CLINICAL BEHAVIOUR AND THERAPEUTIC RESPONSES OF PATIENTS ON REGULAR HEMODIALYSIS ADMITTED WITH COVID 19 IN A TERTIARY CARE HOSPITAL
Main Article Content
Keywords
End-stage renal disease; Maintenance hemodialysis; COVID-19; ICU; Mechanical ventilation; Expired.
Abstract
The novel coronavirus illness (COVID-19) is quickly expanding, posing significant difficulties for patients with hemodialysis maintenance. The clinical manifestations and consequences of COVID-19-treated ESRD patients are presented here.
Methods
ESRD individuals treated with COVID-19 were studied in a retrospective cohort research at Dr. Ziauddin Hospital North Nazimabad in Karachi, Pakistan, between June 2020 and March 2021.
Findings
The ESRD group had lesser symptoms than others. Shortness of breath, fever, and cough were common symptoms, with statistically significant p values (p.007, p.001, and p.033, respectively). Lower median hemoglobin count (10 vs. 12.4; p0.001) and significantly higher inflammatory markers, such as d-dimer and serum ferritin levels (2922 vs. 1275; p.001, 2681 vs. 754; p.001, respectively), were found in the ESRD group. The median lymphocyte count was lower and inflammatory markers, such as C-reactive protein, ferritin, and lactate dehydrogenase, were greater in dying ESRD patients; however, none of these differences were statistically significant. The majority of the patients in the ESRD cohort were admitted with no oxygen requirements. Discharge, expiry, need for ICU hospitalization and invasive assisted ventilation remained statistically non-significant between the two groups. On Kaplan-Meier analysis, patients in ESRD cohort were discharged earlier (5.12 vs. 7.13 days; Log Rank p.013), had lower survival (3.75 vs. 7.29 days; Log Rank p.005). The ESRD cohort, on the other hand, required ICU admission much sooner after the beginning of symptoms. (4.8 vs. 8.13 days; Log Rank p.020).
Conclusion
Symptoms were milder in the ESRD cohort. Results across ESRD versus non-ESRD groups were, however, virtually identical.
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Dr. Faiza Nafees Khan
MBBS, FCPS, MASN (USA), Department of Nephrology, Dr. Ziauddin University Hospital, Karachi, Pakistan
Dr. Sumbal Nasir Mahmood
MBBS, FCPS, MASN (USA), Department of Nephrology, Dr. Ziauddin University Hospital, Karachi, Pakistan
Dr. Imtiaz Begum
MBBS, MRCP, Professor of Medicine, Ziauddin University Hospital Karachi. Pakistan
Dr. Sohail Hussain
MBBS, FCPS, MACG, Associate Professor, Consultant Gastroenterologist and Hepatologist, Assistant Director for Postgraduate Studies, Ziauddin University Karachi, Pakistan
Dr. Ali Raza
MBBS, FCPS, Department of Medicine, Dr. Ziauddin University Hospital, Karachi, Pakistan
Dr. Jamil Muqtadir Bhatti
MBBS, FCPS, Department of Infectious Diseases, Dr. Ziauddin University Hospital, Karachi, Pakistan.