Clinical profile and outcome of hemodialysis patients with SARS COV2 infection in a tertiary care centre in Mumbai, India

Abstract

Introduction: CKD5D is a high risk subgroup with high comorbidity burden, need for frequent visits to dialysis centre and a compromised immune system. The effect of SARS COV2 virus on this population is not well known. Methods: This prospective study enrolled, all CKD5D with COVID 19 infection, admitted to our hospital, from 23 rd April to 30 th June 2020 & whose outcome as discharge/mortality was known. Their clinical profile, investigations, treatment and outcome in terms of mortality or discharge after clearing infection was noted and analysed. Results: Total 203 dialysis patients with COVID 19 were referred to our institute. Of these total, 131 were analysed. Median age was 50 years (19-80 years) with 57% were males. Hypertension (76%) was the commonest comorbidity followed by diabetes (29%) and coronary artery disease (22%). Dyspnoea, fever and cough were present in 50%, 40%, and 33% patients respectively. 26% were asymptomatic. None had dialyser clotting. Mortality was 20.6%. Time to turn RT PCR negative was 14 days (3-40 days). Comparing deceased vs survivors: Age [56 vs 49 yrs], diabetes [56% vs 22%], duration of symptoms at admission [5 vs 4 days], dyspnea [85% vs 40%] and encephalopathy [30% vs 1%] at admission, bilateral opacities on Chest X ray [93% vs 20%] and high leucocyte count [11,059 ± 5,929 vs 7,022 ± 2,935/cmm] were statistically significant variables associated with mortality. Conclusion: Asymptomatic group was 26% of the total CKD5D with COVID 19 infection population analysed. Mortality was 20.61%. Higher age, later presentation to hospital, diabetes, dyspnoea, & encephalopathy at presentation, bilateral opacities on Chest X- Ray & higher leukocyte counts were significantly associated with mortality.