Risk factors and prognosis for coronavirus disease 2019 among 131 hemodialysis patients during the Omicron variant epidemic

Abstract

The present study evaluated the presentations and outcomes of coronavirus disease 2019 (COVID-19) among patients undergoing maintenance hemodialysis (MHD) and the impact of the Omicron BF.7 variant. Adult patients (age ≥ 18 years), who underwent MHD (dialysis vintage ≥ 3 months) at the Hemodialysis Center at Beijing Tsinghua Changgung Hospital between December 2022 and January 2023, were included based on predefined eligibility criteria. Clinical and laboratory characteristics were retrospectively collected. Among 131 patients who underwent MHD (10.7% vaccination rate), 106 (80.9%) tested positive for COVID-19. The prevalence of asymptomatic, mild, moderate, and severe COVID-19 was 8.5%, 58.5%, 17%, and 16%, respectively. Among the 97 patients with symptoms, 23 (23.7%) were hospitalized and six (5.7%) died. Fever was experienced by 74.2% of patients and respiratory symptoms were the most common (81.4%). Residual symptoms persisted in 20.9% of patients one month after the onset of COVID-19. COVID-19-positive hemodialysis patients were more likely to experience weight loss and exhibit reduced albumin levels compared to those without COVID-19 (p < .05). Compared with the asymptomatic group, patients with symptoms were younger, and exhibited higher interleukin-6 levels and lower post-infection phosphate levels (p < .05). Age, dialysis vintage, comorbidities, and inflammatory factors were positively associated with disease severity, while baseline albumin and hemoglobulin levels were associated with death (p < .05). In conclusion, COVID-19 was prevalent among patients undergoing MHD, even during the Omicron variant epidemic. Age, nutritional status, comorbidities, and inflammatory factors were associated with disease severity and prognosis.