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Official publication of the Indian Society of Nephrology
 
ORIGINAL ARTICLE
Ahead of Print

COVID-19 in hemodialysis patients: Experience from a Western Indian center


 Department of Nephrology, Institute of Kidney Diseases and Research Center and Institute of Transplant Sciences (IKDRC-ITS), Ahmedabad, Gujarat, India

Correspondence Address:
Divyesh P Engineer,
Department of Nephrology, Institute of Kidney Diseases and Research Center and Institute of Transplant Sciences (IKDRC-ITS), Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_575_20

Introduction: Chronic kidney disease patients on hemodialysis (CKD-5D) are among the worst hit by the coronavirus disease 2019 (COVID-19) pandemic. Need to travel for dialysis, comorbidities, and immunosuppressive state put them at risk of severe disease and poor outcomes. We report our experience of COVID-19 in a cohort of CKD-5D from a public sector tertiary-care center from western India. Material and Methods: We retrospectively analyzed the records of 58 CKD-5D patients with confirmed COVID-19 admitted to our COVID-19 hospital. Suspected COVID-19, acute kidney injury (AKI), or AKI on CKD were excluded. We studied the clinical, demographic, radiological, and laboratory profiles; treatment; and outcomes of the patients. We assessed the potential clinical and laboratory parameters to predict mortality. Results: The mean age of the patients was 48.7 ± 16.9 years, with 55% males. Comorbidities included hypertension (65%), diabetes (19%), and cardiovascular disease (15.5%). The presenting features included fever (69%), respiratory distress (50%), upper respiratory symptoms (36%), and diarrhea (13%). Five (8.6%) were asymptomatic. Bilateral infiltrates on chest imaging were the commonest radiological pattern. The patients were managed with oxygenation, hydroxychloroquine, steroids, anticoagulation, remdesivir, and favipiravir. Twenty-two (37.9%) patients died, predominantly due to respiratory failure. Disease severity and C-reactive protein (CRP) above 175 mg/L at admission were the only parameters predictive of mortality. Conclusion: CKD-5D patients with COVID-19 were less likely to present with the classical syndrome of fever and respiratory distress compared with reports from the general population and had higher mortality. Only disease severity and high CRP (>175 mg/L) were predictive of mortality in our cohort.


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    -  Banerjee S
    -  Patel HV
    -  Engineer DP
    -  Gupta V
    -  Patel H
    -  Gupta A
    -  Shah PR
    -  Kute VB
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Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07