MO842SARS-COV-2 INFECTION AMONG PATIENTS RECEIVING MAINTENANCE HAEMODIALYSIS: SINGLE HAEMODIALYSIS CENTER EXPERIENCE FROM BANGLADESH

Abstract

Abstract Background and Aims Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infections emerged in Wuhan, China in December 2019 and rapidly became pandemic. Unfortunately, there is lack of evidence about the optimal management of corona virus disease-2019 (COVID-19) and even less is available in patients on maintenance haemodialysis. Patient receiving maintenance haemodialysis are at increased risk for infection by SARS-CoV-2 with poor outcome. So, the purpose of this study was to identify the incidence of SARS-CoV-2 infection among end-stage kidney disease (ESKD) patients on maintenance haemodialysis. Method A cross-sectional study was conducted at a haemodialysis unit of tertiary care hospital of Bangladesh from April to August 2020. All patients, who were on maintenance haemodialysis, twice or thrice weekly, were screened by reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2, irrespective of symptoms. All data were collected in case record forms and patients were followed-up over phone. Results During the study period, a total of 133 patients (males 70, 52.6%) were on regular maintenance haemodialysis in the study centre. Most patients were in 5th and 6th decades of life. Twenty-one (15.8%) patients tested positive for SARS-CoV-2 by RT-PCR with female (16, 76.2%) predominance. Eighteen (18/21, 85.7%) patients had symptoms suggestive of SARS-CoV-2 infection and rest three (3/21, 14.3%) patients were diagnosed during routine screening. Common presentations were fever (42.9%), cough (66.7%) and respiratory distress (66.7%) and most had multiple symptoms. The incidence of SARS-CoV-2 infection in blood group A was 8(38%) and blood group O was 8(38%). There were no significant differences of mortality rate among blood groups. Most patients (16/21, 76.2%) infected by SARS-CoV-2 were referred to COVID-dedicated hospitals, five (5/21, 23.8%) were shifted to intensive care unit (ICU). Outcome was poor; 17 (17/21, 89%) patients died in hospitals and four (4/21, 19%) patients became free of SARS-CoV-2 infection. Caregivers/relative of our patients acquired COVID-19 in course of disease. Conclusion One-sixth of patients on maintenance haemodialysis acquired SARS-CoV-2 infection with nearly ninety percent fatality rates. Despite having risk factors for severe infection by SARS-CoV-2, patients on dialysis must visit health care facilities. So, utmost care should be taken to reduce risk of COVID-19 among such vulnerable group of patients.