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Sci Prog . Mortality and risk factors for COVID-19 in hemodialysis patients: A systematic review and meta-analysis

tetano

Editor, Senior Moderator
Sci Prog


. Jul-Sep 2022;105(3):368504221110858.
doi: 10.1177/00368504221110858.
Mortality and risk factors for COVID-19 in hemodialysis patients: A systematic review and meta-analysis


Pulin Li[SUP] 1 [/SUP], Youhong Guan[SUP] 2 [/SUP], Sijing Zhou[SUP] 3 4 [/SUP], Enze Wang[SUP] 1 [/SUP], Peng Sun[SUP] 1 [/SUP], Guanghe Fei[SUP] 1 [/SUP], Daxiong Zeng[SUP] 5 6 [/SUP], Ran Wang[SUP] 1 [/SUP]



Affiliations

Abstract

Introduction: The present study systematically reviewed the clinical features and risk factors in patients undergoing maintenance hemodialysis (MHD) who also acquired coronavirus disease 2019 (COVID-19). More specifically, clinical manifestations, prognosis, and risk factors for death among this population were explored. Method: A literature search using the PubMed, Web of Science, and Embase databases, for articles involving patients with laboratory-confirmed COVID-19 and undergoing MHD published between January 1, 2020, and March 13, 2022, was performed. Random-effects meta-analyses were performed to calculate the weighted mean prevalence and corresponding 95% confidence interval (CI) or weighted means and 95% CI. Heterogeneity among studies was assessed using I[SUP]2[/SUP] statistics. Results: Twenty-two studies including 13,191 patients with COVID-19 undergoing MHD were selected. The most common symptoms included fever (53% [95% CI 41%-65%]) and cough (54% [95% CI 48%-60%]); however, 17% (95% CI 11%-22%) of the cases were asymptomatic. In subgroup analysis, the proportion of male patients (65% [95% CI 58%-71%]), and patients with coronary artery disease (30% [95% CI 17%-44%) and chronic obstructive pulmonary disease (9% [95% CI 4%-15%]) was greater in the non-survivor group compared with the survivor group. Furthermore, patients undergoing MHD, who were also positive for COVID-19, exhibited a high mortality rate (24% [95% CI 19%-28%]). Conclusions: MHD patients with COVID-19 may initially present as asymptomatic or with mild symptoms; nevertheless, in this study, these patients exhibited a higher risk for death compared with COVID-19 patients not undergoing MHD. Moreover, male sex and underlying cardiovascular and respiratory diseases increased the mortality risk.

Keywords: COVID-19; SARS-coV-2; maintenance hemodialysis; meta-analysis; systematic review.
 
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