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. 2023 Jul 28;85(9):4293-4299.
doi: 10.1097/MS9.0000000000001046. eCollection 2023 Sep.

Clinical manifestations and outcomes of COVID-19 in maintenance hemodialysis patients of a high infectious epidemic country: a prospective cross-sectional study

Mina Mondal  1 , Muhammad Nazrul Islam  2 , Ahsan Ullah  3 , Md Rezwanul Haque  4 , Motiur Rahman  5 , Liza Bosak  6 , Md Foyzur Rahman  7 , Shaikh Riaduz Zaman  8 , Mohammad Meshbahur Rahman  9
Affiliations

Clinical manifestations and outcomes of COVID-19 in maintenance hemodialysis patients of a high infectious epidemic country: a prospective cross-sectional study

Mina Mondal et al. Ann Med Surg (Lond). .

Abstract

Introduction: The outbreak of COVID-19 poses great challenges for patients on maintenance haemodialysis. Here, we reported the clinical characteristics and laboratory features of maintenance haemodialysis (MHD) patients with COVID-19 in Bangladesh.

Methods: Altogether, 67 MHD patients were enroled in the study from two dedicated tertiary-level hospitals for COVID-19 after the prospective cross-sectional execution of selection criteria. Data were collected from medical records and interviews. Different statistical analysis was carried out in the data analysis.

Results: The mean age was 55.0±9.9 years, with 40 males (59.7%). The mean dialysis duration was 23.4±11.5 months. The most common symptoms were fever (82.1%), cough (53.7%), and shortness of breath (55.2%), while the common comorbid condition was hypertension (98.5%), followed by diabetes (56.7%). Among MHD patients, 52.2% to 79.1% suffered from severe to critical COVID-19, 48 patients (71.6%) had 26-75% lung involvement on high resolution computed tomography of the chest, 23 patients (34.3%) did not survive, 20 patients (29.9%) were admitted to ICU, and nine patients (13.4%) needed mechanical ventilation. Patients who did not survive were significantly older (mean age: 63.0 vs. 50.86 years, P=0.0001), had significantly higher cardiovascular risk factors (69.6% vs. 43.2%, P=0.04), severe shortness of breath (82.6% vs. 40.9%, P=0.0001), and longer hospital stays (mean days: 17.9 vs. 13.0, P=0,0001) compared to the survivor group. The white blood cell count, C-reactive protein, lactate dehydrogenase, pro-calcitonin, and thrombocytopenia were significantly (P<0.0001) higher, while the albumin level was significantly lower (P=0.0001) in non-survivor compared to patients who survived.

Conclusion: Maintenance haemodialysis patients had severe to critical COVID-19 and had a higher risk of non-survival if they were older and had comorbidities such as hypertension and diabetes. Therefore, MHD patients with COVID-19 need close monitoring to improve their outcomes.

Keywords: Bangladesh; clinical manifestations; COVID-19; maintenance haemodialysis; mortality.

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Conflict of interest statement

The authors declare that they have no competing interests.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

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