Clinical profile and outcome of patients on Maintenance Hemodialysis hospitalized with Covid 19 infection – A retrospective study from a tertiary care centre of Eastern India

Abstract

Background: Patients on maintenance hemodialysis (MHD) are more vulnerable to SARS-CoV-2infection because of uraemia related immune dysfunction leading to impaired immune defences and pro-inflammatory state, increased comorbidity burden, frequent hospital admissions and the risk of cross-contamination in the dialysis centres. Presence of comorbidities is associated with poor outcome.This study primarily designed to assess the clinical profile, treatment and outcome in MHD patients hospitalized with COVID-19 infection. Methods: This was a retrospective hospital record based study, including all the patients on MHD admitted with COVID-19 infection between1st may2020 to 1st March 2021. Categorical and Continuous variable were presented as proportions and mean  SD.The statistical significance level was set at 0.05 (two-tailed). Results: 56 patients(Male 47 and Female 9) on MHD were admitted during the study period.We observed that half of the patients admitted survived and were discharged from the hospital and median hospital stay being 13.5 (6-17) days.The mean age of non survivors was significantly higher as compared to survivors. 56.9 years (14.9) vs 47.8 (16.8)years (P0.05)No statistical significant difference was found in outcome based on gender or comorbidities. Significantly higher mortality was noted among patients on invasive ventilation (87.1%) Among lab variables Lymphopenia and hypoalbuminemia were significantly associated with poor outcome. Conclusions: We observed a high mortality rate among maintenance hemodialysis patients hospitalized for COVID-19.Lower serum albumin and lymphocyte count at admission were associated with poor prognosis.