OUTCOME OF COVID 19 PATIENTS REQUIRING HEMODIALYSIS

COVID-19 significantly impacts multiple organs, including the kidneys. Patients with end-stage kidney disease (ESKD) and those on maintenance hemodialysis are particularly vulnerable due to compromised immune function, increased comorbidity burden, and higher risk of cross-contamination in dialysis centers. This vulnerability increases mortality risk associated with COVID-19 severity. Pre-existing conditions like age, diabetes, hypertension, coronary artery disease, smoking, and hemodialysis frequency correlate with mortality in non-COVID hemodialysis patients. However, the specific impact of COVID-19 on hemodialysis patients and their clinical and laboratory characteristics remains understudied. This study aims to determine the patient outcomes and mortality rate of COVID-19 patients requiring hemodialysis at a specific hospital.

The provided text does not contain a dedicated literature review section. However, the introduction cites existing knowledge regarding the vulnerability of hemodialysis patients to COVID-19 due to immunosuppression and increased comorbidities, highlighting the lack of comprehensive data on the clinical and laboratory features of COVID-19 in this population. The introduction sets the stage for the current study by emphasizing this knowledge gap.

This study employed a retrospective cohort design. Data were collected from medical records of adult patients on chronic hemodialysis admitted for COVID-19 between March 2020 and December 2020 at Anwar Khan Modern Medical College & Hospital. The dependent variable was patient outcome (mortality rate). Independent variables included clinical conditions, physical examination findings, oxygen requirements, diagnosis, clinical features, and complications. A total of 98 patients were included: 97 on hemodialysis and 1 pre-dialysis patient. The median age was 59 years, with 53.06% male and 46.94% female. Common comorbidities included CKD, hypertension, and diabetes mellitus. Treatment followed WHO and Bangladesh Government COVID-19 guidelines.

Of the 98 patients, 11 (11.23%) died during the observation period. Mortality rates were 7.14% for males and 4.08% for females. The remaining 87 (88.79%) patients survived. Deceased patients presented with severe clinical manifestations and complications such as diabetes, hypertension, CKD, cough, breathlessness, and fatigue. The most frequent comorbidities were chronic kidney disease (CKD), hypertension (including fluctuated blood pressure), vomiting, shivering, and chest pain. The study observed a lower-than-expected mortality rate.

The low mortality rate observed in this study contrasts with the known vulnerability of hemodialysis patients to severe COVID-19 outcomes. This discrepancy might be attributed to several factors, including the relatively small sample size, specific characteristics of the patient population, effective implementation of treatment guidelines, and potentially rigorous infection control protocols within the hospital setting. The study highlights the importance of close monitoring, guideline-adherent medication, and comprehensive patient care in mitigating mortality risks. The findings underscore the need for larger-scale studies to confirm these results and further explore the factors contributing to improved outcomes.

This retrospective cohort study demonstrates a low mortality rate (11.23%) among COVID-19 patients requiring hemodialysis. The successful management of these patients emphasizes the effectiveness of close monitoring, adherence to treatment guidelines, and proactive patient care. Future research should focus on larger, multi-center studies to validate these findings and investigate the influence of specific interventions and patient characteristics on mortality rates.

The study's retrospective nature and relatively small sample size limit the generalizability of the findings. Selection bias is also possible, as the study population is restricted to a single hospital. Further research with a larger, more diverse population and prospective design is needed to strengthen the conclusions.