HAEMODIALYSIS: A KING OR A CLOWN FOR COVID POSITIVE PATIENTS WITH PRE-EXISTING PULMONARY DISEASES!

Abstract

Background: COVID-19 infection in patients with pre-existing respiratory diseases, manifesting as ARDS, while simultaneously affecting multiple organs severely worsened the outcome, raising the need to explore various treatment modalities. To study the impact of haemodialysis on outcomes of COVID-19 pati Objective: ents with pre-existing pulmonary diseases. Methods: Data of patients with known pulmonary comorbities admitted to COVID wards, undergoing haemodialysis for AKI at tertiary care centre, was collected from July 2020 to January 2022. The demographics, baseline parameters and outcomes were recorded. Total 61 Results: patients were included in this retrospective observational study. The percentage of different pre-existing pulmonary pathologies (COPD, Asthma, ILD, and Pulmonary Tuberculosis) were equally distributed among survivors(n=47) and non-survivors(n=14). The non-survivors were older(p=0.003), and had a higher percentage of males (p=0.02), higher percentage of smokers (p=0.02) and alcohol consumers(p=0.011), a lower mean systolic blood pressure, higher pulse rate, higher respiratory rate and lower SpO2. The non-survivors had a lower mean hemoglobin, platelet count, and a higher mean TLC, NLR, and D-dimer levels. On admission, the non-survivors had a higher mean blood urea level and serum creatinine level (p<0.001). The number of hemodialysis done was signicantly higher(p=0.041) in the survivors as compared to non-survivors. Conclusion: Our study strongly suggests that haemodialysis can be used as a life saving treatment modality for AKI in COVID positive patients with pre-existing pulmonary disease. Also protocols need to be redened for early initiation and increased frequency of haemodialysis in patients with acute on chronic multisystem insult.