The Longitudinal Evolution of Post-COVID-19 Outcomes Among Hemodialysis
Title:
The Longitudinal Evolution of Post-COVID-19 Outcomes Among Hemodialysis;
Patients in Turkey
Ozturk, S; Turgutalp, K; Arici, M; Gorgulu, N; Tonbul, HZ; Eren, N; Gencer, V; Ayli, MD; Pembegul, I; 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, I; Durak, BA; Altiparmak, MR; Ecder, SA; Karadag, S; Dincer, MT; Ozer, H; Bek, SG; Ulu, MS; Gungor, O; Bakir, EA; Odabas, AR; Seyahi, N; Ates, K
Date:
2022
Abstract:
Introduction: 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-19 group.Results: A total of 1223 patients (635 patients in COVID-19 group, 588 patients in non-COVID-19 group) from 47 centers were included in the study. The patients' baseline and HD characteristics were almost similar. The 28th-day mortality and mortality between 28th day and 90th day were higher in the COVID-19 group than non-COVID-19 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, and arteriovenous (AV) fistula thrombosis was significantly higher in the COVID-19 group in both the first 28 days and between 28 and 90 days. In the multivariable analysis, age (odds ratio [OR] [95% CI]: 1.029 [1.004-1.056]), group (COVID-19 group vs. non-COVID-19 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-19 period, maintenance HD patients who have had COVID-19 have increased rehospitalization, respiratory problems, vascular access problems, and high mortality compared with the non-COVID-19 HD patients.
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