COVID-19 in End-stage Renal Disease (ESRD) Patients Undergoing Hemodialysis: A Close Follow-up of Clinical Findings and Evolutions in Chest CT Imaging: A Retrospective Study

Background: Coronavirus disease 2019 (COVID-19) has infected millions and caused tens of thousands of casualties. Epidemiologic studies show that specific individuals with pre-existing conditions are prone to severe disease caused by the virus. Thus, it is necessary to determine clinical signs and symptoms and disease progression course in various pre-existing conditions, namely end-stage renal disease (ESRD) patients undergoing hemodialysis. Methods: The present retrospective study was conducted on 17 ESRD patients undergoing chronic hemodialysis. Clinical signs and symptoms were extracted, and laboratory test results and imaging findings were retrieved using the health information systems of the institute where the study was performed. Results: Of 17 patients in the study, six patients were females, and 11 were males. The mean age of the patients was 62.29 ± 15.6 years (22 - 82). The most common pre-existing conditions were hypertension and diabetes. The most common imaging signs were ground-glass opacities. The most common pattern of involvement was peripheral, bilateral, and multifocal involvement, and interestingly, uncommon imaging signs such as crazy-paving, peribronchovascular involvement, and reticulonodular pattern of involvement. The most common laboratory findings were lymphopenia, lymphocytosis, increased erythrocyte sedimentation rate, and positive C reactive protein. Conclusions: ESRD patients undergoing COVID-19 seem to have higher mortalities than the general public and show more significant lung involvement on chest CT imaging. Furthermore, uncommon imaging signs are more common in this group of patients.