Ozturk Savas, Turgutalp Kenan, Arici Mustafa, Gorgulu Numan, Tonbul Halil Zeki, Eren Necmi, Gencer Vedat, Ayli Mehmet Deniz, Pembegul Irem, Dolarslan Murside Esra, Ural Zeynep, Colak Hulya, Ozler Tuba Elif, Can Ozgur, Demir Mehmet Emin, Altunoren Orcun, Huddam Bulent, Onec Kursad, Demirelli Bulent, Aydin Zeki, Altun Eda, Alagoz Selma, Ayar Yavuz, Eser Zeynep Ebru, Berktas Bayram, Yilmaz Zulfukar, Ates Eser Uslu, Yuksel Enver, Sahin Gizem Kumru, Aktar Merve, Cebeci Egemen, Dursun Belda, Kocak Sibel Yucel, Yildiz Abdulmecit, Kazan Sinan, Gok Mahmut, Sengul Erkan, Tugcu Murat, Ozturk Ramazan, Kahvecioglu Serdar, Kara Ekrem, Kaya Bulent, Sahin Garip, Sakaci Tamer, Sipahi Savas, Kurultak Ilhan, Durak Beyza Algul, Altiparmak Mehmet Riza, Ecder Sabahat Alisir, Karadag Serhat, Dincer Mevlut Tamer, Ozer Hakan, Bek Sibel Gokcay, Ulu Memnune Sena, Gungor Ozkan, Bakir Elif Ari, Odabas Ali Riza, Seyahi Nurhan, Yildiz Alaattin, Ates Kenan
Division of Nephrology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Division of Nephrology, Department of Internal Medicine, School of Medicine, Mersin University, Mersin, Turkey.
Kidney Int Rep. 2022 Jun;7(6):1393-1405. doi: 10.1016/j.ekir.2022.03.017. Epub 2022 Mar 25.
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.
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.
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.
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.
血液透析（HD）患者感染2019冠状病毒病（COVID-19）后出现短期不良结局的风险增加。然而，COVID-19后时期的并发症和生存率尚未得到广泛报道。
我们开展了一项全国性、多中心观察性研究，纳入从确诊的COVID-19中康复的成年维持性HD患者。从同一中心的患者中选取未感染COVID-19的HD对照组。我们调查了HD患者随访期间的特征和结局，并将其与未感染COVID-19的组进行比较。
该研究共纳入了来自47个中心的1223例患者（COVID-19组635例，未感染COVID-19组588例）。患者的基线和HD特征几乎相似。COVID-19组第28天的死亡率以及第28天至第90天的死亡率均高于未感染COVID-19组（分别为19例[3.0%] vs. 无[0%]；15例[2.4%] vs. 4例[0.7%]）。在最初28天以及第28天至第90天期间，COVID-19组出现呼吸道症状、再次住院、家庭氧疗需求、下呼吸道感染和动静脉（AV）内瘘血栓形成的情况均显著更高。在多变量分析中，年龄（比值比[OR][95%置信区间]：1.029[1.004 - 1.056]）、组别（COVID-19组 vs. 未感染COVID-19组）（OR[95%置信区间]：7.258[2.538 - 20.751]）和血管通路类型（带隧道的导管/AV内瘘）（OR[95%置信区间]：2.512[1.249 - 5.051]）被发现是与90天死亡率相关的独立参数。
在COVID-19后时期，与未感染COVID-19的HD患者相比，感染过COVID-19的维持性HD患者再次住院、呼吸问题、血管通路问题增多，且死亡率较高。
