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Prevalence and Outcomes of COVID-19 Infection among Hemodialysis Patients in Nephrology-accredited Training Institutions in the Philippines
iD
Ricardo Francisco2
Juliet Chua Chong-Noel3
Arlene I. Afaga4
Agnes T. Cruz5
Jan Melvin Zapanta6
Aileen D. Merioles7
Jan Roslyn T. Empinado8
Charmaine Que9
Karen Cabigas10
Arnel Chua11
Brian Michael I. Cabral12
Anthony Russell Villanueva13
Bevy Lynn Leano4
Mel-hatra Arakama14
Maria Rachelle Uy15
Maritess Lopez16
Mizzenlei Soriano17
Joel John Mejos18
Vonn Velasco19
Rachelle Manalaysay20
Jennifer Ivy T. Leano20
Marissa Elizabeth L. Lim10
Carlsberg Howard Tsang21
Rica Nell Mendoza22
Ana Patricia Abellana23
Arra Marie Rojales24
Minerva G. Nicolas25
Vera Joy Bajarias3
Authors Info & Affiliations
Abstract
Introduction
Patients on maintenance hemodialysis are at an increased risk of SARS-CoV-2 infection and mortality. This study aimed to determine the prevalence of COVID-19 antibodies in a large sample of patients on dialysis in PSN-Accredited Nephrology Training Institutions.
Methods
This retrospective cohort study was conducted in partnership with eighteen medical centers with PSN-Accredited Nephrology Training. Adult patients who had RT-PCR confirmed COVID infection from March 2020 to March 2022 were included. Patient records were then collected, and pertinent data were collected using a standardized form. It was then transferred to an electronic database for further analysis.
Results
There were 785 hemodialysis patients who developed COVID-19 during the mentioned period, having an overall prevalence of 5.1%. Of these, 171 patients (22%) died during their hospitalization. There was a higher proportion of hypertensive patients and dyspnea on presentation in the mortality group. The mortality group also has significantly higher hematocrit and inflammatory markers (D-dimer, Ferritin, CRP). Based on multivariate analysis, the presence of cytokine storm, sepsis, higher D-dimer values, use of extracorporeal circuit, and tocilizumab were significant factors of mortality.
Discussion
This study has the largest number of centers involved in any COVID studies done locally. It showed variations in terms of complications and how the patients were managed.
Conclusion
This study found that the prevalence and mortality rate of COVID-19 infections are higher among patients receiving hemodialysis than in the general population. These findings highlight the importance of vaccination and other preventive measures to protect this vulnerable population.