MO895EVOLUTION AND PROGNOSIS OF HEMODYALISIS PATIENTS WITH MODERATE AND SEVERE COVID INFECTION: SINGLE HOSPITAL CENTRE EXPERIENCE

BACKGROUND AND AIMS: One of the major challenges of our century seems to be the SARS-COV2 virus pandemic that has resulted, at least until now, in over 2 million deaths worldwide. Multiple observational studies showed that patients with chronic kidney disease and especially those on the hemodialysis program have an increased risk of severe morbidity and mortality caused by the novel coronavirus. AIM OF STUDY: was to determine the prognosis and mortality risk in hemodialysis patients hospitalized for symptomatic COVID-19 infection, using the ALAMA age score and the COVID-GRAM critical illness risk score. METHOD: Prospective and retrospective study that included 74 patients undergoing chronic hemodialysis, hospitalized in the Constanta County Emergency Clinical Hospital between March 2020-December 2020, confirmed with SARS-CoV 2 infection by RT-PCR testing. RESULTS: Out of the total number of 74 hospitalized patients (64.58% M, 35.41% F;mean age = 66.64 years), having moderate and severe forms of the disease. 56.25% needed conventional oxygen therapy, 22.9% non-invasive mechanical ventilation and 12.5% intubation and ventilation. All patients underwent specific treatment according to the national protocols, updated with the rapid changes and increasing informations regarding the disease management. The mean duration of hospitalization was 12.33 days. 94.7 % of patients had additional risk factors (diabetes mellitus-47.56%, arterial hypertension-87.3%, COPD-7.8%, systemic aterosclerosis-35.4%, immunosuppression-11.6%, malignant tumors-4.8% ). Mean ALAMA score was more than 85 years (p<0.01) and mean COVID-GRAM critical illness risk score was 202 (92.1% risk for critical illness). Fatal outcome affected 37.8% of the patients, mainly due to severe respiratory failure, myocarditis, arrhythmias and stroke. CONCLUSION: Hemodialysis patients with SARS-CoV 2 infection have an unfavorable evolution and a reserved prognosis with a high risk of death, depending especially on the need for ventilatory support. 6.25% of the patients followed had post-COVID syndrome (disseminated intravascular coagulation, severe bacterial infections, enterocolitis), but these long-term complications of the survivors will need further studies.