The Longitudinal Evolution of Post-COVID-19 Outcomes Among Hemodialysis

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.

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[Turgutalp, Kenan; Eser, Zeynep Ebru] Mersin Univ, Sch Med, Dept Internal Med, Div Nephrol, Mersin, Turkey.

[Arici, Mustafa] Hacettepe Univ, Sch Med, Dept Internal Med, Div Nephrol, Ankara, Turkey.

[Gorgulu, Numan; Dincer, Mevlut Tamer] Univ Hlth Sci, Bagcilar Training & Res Hosp, Dept Nephrol, Istanbul, Turkey.

[Tonbul, Halil Zeki; Ozer, Hakan] Konya Necmettin Erbakan Univ, Meram Fac Med, Div Nephrol, Konya, Turkey.

[Eren, Necmi; Bek, Sibel Gokcay] Kocaeli Univ, Kocaeli Fac Med, Dept Internal Med, Div Nephrol, Kocaeli, Turkey.

[Gencer, Vedat] Yozgat Bozok Univ, Fac Med, Dept Internal Med, Div Nephrol, Yozgat, Turkey.

[Ayli, Mehmet Deniz] Univ Hlth Sci, Diskapi Yildirim Beyazit Educ & Res Hosp, Dept Nephrol, Ankara, Turkey.

[Pembegul, Irem] Malatya Turgut Ozal Univ, Dept Internal Med, Div Nephrol, Malatya, Turkey.

[Dolarslan, Murside Esra] Univ Hlth Sci, Trabzon Kanuni Training & Res Hosp, Dept Nephrol, Trabzon, Turkey.

[Ural, Zeynep] Gazi Univ, Fac Med, Dept Internal Med, Div Nephrol, Ankara, Turkey.

[Colak, Hulya] Univ Hlth Sci, Tepecik Training & Res Hosp, Dept Nephrol, Izmir, Turkey.

[Ozler, Tuba Elif] Amasya Univ, Sabuncuoglu Serefeddin Training & Res Hosp, Dept Nephrol, Amasya, Turkey.

[Can, Ozgur] Bitlis State Hosp, Dept Nephrol, Tatvan, Turkey.

[Demir, Mehmet Emin] Istanbul Yeni Yuzyil Univ, Private Gaziosmanpasa Hosp, Dept Nephrol, Istanbul, Turkey.

[Altunoren, Orcun] Kahramanmaras Sutcu Imam Univ, Fac Med, Div Nephrol, Kahramanmaras, Turkey.

[Huddam, Bulent] Mugla Sitki Kocman Univ, Fac Med, Dept Internal Med, Div Nephrol, Mugla, Turkey.

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[Altun, Eda] Golcuk Necati Celik Statement Hosp, Dept Nephrol, Kocaeli, Turkey.

[Alagoz, Selma] Univ Hlth Sci, Istanbul Training & Res Hosp, Dept Nephrol, Istanbul, Turkey.

[Ayar, Yavuz] Bursa City Hosp, Bursa Med Fac, Nephrol Dept, Bursa, Turkey.

[Berktas, Bayram] Inonu Univ, Turgut Ozal Med Ctr, Dept Internal Med, Div Nephrol, Malatya, Turkey.

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[Sahin, Gizem Kumru] Univ Hlth Sci, Van Training & Res Hosp, Dept Nephrol, Van, Turkey.

[Aktar, Merve] Ankara Univ, Fac Med, Dept Internal Med, Div Nephrol, Ankara, Turkey.

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[Ozturk, Ramazan] Univ Hlth Sci, Ankara Training & Res Hosp, Dept Nephrol, Ankara, Turkey.

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[Sakaci, Tamer] Hlth Sci Univ, Sisli Hamidiye Etfal Training & Res Hosp, Seyrantepe Campus Nephrol Clin, Istanbul, Turkey.

[Sipahi, Savas] Sakarya Univ, Educ & Res Hosp, Fac Med, Dept Nephrol, Sakarya, Turkey.

[Kurultak, Ilhan] Trakya Univ, Fac Med, Dept Internal Med, Div Nephrol, Edirne, Turkey.

[Durak, Beyza Algul] Ankara Bilkent City Hosp, Nephrol Dept, Ankara, Turkey.

[Altiparmak, Mehmet Riza] Istanbul Univ Cerrahpasa, Cerrahpasa Fac Med, Dept Internal Med, Div Nephrol, Istanbul, Turkey.

[Ecder, Sabahat Alisir] Istanbul Medeniyet Univ, Fac Med, Dept Internal Med, Div Nephrol, Istanbul, Turkey.

[Ulu, Memnune Sena] Bahcesehir Univ, Fac Med, Dept Internal Med, Div Nephrol, Istanbul, Turkey.

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[Arici, Mustafa] Hacettepe Univ, Fac Med, Dept Nephrol, Ankara, Turkey.