ABSTRACT
Background: We examined the clinical characteristics of hemodialysis patients with COVID-19 during the 6th wave of infection (mainly Omicron variant) in Japan. Methods: Hemodialysis patients admitted in January 2022 and thereafter were grouped as the 6th wave group (n = 53), while others were grouped as the 1st-5th wave group (n = 47). Results: The proportion of vaccinations was significantly higher in the 6th wave group than in the 1st-5th wave group (96.2% vs 10.6%, p < 0.0001). Neutralizing antibody and molnupiravir were used more frequently in the 6th wave group (75.5% and 88.7%) than in the 1st-5th wave group (14.9% and 0%, both p < 0.0001). The critical disease was seen in 21.3% of the patients in the 1st-5th wave group and 0% in the 6th wave group (p < 0.001). Conclusion: The prognosis of hemodialysis patients in the 6th wave group was good. The vaccination and advances in the treatment may have contributed to the outcomes.
ABSTRACT
INTRODUCTION: The clinical course of hemodialysis patients with COVID-19 still remains unclear. METHODS: Thirty-four hemodialysis patients were retrospectively enrolled. Patients were divided according to disease severity, and clinical symptoms and laboratory data at admission were compared. RESULTS: The serum C-reactive protein (CRP) level, d-dimer level, and white blood cell (WBC) count were significantly higher in the group with critical disease than in the group with mild to severe disease (p = 0.005, p = 0.039, and p = 0.045). The serum CRP level exceeded 10 mg/dl within 7 days of clinical onset in all the cases with critical disease. CONCLUSION: Hemodialysis patients with COVID-19 who have elevated serum CRP and d-dimer levels, and an elevated WBC count at admission and patients with serum CRP levels exceeding 10 mg/dl before day 7 after clinical onset should be carefully monitored for possible progression to critical disease.