The Longitudinal Evolution of Post-COVID-19 Outcomes Among Hemodialysis Patients in Turkey
Citation
Ozturk S, Turgutalp K, Arici M, Gorgulu N, Tonbul HZ, Eren N, Gencer V, Ayli MD, Pembegul İ, Dolarslan ME, Ural Z, Colak H, Ozler TE, Can O, Demir ME, Altunoren O, Huddam B, Onec K, Demirelli B, Aydin Z, Altun E, Alagoz S, Ayar Y, Eser ZE, Berktas B, Yilmaz Z, Ates EU, Yuksel E, Sahin GK, Aktar M, Cebeci E, Dursun B, Kocak SY, Yildiz A, Kazan S, Gok M, Sengul E, Tugcu M, Ozturk R, Kahvecioglu S, Kara E, Kaya B, Sahin G, Sakaci T, Sipahi S, Kurultak İ, Durak BA, Altiparmak MR, Ecder SA, Karadag S, Dincer MT, Ozer H, Bek SG, Ulu MS, Gungor O, Bakir EA, Odabas AR, Seyahi N, Yildiz A, Ates K. The Longitudinal Evolution of Post-COVID-19 Outcomes Among Hemodialysis Patients in Turkey. Kidney Int Rep. 2022 Mar 25. doi: 10.1016/j.ekir.2022.03.017. Epub ahead of print. PMID: 35350104; PMCID: PMC8949692Abstract
Background: 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 group.
Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. 28th day mortality and mortality between 28th day-90th day were higher in the COVID-19 group than non-COVID 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, A-V fistula thrombosis were significantly higher in the COVID-19 group in both the first 28 days and between 28-90 days. In the multivariable analysis, age [Odds ratio (OR) (95% confidence interval[CI]): 1.029(1.004-1.056)], group (COVID-19 group vs. non-COVID 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 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared to the non-COVID HD patients.
