Chronic Kidney Disease on Maintenance Hemodialysis with Covid 19 Infection - a Single Centre Experience

ABSTRACT

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 is a highly transmissible and pathogenic coronavirus that emerged in late 2019. This has been posing great threats to the world in many aspects. Comprehensive understandings on SARS-CoV-2 and the interaction of the virus with hosts are fundamentally important in the fight against SARS-CoV-2. SARS-CoV-2 is a positive-sense single-stranded RNA virus. The purpose of this study is to assess the clinical profile of ESRD patients undergoing maintenance hemodialysis with COVID-19 infection. Patients with Chronic Kidney Disease on hemodialysis are at an increased risk for any infections and often have unfavorable outcomes in case of serious infections. Here we present the data regarding the outcome of maintenance hemodialysis patients who had COVID 19 infection. AIM OF THE STUDY To study incidence of COVID 19 infection and clinical profile in Chronic Kidney Disease -Maintenance hemodialysis patients METHODS: This is single-center cross-sectional observational study conducted at Amrita Institute of Medical Science and Research Centre Kochi between March 2020 to August 2022. All patients on maintenance hemodialysis who developed COVID19 infection was included in the study. Patients who become COVID positive were managed as per institutional COVID 19 protocols. Only patients who received 2 doses of COVID 19 vaccine and crossed 14 days after second dose of vaccination were considered as vaccinated in the study population. RESULT(S) The incidence of COVID 19 infection among our maintenance hemodialysis patients was 56%. 62 out of our 110 maintenance hemodialysis patients were COVID 19 positive. Majority were males, hypertension was common among this population. 30% developed COVID-19 pneumonia. 90% of the study population were vaccinated, 75% of them were infected after 6 months of taking second dose of COVID 19 vaccine. 88% of the vaccinated patients had only mild infection. The mortality was 31%. There was no mortality in patients who received the cocktail antibody. CONCLUSION(S) The study shows that incidence of COVID 19 infection was high in our hemodialysis patients, frequent hospital visits and travel could be one of the reasons for the same. COVID 19 vaccination was effective especially during the first 6 months after the second dose of COVID 19 infection, it helps in reducing the severity of COVID 19 infection and has a good recovery rate. Cocktail antibody ( Casirivimab and imdevimab ) were effective in reducing the mortality rate in hemodialysis patients. More studies are warranted for scheduling further doses of COVID 19 vaccines in maintenance hemodialysis patients.