MO860: Dialysis Department Patients’ Mortality During Covid-19 Pandemic—A Single Centre Experience

Abstract BACKGROUND AND AIMS An epidemic of coronavirus (COVID-19) has been reported in Serbia since March 2020. Patients requiring chronic haemodialysis (HD) are considered particularly vulnerable due to altered immune response. However, severe form of COVID-19 infection has also been associated with multiple organ disfunction that, in some patients, may lead to acute kidney injury (AKI) or acutisation of previously known chronic kidney disease (aCKD). This study aimed to evaluate mortality rates in dialysis dependent patients hospitalized due to COVID-19. METHOD This retrospective study included 189 patients hospitalized in Clinical Hospital Centre Zemun between March 2020 and March 2021 due to COVID-19. All patients underwent haemodialysis during hospitalization and have been distributed in three groups depending on their renal status: AKI, HD and aCKD. Clinical presentation of the COVID-19 was defined as asymptomatic, mild, moderate, severe or critical. Demographic data and laboratory analyses were derived from the patients’ electronic record. Statistical analysis of the acquired data was performed in SPSS program. RESULTS Out of 189 patients, majority (75.1%) were receiving chronic haemodialysis, while 14.8% had AKI and 10.1% aCKD. The oldest patients were in AKI group, with average age of 70 ± 15 years, although difference did not reach statistical significance. Bilateral pneumonia was a predominant radiography finding in all patients, independently of study group (P = 0.168). Clinical presentation was mostly defined as mild in CHD group, whereas critical in AKI and aCKD group. Regarding complications, AKI group of patients had significantly higher sepsis rate (21.4%, P = 0.027) and respiratory insufficiency (78.5%, P = 0.000) than other groups. Mortality rate among overall population was high, precisely occurred in 64 (34.6%) patients. Statistically significant difference was observed between study groups regarding outcomes (P = 0.000). The worst survival rate was observed in AKI, while the lowest in HD group of patients, 82.1% and 21.9%, respectively. CONCLUSION Among COVID-19 positive population, patients who develop AKI have higher mortality rate compared with patients with previously acknowledged CKD, irrespectively of pre-hospital initiation of dialysis.