Clinical Characteristics of Hemodialysis Patients with COVID-19 Referred to Hemodialysis Centers Affiliated with the Shahrekord University of Medical Sciences Between 2020 and 2021

Abstract

Background: The coronavirus pandemic (COVID-19) seriously threatens the health and life of people with underlying diseases, such as patients undergoing hemodialysis. Objectives: This study aimed to determine the clinical characteristics of COVID-19 patients with chronic kidney disease undergoing hemodialysis referring to hemodialysis centers affiliated with the Shahrekord University of Medical Sciences between 2019 and 2021. Methods: This was a retrospective descriptive-analytical study with a sample size of 144 hemodialysis patients with COVID-19. The data were collected by a demographic questionnaire, a checklist based on the presence of underlying diseases, the cause of the kidney failure, drugs received during hemodialysis, medications used for COVID, the result of COVID-19 treatment, and outpatient or inpatient treatment, and the checklist of laboratory indices extracted from the patient’s medical records. Data were analyzed by SPSS version 20 and descriptive and analytical statistical tests. Results: The average age was 57.2 ± 14.42 years, and 64.6% were men, 35.4% were women, 64.6% recovered, and 35.4% died, although 42.4% of patients were treated on an outpatient basis, and 57.6% needed hospitalization. Also, 93.7% of patients were vaccinated. The average duration of hemodialysis treatment was 6.44 years, and diabetes accounted for 31.1% of the causes of kidney failure, and these people had a higher chance of mortality. Positive c-reactive protein (CRP) results were found in 72.2% of patients, and 54.2% had a positive erythrocyte sedimentation rate (ESR). In addition, 22.2% of patients used mechanical ventilation, and 88.2% had positive PCR results. Iron, ferritin, albumin, and hemoglobin index were lower than normal in all patients. Patients with positive hepatitis B antigens were treated with sofosbuvir. In outpatient treatment, 65.6% used remdesivir, and 70.5% used dexamethasone. Regarding inpatient treatment, 75.9% used methylprednisolone, 56.6% used tocilizumab, and 54.2% used pirfenidone. Conclusions: The rate of death and hospitalization in hemodialysis patients with COVID-19 was higher than that of normal people. Diabetes increases the chance of morbidity and mortality of COVID-19 in hemodialysis patients. The reduction of hemoglobin, iron, ferritin, and albumin weakened the therapeutic response of hemodialysis patients to COVID-19 and increased the chance of death. Although various drugs were used in the treatment of COVID-19 hemodialysis patients, the patients did not follow a single regimen.