OUTCOME OF COVID 19 PATIENTS REQUIRING HEMODIALYSIS

COVID-19 affects multiple organs including the kidneys, with higher mortality in patients with comorbid conditions such as end-stage kidney disease. Patients on maintenance hemodialysis are vulnerable due to uremia-related immune dysfunction, high comorbidity burden, frequent hospital visits, and cross-contamination risks in dialysis centers. The aim of this study was to determine the outcomes and mortality rate of COVID-19 patients requiring hemodialysis at Anwar Khan Modern Medical College & Hospital.

Design: Retrospective cohort study of medical records. Setting: Anwar Khan Modern Medical College & Hospital, Dhaka, Bangladesh. Period: September 2020 to January 2021. Population: Hospitalized patients with COVID-19 requiring hemodialysis (including one predialysis patient). Variables: Dependent variable— inpatient outcome and mortality rate. Independent variables— clinical conditions, physical examination findings, oxygen requirements, diagnosis, clinical features, and complications. Treatment approach: According to WHO and Bangladesh Government COVID-19 treatment guidelines.

- N=98 hospitalized COVID-19 patients; 97 on hemodialysis and 1 predialysis. - Median age: 59 years; sex: 52 male (53.06%) and 46 female (46.94%). - Frequent comorbidities: CKD and hypertension. - Reported symptoms/complications included fluctuated blood pressure (50.1%), vomiting (19.38%), shivering (37.76%), and chest pain (16.33%). - Mortality: 11/98 (11.23%); male deaths 7 (7.14% of total), female deaths 4 (4.08% of total). - Survivors: 87/98 (88.79%).

The study found an overall mortality of 11.23% among COVID-19 patients requiring hemodialysis at a single center, suggesting a relatively low mortality in this cohort under guideline-based care. Deaths occurred predominantly among patients with severe clinical manifestations and multiple comorbidities (DM, HTN, CKD) and respiratory symptoms such as cough, breathlessness, and fatigue, underscoring the importance of comorbidity burden and disease severity in outcomes. These findings address the research question by quantifying outcomes and highlighting clinical features associated with mortality, reinforcing the need for close monitoring and standardized treatment protocols in this high-risk population.

This retrospective cohort observed a low mortality rate among COVID-19 patients requiring hemodialysis. Patients who died had severe clinical manifestations and comorbidities (DM, HTN, CKD) with respiratory symptoms. Close monitoring, adherence to guidelines, and comprehensive patient care appear to reduce mortality.