Clinical and laboratory predictors for acquiring COVID-19 infections in patients on maintenance hemodialysis in 5th wave of epidemic in Myanmar

Abstract

Background: Patients on maintenance hemodialysis (MHD) are at high risk of contracting SARS-CoV-2 and developing severe COVID-19 infection because they have low innate immunity as well as poor antibody response to COVID-19 vaccine. This study aimed to assess the clinical and laboratory predictors for 5th  wave of COVID-19 infections in patients on maintenance hemodialysis.

Methods: A hospital based, case control study was conducted in July 2022 to November 2022 among patients on MHD who had confirmed COVID-19 infection by nasopharyngeal swab PCR. Data were collected by using standardized forms and analysis was done.

Results: A total of 22 patients out of 61 patients on maintenance hemodialysis ( MHD) developed COVID-19 infection in same public hemodialysis (HD) center in Yangon. The comparison of clinical and laboratory parameters (age, BMI, vaccination history, type of vaccine, duration from last vaccination , smoking status, vaccination time, comorbid status, duration of hemodialysis, hemoglobin level, serum albumin level and anti-Spike antibody level) was made between infected group and non-infected group. Patients in both groups had 4 doses of vaccine: Covaxin, Sinovax, Sinopharm and Covishield. Baseline clinical characteristics were not significantly different  between infected cases and non-infected cases;  mean age was 49.77 ± 11.58 years vs 51.92 ± 13.6 years; BMI was 19.75 ± 3.00 kg/m2 vs 20.03 ± 2.76 kg/m2 ; duration from last vaccination was 37.64 ± 2.22 days vs 38.77 ± 3.62 days; number of current smokers was 4 vs 8 ; and vaccination time in the morning was 14 vs 29 patients. The proportion of patients with past COVID-19 infection was the same; 63.6% (14/22) in infected group and 66.7 % (26/39) in non-infected group. Hemoglobin level was lower in infected groups (8.26 ± 2.07 gm% vs 8.33 ± 2.02 gm%); and serum albumin level was lower in infected group (42.47 ± 4.82 gm/dl vs  43.17 ± 4.10 gm/dl) too. The race, religion, comorbid status (diabetic nephropathy, coronary heart disease) and the duration of hemodialysis was not different between 2 groups. The proportion of patients with cerebrovascular accident was higher in infected group. Median (IQR) anti-Spike antibody level of infected cases was  4732 (5206) U/mL and it was 3195 (4883) U/mL in non-infected cases; it was not different significantly.

Conclusions: The baseline characteristics like age, race, religion,  BMI, comorbid status (diabetic nephropathy, coronary heart disease), smoking status, duration of hemodialysis, past COVID-19 infection, anti-Spike antibody level, vaccination time and duration from last vaccination were non-predictors for 5th  wave of COVID-19 infection among patients on MHD who had 4 doses of COVID-19 vaccine. The likely predictors were cerebrovascular accident, low hemoglobin and low serum albumin.

How to Cite

Pyar, K. P. ., Hla, S. A. ., Lwin, K. T. Y. ., Aung, Z. N. H. ., Myat, K. ., Maung, L. M. ., Hein, Y. M. ., Aung, L. H. ., Thant, M. M. ., Maung, M. M. ., Zaw, M. H., Mg, Y. H. ., Maung, N. L. ., Win, T. ., Mg, K. T. ., Phone, S. S. ., Ya, K. Z. ., Kyaw, A. P. ., Aung, Z. P. ., Kyaw, M. T. ., Min, S. ., Moe, T. A. ., Oo, K. M. ., & Ko, M. K. . (2022). Clinical and laboratory predictors for acquiring COVID-19 infections in patients on maintenance hemodialysis in 5th wave of epidemic in Myanmar. Journal of Medical Research and Health Sciences, 5(12), 2345–2354. https://doi.org/10.52845/JMRHS/2022-5-12-2

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