Demographic and clinical characteristics of patients with CKD and SARS-COV2 undergoing hemodialysis treatment

ABSTRACT

Background: Patients on HD or PD are likely to be at increased risk of COVID-19 and its complications because they have multiple comorbid conditions. There is a lack of evidence about the optimal management and even clinical manifestations because clinical presentation is highly variable. The delayed diagnosis is because it's not recognized by the treating centers and the confusion with patients with fluid overload or uremic syndrome can be fatal in this population. Methods: Retrospective, observational, single-center study in Mexico. We analyzed the clinical manifestations and outcomes of all maintenance HD patients hospitalized with COVID-19 from April 9th to May 31st, 2020 as confirmed by real-time polymerase chain reaction Results: 20 patients followed in our hospital with median age of 45.2±13.8 years, 50% were men. All the patients have HTA (100%), DM (50%), the most common symptoms at admission were asthenia (75%), dyspnea (65%), cough (55%) followed by myalgias (50%) and fever (45%). Poor oxygen saturation (<95%) breathing room air was observed in 18 patients (90%) with mean oxygen saturation of 77± 9%. Lung abnormalities on initial chest X-ray were observed in all patients. Peripheral ground-glassopacities, the typical radiologic pattern, were bilateral in 13 patients and unilateral in 7. Laboratory studies with lymphopenia in 85% of patients with a mean of 0.7+0.38. There were no differences baseline leukocyte or lymphocyte from patients who survived vs from those who died. The mortality rate (40%) was much higher than that observed in the general population (8%). Mortality was higher in women. Conclusions: The impact of this virus on patients with CKD is poorly understood. The evaluation of the nephrologist must be very detailed, most of the patients had mild dyspnea, however on physical examination, desaturation and radiological images were suggestive of infection by SARS-CoV2. The current situation provides a unique opportunity to gather vital information to process and learn from the experience worldwide. These results will allow us to treat them in a timely manner and reduce lethality in dialysis patients.