Severity and Mortality in Maintenance Hemodialysis Patients Infected with COVID-19 Omicron Strain: a Single-Centered, Retrospective Study in China

Purpose The aim of this study was to observe the characteristics of COVID-19 infected maintenance hemodialysis (MHD) patients, identify the risk factors for severe illness and mortality in this population, and establish a preliminary risk prediction model for severe COVID-19 infection of MHD patients. Methods We included patients who underwent long-term maintenance hemodialysis and were hospitalized for COVID-19 infection at our hospital from December 2022 to March 2023. We retrospectively analyzed their demographic characteristics, clinical manifestations, laboratory tests, hemodialysis-related information, treatment strategies and complications. The patients were divided into severe (heavy and critical) and non-severe (mild and moderate) groups. Logistic regression and Cox proportional hazards analysis were used to identify the risk factors for severe COVID-19 progression. Results The presence of cerebrovascular disease, elevated NLR, fibrinogen, and D-dimer are independent risk indicators for severe COVID-19 infection in MHD patients in early stage. The presence of diabetes, cerebrovascular disease, and elevated D-dimer and NLR were associated with mortality. Conclusion MHD patients have a high probability of developing into severe and critical COVID-19 infection, and NLR, fibrinogen, and D-dimer can serve as early warning indicators for severe and critical progression of COVID-19 infection. The presence of diabetes, cerebrovascular disease, elevated NLR and D-dimer levels attribute to worse clinical outcomes and increased mortality.