Background: Haemodialysis (HD) patients are particularly vulnerable to SARS-CoV-2 due to frequent healthcare exposure and multiple comorbidities. This study examines outcomes of HD patients infected with SARS-CoV-2 and evaluates risk factors for hospital admission, Intensive Care Unit (ITU) admission, length of stay, and 30-day mortality.
Methods: A retrospective cohort study was conducted in four HD centres at a major London hospital, including 249 SARS-CoV-2-positive HD patients from March 2020 to August 2021. Data on demographics, comorbidities, deprivation, and COVID-19 wave were collected. PCR was used for nasopharyngeal swabs, with genotypic analysis in waves 2 and 3. Logistic regression models assessed risk of hospital and ITU admissions, while a Cox proportional hazards model was applied for 30-day mortality.
Results: Of the HD population, 28.9% contracted SARS-CoV-2, 96% had at least one comorbidity, 40% required hospital admission, 11% needed ITU care, and 11% died within 30 days (median time-to-death: 14 days). Mortality was significantly higher in the second wave (p = 0.038), coinciding with the Alpha variant. Age was the only factor associated with hospital admission (OR 1.03, 95% CI 1.01–1.06, p = 0.008). In multivariate analysis, age, comorbidities, deprivation, and wave 2 infection were linked to increased mortality hazard, with lower deprivation significantly reducing risk (HR 0.50, 95% CI 0.26–0.95, p = 0.036).
Discussion: The findings underscore the increased vulnerability of HD patients to COVID-19, particularly with emerging variants. Although age was the main predictor of hospital admission, mortality was also influenced by comorbidities and deprivation, indicating socio-economic disparities despite uniform healthcare access.
Caitlin Norris Grey1 , Shiv Raj Sharma1 , Cate Goodlad2 , Andrew Davenport2 , Tabitha Mahungu1 and Tanzina Haque1*
