The clinical characteristics and course ofCOVID-19 in hemodialysis patients

Introduction In December 2019, pneumonia cases emerging in China rapidly spread and became a global pandemic. The disease called COVID-19 threatens health and life in patients with comorbid disease, especially in patients with kidney failure. In this study, we aimed to evaluate the clinical findings, laboratory parameters, and prognosis of COVID-19 disease in end-stage renal patients undergoing hemodialysis treatment. Methods We included the hemodialysis patients who have been diagnosed with COVID-19 disease and received inpatient treatment between 11 Match 2020 and 24 April 2020 in hospital. The demographic characteristics, comorbidities, symptoms, clinical course, laboratory parameters, and treatments were recorded. Findings The study included 25 hemodialysis patients; 15 (60%) were female. The mean age was 60.5 +/- 15 years. All patients had chest computed tomography findings compatible with COVID-19 disease. The findings were bilateral in 88% of patients. The real-time reverse transcriptase-polymerase chain reaction test was positive in 48% of the patients. The most common symptoms were dyspnea (56%) and fever (52%). The most common comorbid disease was hypertension (76%). Leukocytosis in 12% of the patients while 72% had lymphopenia. All patients had a high C-reactive protein value. 64% of patients required oxygen support and 32% intensive care. 28% developed a secondary infection. 76% (19/25) of the patients has been discharged with cure and 20% (5/25) died. The inpatient follow-up of a patient (4%) continues. Secondary infection development was significantly associated with oxygen demand (P = 0.027) and need for intensive care (P = 0.001). Discussion The associated clinical symptoms of COVID-19 were similar in hemodialysis patients to those of patients without renal disease. However, it caused pneumonia in all hemodialysis patients. It was associated with a more severe disease and worse prognosis with a mortality rate of 20%. Our study suggests that COVID-19 disease has a significantly more severe course and worse prognosis in hemodialysis patients.