Mortality rate of COVID-19 infection in end stage kidney disease patients on maintenance hemodialysis: A systematic review and meta-analysis

Ivan Cancarevic; Mahmoud Nassar; Ahmed Daoud; Hatem Ali; Nso Nso; Angelica Sanchez; Avish Parikh; Asma Ul Hosna; Bhavana Devanabanda; Nazakat Ahmed; Karim M Soliman

doi:10.5501/wjv.v11.i5.352

Mortality rate of COVID-19 infection in end stage kidney disease patients on maintenance hemodialysis: A systematic review and meta-analysis

World J Virol. 2022 Sep 25;11(5):352-361. doi: 10.5501/wjv.v11.i5.352.

Authors

Affiliations

¹ Department of Medicine, Icahn School of Medicine at Mount Sinai (NYC Health and Hospitals: Queens), New York, NY 11432, United States.
² Department of Medicine, Kasr Alainy Medical School, Cairo University, Cairo 11562, Egypt.
³ Department of Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, United Kingdom.
⁴ Department of Medicine, Universidad Autonoma de Santo Domnigo, Santo Domingo 10105, Dominican Republic.
⁵ Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, United States. drkarimsoliman@gmail.com.

Abstract

Background: Coronavirus disease 2019 (COVID-19) has been the most talked-about disease of the past few years. Patients with significant comorbidities have been at particular risk of adverse outcomes. This study looked at the outcomes and risk factors for adverse outcomes among patients on chronic hemodialysis for end-stage renal disease, a group of patients known to be particularly susceptible to infectious complications.

Aim: To assess outcomes and risk factors for adverse outcomes of COVID-19 infection among patients on chronic hemodialysis.

Methods: We searched PubMed/MEDLINE, EMBASE, Reference Citation Analysis (https://www.referencecitationanalysis.com/) and Web of Science databases for relevant terms and imported the results into the Covidence platform. From there, studies were assessed in two stages for relevance and quality, and data from studies that satisfied all the requirements were extracted into a spreadsheet. The data was then analyzed descriptively and statistically.

Results: Of the 920 studies identified through the initial database search, only 17 were included in the final analysis. The studies included in the analysis were mostly carried out during the first wave. We found that COVID-19 incidence among patients on hemodialysis was significant, over 10% in some studies. Those who developed COVID-19 infection were most likely going to be hospitalized, and over 1 in 5 died from the infection. Intensive care unit admission rate was lower than the infection lethality rate. Biochemical abnormalities and dyspnea were generally reported to be associated with adverse outcomes.

Conclusion: This systematic review confirms that patients on chronic hemodialysis are very high-risk individuals for COVID-19 infections, and a significant proportion was infected during the first wave. Their prognosis is overall much worse than in the general population, and every effort needs to be made to decrease their exposure.

Keywords: COVID-19; End stage kidney disease; Infection; Maintenance hemodialysis; Mortality; Systematic review.