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Impact of COVID-19 on maintenance haemodialysis patients: The Indian scenario
Mayuri Trivedi1, Aakash Shingada2, Meera Shah1
1Department of Medicine (Nephrology Services), L.T.M.G. Hospital, Mumbai, India.
Insights
COVID-19 significantly impacts patients with chronic kidney disease stage V-dialysis (CKD V-D), especially in resource-limited settings. Severe COVID-19 cases in this cohort resulted in a 100% mortality rate, highlighting critical care needs.
Area of Science:
- Nephrology
- Infectious Diseases
- Public Health
Background:
- Limited data exists on COVID-19 impact on chronic kidney disease stage V-dialysis (CKD V-D) patients in resource-limited countries.
- Existing literature suggests CKD V-D patients have increased COVID-19 susceptibility and adverse outcomes.
Purpose of the Study:
- To describe the clinical presentation and outcomes of COVID-19 in CKD V-D patients from Mumbai, India.
- To identify unique challenges faced by CKD V-D patients in a resource-limited setting during the pandemic.
Main Methods:
- Retrospective analysis of 37 consecutive CKD V-D patients with COVID-19.
- Data collected from two dialysis centers in Mumbai, India.
Main Results:
- 56.7% of patients had asymptomatic or mild COVID-19; 27% had severe symptoms.
- The overall recovery rate was 63%.
- All patients with severe COVID-19 (100% mortality) succumbed to the infection.
- 30% experienced extended dialysis breaks due to logistic and social issues.
Conclusions:
- Clinical presentation and outcomes in this resource-limited cohort mirror global trends.
- Unique social and logistic challenges exacerbate patient and healthcare burdens, potentially worsening future outcomes.
- Urgent attention to these factors is needed to mitigate COVID-19's impact on CKD V-D patients in similar settings.
Abstract:
There is a lack of data describing the impact of the novel coronavirus 19 pandemic on the patients of chronic kidney disease stage V-dialysis (CKD V-D) from resource-limited countries. A growing body of literature describes an increased susceptibility of CKD V-D to COVID-19 with adverse outcomes in those with severe disease. In the current retrospective report, we elucidate the outcome in consecutive 37 CKD V-D patients with COVID-19 from two dialysis centres in Mumbai, India. Of the 37 patients included in the study, 56.7% of patients were asymptomatic or had mild disease and 27% presented with severe symptoms. The recovery rate was 63%, all those who presented with a severe disease succumbed to the infection. Thirty per cent of patients presented with an extended dialysis break due to various logistic and social issues. Though the overall clinical presentation and outcomes of this cohort from a limited resource setting mimic the global scenario, unique social and logistic issues are an additional burden to the patient, caregivers and the health-care facilities, which may worsen the outcomes in the future as the pandemic continues to spread.
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