MO166: The Longitudinal Evolution of Covid-19 Outcomes Among Hemodialysis Patients: A Nationwide Multicentre Controlled Study
Authors: Ozturk Savas , Turgutalp Kenan , Arici Mustafa , Gorgulu Numan , Zeki Tonbul Halil , Eren Necmi , Gencer Vedat , Ayli Deniz , Pembegul Irem , Esra Dolarslan Murside , Ural Zeynep , Colak Hulya , Elif Ozler Tuba , Can Ozgur , Emin Demir Mehmet , Altunoren Orcun , Huddam Bulent , Onec Kursad , Demirelli Bülent , Aydin Zeki , Altun Eda , Alagoz Selma , Ayar Yavuz , Ebru Eser Zeynep , Berktaş Bayram , Yilmaz Zulfukar , Uslu Ates Eser , Yuksel Enver , Kumru Sahin Gizem , Aktar Merve , Cebeci Egemen , Dursun Belda , Yucel Kocak Sibel , Yildiz Abdulmecit , Kazan Sinan , Gok Mahmut , Erkan Sengul , Tugcu Murat , Ozturk Ramazan , Kahvecioglu Serdar , Kara Ekrem , Kaya Bulent , Sahin Garip , Sakaci Tamer , Sipahi Savas , Kurultak Ilhan , Algül Durak Beyza , Riza Altiparmak Mehmet , Alisir Ecder Sabahat , Karadag Serhat , Tamer Dincer Mevlut , Ozer Hakan , Bek Sibel , Ulu Sena , Gungor Ozkan , Ari Bakir Elif , Riza Odabas Ali , Seyahi Nurhan , Yildiz Alaattin , Ateş Kenan 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Haemodialysis (HD) patients are at increased risk for adverse short-term consequences of COVID-19. In this study, we investigated the characteristics of chronic HD patients in the post-COVID-19 period and compared them with the control group.

METHOD
We conducted a national multicentre observational study involving adult chronic HD patients recovering from COVID-19. The control HD group was selected from patients with similar characteristics who did not have COVID-19 in the same center. SARS-CoV-2 RT-PCR negative patients and patients in the active period of COVID-19 were not included.

RESULTS
A total of 1223 patients (635 COVID-19 groups, 588 control groups) were included in the study from the data collected from 47 centres between 21 April 2021 and 11 June 2021. The patients' baseline demographics, comorbidities, medications, HD characteristics and basic laboratory tests were quite similar between the groups (Table 1). 28th-day mortality and between 28th day and 90th day mortality were higher in the COVID-19 group than in the control group [19 (3.0%) patients and 0 (0%) patients; 15 (2.4%) patients and 4 (0.7%) patients, respectively]. Presence of respiratory symptoms, rehospitalization, need for home oxygen therapy, lower respiratory tract infection and A-V fistula thrombosis were significantly higher in the COVID-19 group in the first 28 days of illness and between 28 and 90 days.
Mortality was significantly associated with preexisting COVID-19, age, current smoking, use of tunneled HD catheter, persistence of respiratory symptoms, rehospitalization, need for home oxygen support, presence of lower respiratory tract infection within 28 days and persistence of respiratory symptoms.

CONCLUSION
In the post-COVID-19 period, mortality, rehospitalization, respiratory problems and vascular access problems are higher in maintenance HD patients who have had COVID-19 compared to control HD patients.
Table 2. Comparative presentation of patients data on the 28th day and between 28 and 90 day COVID-19 groupN = 635 Control groupN = 588 28th-day results, n(%) Death* 19(3.0) 0(0) Any respiratory symptoms* 152(23.9) 11(1.9) Rehospitalization for any reason* 52(8.2) 24(4.1) Need for home oxygen support * 26(4.1) 2(0.3) Lower respiratory tract infection* 65(10.2) 8(1.4) AV fistula thrombosis* 13(2.0) 2(0.3) Other thromboembolic events * 15(2.4) 4(0.7) Need for HD catheter placement* 21(3.3) 9(1.5) 28th day-90. day resultsa n(%) N:616 N:588 Death* 15(2.4) 4(0.7) Any respiratory symptoms* 45(7.3) 10(1.7) Rehospitalization for any reason* 44(7.1) 18(3.1) Need for home oxygen support* 12(1.9) 2(0.3) AV fistula thrombosis* 9(1.5) 1(0.2) Other thromboembolic events* 9(1.5) 2(0.3) Need for HD catheter placement 13(2.1) 10(1.7) HD: haemodialysis, AV: arteriovenous. *P &lt; .05. a Patients who died before 28 days were not included.