SARS-CoV-2 Infection after Vaccination: A Comparative Profile between Dose 1 and Dose 2.

Since the initial shipment of vaccination campaign against SARS-CoV-2 infection, it was a major concern all over the world regarding appropriate gapping between the first and second dose and also the necessity of booster dose after being vaccinated with the second dose. This cross-sectional type of comparative study was conducted at Kuwait Bangladesh Friendship Government Hospital, from the period of March 01 2021 to August 31 2021, on 148 hospitalized patients who were vaccinated with Astra Zeneca. They were divided into two groups on the background of 1st dose and 2nd dose. Collected data were entered into SPSS-26 version and after data cleaning, descriptive analysis was done with frequency distribution. To find out the significant difference between the two groups considering clinico-demographic information, disease severity, and duration of the last dose of vaccine; the Pearson Chi-square test was done with a significance level ≤0.05. The patients from both groups were mostly male and above 60 years. There were no significant age or sex variations between the two groups. SARS-CoV-2 infection was common after 38 days of dose 1 and after 63 days of dose 2. Fever, cough, running nose, shortness of breath, fatigue, nausea, vomiting, lower oxygen saturation, radiological involvement were comparatively more in patients who got only a single dose. Mild pneumonia (70.7%) was the commonest presentation in both doses of vaccinated patients and single dose vaccinated patients mostly (45.5%) presented with severe pneumonia. Elderly clinically risks group patients were mostly hospitalized with infection after 1 month of the 1st dose and on the other hand after 2 months of completing the 2nd dose. Symptomatic infection and disease severity were more in 1st dose vaccine recipients in comparison to 2nd dose.

POS-179 Outcomes of Acute Kidney Injury in Patients Requiring Dialysis in Nephrology Department of a Tertiary Care Hospital in Bangladesh

Introduction: Acute kidney injury (AKI) requiring dialysis is an important health care burdenand is associated with very high in-hospital mortality. As no specific treatment is available toreverse AKI, the management remains supportive, including optimized fluid, electrolyte andacid-base balance, adjusting the dose of potentially nephrotoxic medications or avoidingsecondary haemodynamic and nephrotoxic kidney injury with timely initiation of dialysis.Timely initiation of dialysis in AKI is fundamental to achieve treatment goals and to providesolute clearance and removal of excess fluid while awaiting recovery of kidney function. Ifkidney function remains inadequate after a period of discontinuation from dialysis, it should bereinstituted by the foresight of the treating physician. The primary outcome of interest of thestudy was recovery of sufficient kidney function to discontinue haemodialysis therapy andcomplete recovery of renal function. Methods: This prospective observational study has beenconducted in the Department of Nephrology, Mymensingh Medical College Hospital,Bangladesh from September 2019 to February 2021. All adult patients in whom conventionalintermittent haemodialysis was initiated in the dialysis ward were included in the study. Allpatients were followed up till death or complete recovery or for a maximum period of six month.A structured data collection sheet was used to collect patients detail and recorded data wereanalyzed by IBM SPSS version 23. Results: A total of 134 patients of AKI requiring dialysiswere included in the study with the mean age of 42.3±15.7 years. Male (54.5%) were slightlymore than female with a male to female ratio of 1.2:1. Diabetes was present in 16 (11.9%)patients and hypertension was present in 47 (35.1%) patients. The causes of AKI weresepticaemia (35.1%), urinary tract infection (34.3%), surgery (18.7%), vomiting (16.4%),leptospirosis (11.2%), obstetric (10.4%), acute watery diarrhoea (9.7%), malignancy (8.2%), postrenal obstruction (8.2%), drugs (7.5%), rapidly progressive glomerulonephritis (6%), COVID-19(5.2%), rhabdomyolysis (4.5%), intestinal obstruction (3.7%), acute gastroenteritis (2.2%), waspbite (2.2%), organophosphorus compounds (OPC) poisoning (1.5%), starfruit toxicity (1.5%),haemolytic uremic syndrome (0.7%) and unknown (1.5%). Mean number of dialysis requirementwas 5.9±8.6 and length of hospital stay was 15.4±10.5 days. Out of 134 patients, 95 (70.9%)were discharged from hospital and 39 (29.1%) died in hospital. Total death of patients during thestudy period were 49 (36.6%) including home death of 10 (7.5%) patients. Complete recovery ofkidney function was achieved in 70 (52.2%) patients and partial recovery of kidney function whocan survive without dialysis were observed in 12 (9%) patients. 3 (2.2%) patients remain ondialysis and total survival during the study period was observed in 85 (63.4%) patients. Survivalrate was significantly higher in patients with ≤ 40 years (72.6%) and significantly lower inpatients with malignancy (18.2%) and post renal obstruction (27.3%). Conclusions: Outcomes ofacute kidney injury in patients requiring dialysis remains poor. Early detection, optimization offluid and electrolyte balance and timely initiation of haemodialysis are the keys to improvesurvival and overall mortality. No conflict of interest