CKD patients on hemodialysis (HD) with COVID-19 infection: Characteristics and outcome

Background: The COVID-19 pandemic has special significance for Chronic Kidney Disease patients on HD Clinical characteristics and outcome from low resource settings are not well known Methods: From March 15 2020 until May 20, 2020, quality managers reviewed all patients with confirmed COVID-19 infections in 200 HD centres among MHD patients For patients with COVID-19 infections: age, gender, geographical zone, type of Insurance, continuity of care was noted, HD characteristics and outcome were reviewed Comparison of median was done with Mann Whitney/Wilcoxon 2 sample test and proportion with Fisther exact test All patients were transferred to public hospital for regulatory compliance limiting follow up of HD sessions Results: 39 out of 18402 patients developed COVID-19 infection M: F: 28: 11, Age;54 62 + 14 92 years Geographically: East zone:3(7%), North:12(31%), South:5(12%), West:19(50%) Payers: self pay:19(49%), government insurance:15 (38%) and private Insurance:5(13%) 32(82%) hypertensives, 23(59%)diabetics Outcome: 8(20%) expired, 18(46%) discharged, 12(31%) in hospital and 1 at home Mean Hb (77%) : 9 81 ±1 71 g%, Adequacy (74%): 1 30 ± 44, Vascular access (72%): 75% permanent access, 7% temporary catheter, 18% tunneled catheter, Albumin (64%): 3 69 ± 31 Conclusions: Maintenance HD patients have increased mortality as compared to reports in normal population and is associated with need for intensive care, steroid use and ventilatory support