COVID-19 in a haemodialysis unit: Our experience in the pandemic, and the measures taken

Abstract

Patients on haemodialysis are more susceptible to the novel 2019 corona virus disease (COVID-19). Its complications remain high in the presence of co-morbidities such as CKD. However, there is a relative lack of data on impact of COVID on patients undergoing haemodialysis, and on infection control measures to prevent further spread in the haemodialysis unit. The objective of this study is to describe the clinical features and outcome of patients undergoing haemodialysis at our unit with COVID-19, and the measures taken to prevent further transmission of the infection. This is a single-center, descriptive, observational study. There were 189 patients on regular haemodialysis at our dialysis unit at the tertiary care hospital in Chennai, India during the study period of March–October 2020. We included in this study 32 haemodialysis (HD) patients who were diagnosed with COVID-19, confirmed by RT–PCR and CT chest. Of 17.9% of patients undergoing haemodialysis were detected to have COVID-19. Among the 32 patients, 22 were males and the median age was 62.9 ± 2.10 years. The most common clinical features reported were fever (78.1%), body pain (56.3%) followed by cough (50%). CT chest showed positive findings in 28 patients – ground glass opacity was present in 18 patients, consolidation in eight patients and crazy-paving pattern was present in two patients. Of the 32 patients, only seven patients required hospitalization. The rest of the patients were managed as outpatients, with telemedicine monitoring of their symptoms. Among them, three patients were discharged, three died due to ARDS and one patient among the non-hospitalized suffered sudden cardiac death at home. Strict isolation protocols and identification of cases were the keys to the low prevalence of COVID-19 in our unit