Radiology, laboratory, clinical course and outcomes of COVID-19 in chronic hemodialysis patients: a retrospective case-control study

INTRODUCTION: Coronavirus disease 2019 causes higher mortality in chronic hemodialysis patients. Previous studies on this subject generally covered 30 days or a hospital stay. This study compares the 100-day mortality of chronic hemodialysis patients with patients without kidney disease with the same disease severity.
METHODS: This retrospective case-control study is conducted in a single center, including 24 chronic hemodialysis in-patients and 48 control in-patients without renal disease, all diagnosed with coronavirus disease 2019.
RESULTS: According to the findings, the 100-day mortality rate of the hemodialysis group was significantly higher than that of the control group (odds ratio 4,53; %95 confidence interval 1.17-17.47). Multivariable regression analysis in Model A showed that chronic hemodialysis and critical illness were significantly associated with 100-day mortality, while cardiovascular disease comorbidity was a significant factor only in univariable analysis. The pneumonia severity index score was beneficial in predicting the in-hospital mortality of hemodialysis patients (odds ratio 1.07; %95 confidence interval 1.01-1.14). In addition, while all the patients in the control group were alive in the 90-day follow-up after discharge, three hemodialysis patients died at home due to sudden cardiac death.
DISCUSSION AND CONCLUSION: Patients undergoing chronic hemodialysis are at a higher mortality risk than those without kidney disease, even with the same severity of coronavirus disease 2019. Monitoring deaths among chronic hemodialysis patients during their hospital stay and the first three months after discharge is crucial. Clinicians can predict in-hospital mortality and manage patients more effectively by evaluating the pneumonia severity index scores.