Clinical Features & Outcome of 352 Covid-19 Positive Maintenance Haemodialysis Patients in Second Covid Wave in Tertiary Care Centre in South India

BACKGROUND Coronavirus disease (COVID-19) infection by severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) virus is an ongoing pandemic with high morbidity and mortality rates. The second COVID-19 wave was observed between April–July 2021. Patients with underlying CKD, ˃ 65 years, immunocompromised, post-transplants are at high risk for COVID-19 infection. AIMS AND OBJECTIVES Clinical features and outcome of 352 COVID-19 positive maintenance hemodialysis (MHD) patients in a tertiary care centre in South India. METHOD Patients admitted with respiratory symptoms with nasal RTPCR positive and on MHD referred to us from April to July 2021, were included. The study design was an observational study. The analysis included clinical profile, epidemiological data, vascular access, lab parameters and outcomes. Data analysed using SPSS version 17 (P-value < 0.05-significant) STUDY DESIGN: This is an Observational Retrospective study RESULTS Clinical profile constituted fever (82.6%), SOB (61.2%), cough (29.8%). Baseline characteristics were: Oxygen was required in 244 patients (69.31%), CPAP in 71 patients (20.17%) and mechanical ventilation in 21 patients (5.96%). Mortality seen in 132 patients (37.5%). Factors affecting mortality were age (P = 0.001), thrombocytopenia (P = 0.004), q SOFA >1 (P = 0.001), CPAP (P = 0.002) and mechanical ventilation (P = 0.0001). CONCLUSION The mortality rate was 37.5%. The factors associated with mortality were age, thrombocytopenia, q SOFA score > 1, hypoxemia, patients on oxygen support, CPAP, mechanical ventilation.Table 1.VariableNo.Mean age (years)50.7Male : Female269:83DM157HTN320CAD28Access : AVF/IJV/Femoral/Permcath303/35/10/4Haemoglobin (gm/dL)8.1Platelet count (lakhs/mm3)1.18

Coronavirus disease 2019 and pregnancy-related acute kidney injury: Our initial experience of six cases.

Pregnancy is identified as one of the risk factors for increased severity of illness in severe acute respiratory syndrome novel coronavirus 2019 infection. The severity of illness may range from mild infection to severe multi-organ failure. Acute kidney injury (AKI) may occur in pregnant patients with coronavirus disease (COVID) either due to obstetric cause or due to severe COVID illness. We report six cases of COVID-pregnancy with AKI and their outcomes.

Clinical features and outcomes of 84 COVID-Positive hemodialysis patients in a resource poor setting from India.

With the declaration of severe acute respiratory syndrome novel coronavirus-2019 as pandemic by the World Health Organization on March 11, 2020, there has been a steady rise in number of cases. Chronic kidney disease and dialysis population are risk factors for increased severity of illness. Literature about the coronavirus disease 2019 (COVID-19) in dialysis population is scarce. Management of COVID-19 patients in resource poor setting in a developing country does vary compared to developed nations. Nonavailability of the advanced laboratory facility and the newer medicines forces the treating team to manage the patients with available investigations and drugs. We aimed at analysis of clinical characteristics and outcomes of 84 patients on maintenance hemodialysis (HD). Data of all COVID-positive patients on maintenance HD, who were referred to our center were collected. All patients were given HD on NIKISSO machines. Outcomes of all the admitted patients were analyzed. Maintenance HD group formed majority of the kidney referrals (54%). Age group that was commonly affected was >50 years. Factors associated with mortality were age, diabetes, thrombocytopenia, prolonged baseline activated partial thromboplastin time, admission hypoxemia, high qSOFA score. Institutional Ethics Committee approval has been obtained for the study. Methodology of the study was in accordance with the Declaration of Helsinki. Verbal consent was obtained from patients/ attendants. In the ongoing COVID pandemic, in a developing nation where resources are constrained, it is difficult to salvage the critically ill patients. With the drugs available and the changing strategies, treatment was given to all the patients admitted with bedside renal replacement therapies. Our mortality rate was high compared to other studies due to delay in referral, admission hypoxemia, and late initiation of steroids.