(1428) The Impact of Chronic Kidney Disease on the Course and Outcomes of COVID-19

Introduction: Patients with Chronic Kidney Disease (CKD) have a significantly higher risk of developing severe forms of COVID-19, as their immune system may be weakened and organ function is compromised. This category of patients requires more careful medical supervision and an individual approach to the treatment of COVID-19 due to their special medical needs, including dialysis therapy. Our study was designed to identify the clinical features of COVID-19 in patients with CKD requiring long-term dialysis, comparing them with a group of patients with CKD not requiring dialysis.

Methods: The clinical material is based on the analysis of data on the treatment of patients with COVID-19: 223 patients with CKD required long-term dialysis and 220 patients with CKD not requiring dialysis. The average age was 53±2.5 years (from 20 to 78 years). The time from the onset of the first symptoms of COVID-19 to hospitalization averaged 3 (2-7) days. The majority of patients were admitted via emergency medical care (68.2%), while 22% were transferred from other departments and 9.9% from other medical institutions.

Results: In the group of patients with CKD requiring long-term dialysis, pronounced clinical and symptomatic features of COVID-19 are observed. Hyperthermia (64.1% vs. 47.7%; p< 0.001) and myalgia/arthralgia (37.2% vs. 23.6%; p=0.002) were more often observed in patients with CKD requiring long-term dialysis. Patients with CKD required long-term dialysis had a higher need for invasive (14.8% vs. 6.8%; p=0.007) and noninvasive mechanical ventilation (19.3% vs. 11.4%; p=0.021), higher mean PEEP, and lower pO2/FiO2 ratio. Patients with CKD required long-term dialysis had a higher rate of intensive care unit admission (38.6% vs. 20.9%; p< 0.001), acute respiratory distress syndrome (23.3% vs. 11.8%; p=0.002), and in-hospital mortality (16.6% vs. 8.2%; p=0.008) compared to patients with CKD not requiring dialysis.

Conclusions: The study showed that in the state of COVID-19 infection, patients with CKD requiring long-term dialysis have a higher rate of intensive care unit admission, development of acute respiratory distress syndrome, and hospital mortality compared with patients with CKD not requiring dialysis.