ABSTRACT
Objective: This study aims to determine the difference in the coronavirus disease 2019 incidence between our patient group performing home dialysis, including home hemodialysis and peritoneal dialysis, and our patient group performing in-center hemodialysis. Methods: The study consists of the patients followed up in our center: 58 scheduled hemodialysis, 9 home hemodialysis, and 54 peritoneal dialysis patients. All the patients were closely followed for the coronavirus disease 2019 symptoms between March 2020 and May 2020. The follow-up intervals of our patients who underwent peritoneal dialysis and home hemodialysis were increased from 1 month to 2 months;all of them were contacted over the phone at the beginning of the pandemic and 2 months later, and the patients were questioned in terms of the coronavirus disease 2019 symptoms. Relevant descriptive statistics were presented. Binary logistic regression model was applied to compare the development of coronavirus disease 2019 in the patient group who performed home dialysis (home hemodialysis and peritoneal dialysis) and in the patient group who performed in-center hemodialysis via the glm function in R that fits generalized linear models. Age and the number of critical comorbidities (diabetes mellitus, hypertension, coronary artery disease, congestive heart failure, and chronic obstructive lung disease) were employed as the other independent variables in the model. Results: Three of the 58 patients who underwent dialysis in our center were followed up in our pandemic service with the diagnosis of coronavirus disease 2019. Coronavirus disease 2019 positivity was not detected in any patient who applied dialysis methods at home. The number of critical comorbidities appeared as the only significant variable in explaining the development of COVID-19 (P =.0569<0.10). The non-reflection of the difference of the applied methods (in-center hemodialysis vs. home dialysis (home hemodialysis and peritoneal dialysis)) in coronavirus disease 2019 development to the statistics may be due to the somewhat low number of total observations. Conclusion: In our study, we observed no peritoneal dialysis or home hemodialysis patient diagnosed with coronavirus disease 2019 in our center during the pandemic period. Home dialysis methods may prove to be the gold standard treatment, especially during the pandemic period.
ABSTRACT
Aim: The novel coronavirus causes acute severe respiratory syndrome (SARS COV 2), and the disease is named COVID-19. The virus spreads easily, and CO-VID-19 may be asymptomatic or cause severe pneumonia and ARDS. Hemodialysis patients are affected by COVID-19 because of the immunosuppression caused by uremia, comorbid diseases and the risk of cross-contamination during dialysis. In this study, we aimed to examine the clinical features and outcomes of 55 hemodialysis patients diagnosed with COVID-19. Material and Methods: Fifty-five hemodialysis patients who met the COVID-19 probable case definition were included in the study. Clinical and laboratory features were recorded from patient files and electronic data retrospectively. Results: The study included 55 patients, the average age was 59.6 ± 13.2 years, 49% (n = 27) were female. Hypertension, Diabetes Mellitus, coronary heart diseases were the most common comorbid diseases. Comparing survivors and non-survivors, it was seen that the non-survivors were older (p=0.010). Logistic regression analyses revealed that age, SO2, lactate, WBC, neutrophil count, CRP, LDH, CK, ALT, AST, albumin, total protein, ferritin and D-Dimer were associated with the risk of mortality Discussion: Myalgia, cough, and shortness of breath are the most common symptoms of COVID-19 infection in HD patients, with no apparent fever. Age, SO2, WBC count, neutrophil count, CRP, LDH, CK, ALT, AST, albumin, total protein, ferritin and D-Dimer were found to be associated with mortality. Close monitoring of these parameters during the follow-up and treatment of patients may provide additional benefits in terms of survival.