predictors of in-hospital mortality among covid-19-infected chronic kidney disease patients on maintenance hemodialysis: a retrospective cohort study

Background: patients with chronic kidney disease (ckd) on maintenance hemodialysis are highly vulnerable to coronavirus disease 2019 (covid-19) infection and poorer outcomes and mortality. objectives: the study aimed at identifying the various clinical and biochemical predictors of in-hospital mortality in this particular group of patients. methods: in this retrospective cohort study, the baseline demographic, clinical, and laboratory data were collected from patients with preexisting ckd on maintenance hemodialysis and with covid-19 infection. the statistical analysis of the collected data was performed using spss version 24 (spss inc, chicago, il, usa). results: the data obtained from 35 patients from the first wave of the pandemic were analyzed. the mortality rate was 23% (8 patients). analyzing the comparison between survivors and non-survivors revealed that the older age (49 [iqr, 42 – 55] years vs. 70 [iqr, 54 – 74] years, p = 0.016), severe disease at presentation (15% vs. 75%, p = 0.004), and need for invasive mechanical ventilation (0% vs. 75%, p = 0.001) were the factors significantly associated with in-hospital mortality. among baseline biochemical markers, severe lymphocytopenia (11 [iqr, 7 – 16] vs. 4.2 [iqr, 3 – 8], p = 0.011), high serum glutamic oxaloacetic transaminase (23 [iqr, 15.6 – 48] vs. 80 [iqr, 60- 105], p = 0.001), blood urea (71 [iqr, 28 - 120) vs. 160 (iqr, 142 - 355), p = 0.002) and higher value of inflammatory markers, interleukin-6 (il-6), and procalcitonin, as well as fibrinogen and low baseline albumin, were also significantly associated with in-hospital mortality. conclusions: the older age, severe disease at presentation, need for invasive mechanical ventilation, raised baseline il-6, procalcitonin, serum glutamic oxaloacetic transaminase, blood urea, and lower level of albumin may have been valuable predictors of in-hospital mortality and poor outcomes in patients with covid-19-infected chronic kidney disease on maintenance hemodialysis.