to ICU and the level of inflammatory indicators were critical factors. It takes a week longer for MHD patients to return negative PCR than non-dialysis patients. MHD patients combined with hypertension and DM, lower level of Ct- RNA need longer SARS-CoV-2 RNA clearance time than others.