ABSTRACT
BACKGROUND AND AIMS: Patients on maintenance hemodialysis (HD) experience a heavy burden of the disease and frequently report poor quality of life (QoL) scores.[1,2] During the coronavirus 2019 (COVID-19) pandemic, additional challenges were posed to this vulnerable group. Restriction policies affected social contact and physical activity, even leading to intradialytic exercise programs' suspension.[3] Few studies analyze the impact of the pandemic on the QoL of this population. Thus, we aimed to assess the QoL of HD-dependent patients during the pandemic. METHOD: This is a retrospective single-center study. Demographic data originated from electronical medical records. The health-related QoL EQ-5D-5L questionnaire, developed by the EuroQol Group in 2005 and widely used for various diseases, was applied and assessed the five following self-reported scores: health (0-100 points), mobility (1-5 points), self-care (1-5 points), usual activities (1-5 points), pain/discomfort (1-5 points) and anxiety/depression (1-5 points).[4] With the exception of health, higher scores relate to greater difficulties, as inverted scales. Patients undergoing regular HD who filled in the questionnaire during the pandemic and at least one year prior were included. IBM® SPSS ® 27 software was used for statistical analysis. RESULTS: A total of 71 patients were included with a predominance of the male gender (54.9%). The median age was 77 years (IQR = 18 years) and the median time on HD was 78 months (IQR = 99 months). Thirty patients had diabetes (42.25%). During the pandemic, 12 patients (16.9%) had COVID-19. Analyzing the different QoL scores, no difference was reported concerning health (mean score 67.89 ± 18.3 versus 65.23 ± 20.6;T = 1.059, P = 0.297, IC (95%) = (-2.1;7.6);d = 0.126), usual activities (mean score 1.8 ± 1.09 versus 1.97 ± 1.32;T (71)= -1.136, P = 0.260, d = -0.135), pain/discomfort [mean score 1.8 ± 0.95 versus 2.07 ± 1.13;T (71) = -0.894, P = 0.260, d = -0.374], and anxiety/depression [mean score 1.8 ± 0.82 versus 1.94 ± 1.04;T (71) = -1.055, P = 0.295, d = 0.125] comparing with the pre-pandemic period. There was a statistically significant decrease in mobility (mean score of 1.96 ± 1.09 versus 2.44 ± 1.34) with moderate size effect [T (71) = -3.525, P < 0.001, d = -0.418]. There was also a statistically significant decrease in self-care (mean score of 1.45 ± 0.86 versus 1.82 ± 1.43) with small size effect [T (71) = -2.983, P = 0.004, d = -0.354). There were no differences in any score when adjusting to diabetes or COVID-19. CONCLUSION: During the pandemic, most QoL scores appear to have been unaffected. Higher resilience among these patients and the support from caregivers and healthcare professionals might have contributed to better coping during this period. Nonetheless, mobility seems to have become compromised and movement restrictions could have accelerated this process. Therefore, even in such times, promoting physical activity may play a role in improving the QoL of HD-dependent patients.