Prognostic Factors for Mortality in Maintenance Hemodialysis Patients Infected with SARS-CoV-2.

Background: Maintenance hemodialysis patients are immunosuppressed, which increases their mortality risk if they contract coronavirus disease 2019 (COVID-19).

Methods: We studied data from 36 consecutive patients undergoing maintenance hemodialysis who were diagnosed as having COVID-19 from January 2020 to September 2023. Clinical data such as age and sex, laboratory data, radiological findings, modalities for blood purification therapy, and outcome at the time of discharge were collected from their hospital records. Binomial logistic regression analysis was used to predict risk factors for mortality and continuous hemodiafiltration (CHDF).

Results: After analyzing the correlation of outcomes with each prognostic factor, we identified 6 significant factors (P < 0.05). Age and initiation of CHDF were both associated with mortality. COVID-19 severity, steroid treatment, and serum lactate dehydrogenase level at admission were positively correlated with risk for CHDF initiation, while a greater number of vaccine doses was associated with lower risk.

Conclusions: Elderly hemodialysis patients have a higher mortality risk if they develop COVID-19 and require CHDF. More attention is warranted for vulnerable older patients with COVID-19 if they require hemodialysis. Risk reduction strategies, such as appropriate vaccination, are necessary.