EPIDEMIOLOGY OF COVID -19 HEMODIALYSIS PATIENTS AT THE MILITARY HOSPITAL OF RABAT

Introduction:Sars Cov2 infection is a risk factor for mortality in chronic hemodialysis (HD) patients and those with chronic kidney disease. In addition, it can be responsible for acute kidney injury (AKI) with a poor prognosis in patients requiring renal replacement therapy.The objective of our study is to determine the epidemiological and evolutionary profile of Covid 19 patients undergoing hemodialysis sessions.

Method:This is a monocentric retrospective study including patients with the severe form of Covid-19 referred to the Mohammed V military instruction hospital and undergoing one or more dialysis sessions between March 2020 and April 2021.

Results:Of 30 dialysis patients, 63.3% (n=19) were on chronic hemodialysis, 20% (n=6) presented an acutization of their chronic renal failure, and 16.7% (n=5) developed acute kidney injury. The average age was 64.4 years with a male predominance (70%).

Type 2 diabetes was the most common comorbidity (50%), followed by hypertension (33.3%) and cardiovascular disease (13.3%). About two-thirds of the patients presented with severe lesions on the chest CT classified as Co-RADS 5.

The overall mortality rate was 51.7%. This rate was 100% (n=5) in the AKI group, 66% (n=4) in the case of pre-existing renal failure and 33% (n=7) in the group of chronic hemodialysis patients.

There is a statistically significant difference in mortality between the group of hemodialysis patients and that of patients with AKI (p=0.034). The hospitalization departmentalso seems to be statistically associated with patient mortality (p=0.014). Among the comorbidities, only diabetes was statistically associated with patient mortality (p=0.05).

In our study, the levels of C reactive protein (CRP), ferritin, Lactate Dehydrogenase (LDH), white blood cells were lower in the chronic hemodialysis group compared to the other groups.

Conclusion:Our results underline the vulnerability of chronic hemodialysis patients to Covid 19 infection. They also confirm the poor prognosis of patients who develop AKI requiring hemodialysis, as well as those with diabetes.