Clinical Courses and Outcomes of COVID-19 in Patients Undergoing Chronic Hemodialysis and Peritoneal Dialysis in Northeast Thailand

Abstract

End-stage renal disease (ESRD) is one of the risk factors for infection, morbidity, and mortality in SARS-CoV-2. This study was aimed to evaluate the prevalence, clinical courses, and outcomes of patients undergoing chronic hemodialysis (HD) and peritoneal dialysis (PD). Materials and Methods: This was a retrospective study of ESRD patients admitted to Sakon Nakhon Hospital between October 2020 and September 2022. Data were analyzed for the incidence, demographic characteristics, clinical outcomes, laboratory tests, and mortality rates of the HD and PD patients who tested positive for COVID-19. Results: There were 73 ESRD patients (mean age 58.7 years, male 50.7%), who were positive for COVID-19 infection, of which 76.7% were on HD and 23.3% in the PD program. Hypertension (89.0%) and diabetes (54.8%) were more frequent comorbid conditions. Compared to the route of transmission, the HD group was more from hospital transmission (P = 0.03), while home transmission was more common in the PD group (P = 0.003). Serum potassium (P = 0.008) and albumin (P = 0.0005) were more in HD than PD, but bicarbonate (P = 0.01) was less. There was no significant in severity (P = 0.88) and mortality (P = 0.55) between both groups. Seven (9.6%) patients died. Risk factors compared between survivor and non-survivor groups significantly were serum albumin <3.5 g/dL (P = 0.008) and vaccination <2 shots (P = 0.04). Risk factor associated mortality in COVID-19 patients ongoing dialysis was low serum albumin <3.5 g/dL ([OR] 11.22, 95%, [CI] 1.27–98.91, P = 0.029). Conclusion: ESRD patients undergoing HD or PD were susceptible to COVID-19 infection. A comparison between the standard deviation and PD was found, but there was no significant difference in the clinical course and outcome of treatment in both groups.