The Longitudinal Evolution of Post-COVID-19 Outcomes Among Hemodialysis Patients in Turkey


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Ozturk S., TURGUTALP K., ARICI M., Gorgulu N., TONBUL H. Z. , EREN N., ...More

KIDNEY INTERNATIONAL REPORTS, vol.7, no.6, pp.1393-1405, 2022 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 7 Issue: 6
  • Publication Date: 2022
  • Doi Number: 10.1016/j.ekir.2022.03.017
  • Journal Name: KIDNEY INTERNATIONAL REPORTS
  • Journal Indexes: Science Citation Index Expanded, Scopus, EMBASE, Directory of Open Access Journals
  • Page Numbers: pp.1393-1405
  • Keywords: COVID-19, hemodialysis, nationwide study, outcome, MORTALITY-RATES, COVID-19, TRANSPLANT

Abstract

Introduction: Hemodialysis (HD) patients have increased risk for short-term adverse outcomes of COVID-19. However, complications and survival at the post-COVID-19 period have not been published extensively.Methods: We conducted a national, multicenter observational study that included adult maintenance HD patients recovered from confirmed COVID-19. A control HD group without COVID-19 was selected from patients in the same center. We investigated the characteristics and outcomes in the follow-up of HD patients and compare them with the non-COVID-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 group (19 [3.0%] patients vs. none [0%]; 15 [2.4%] patients vs. 4 [0.7%] patients, respectively). The presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 group) (OR [95% CI]: 7.258 [2.538-20.751]), and vascular access type (tunneled catheter/AV fistula) (OR [95% CI]: 2.512 [1.249-5.051]) were found as independent parameters related to 90-day mortality.Conclusion: In the post-COVID-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients.