Abstract

Hemodialysis is a necessary treatment for end-stage kidney disease patients. It imposes undergoing three sessions of dialysis per week in a specialized center. Amid the SARS-CoV-2 pandemic, precautionary measures were mandatory in all dialysis facilities and may have negatively impacted patients’ well-being. This study aimed to uncover the scale of this effect. We performed a cross-sectional study of all patients undergoing chronic hemodialysis in two dialysis units (one urban and another rural). Patients with Alzheimer’s disease were excluded. Patients filled a questionnaire including information on socio-demographics, factors related to the dialysis facility, and the impact of the COVID-19 epidemic on their mental health. A total of 72 patients responded. Their median age was 70 (60.79) years. Of them, 68% were males, 71% were married, and 10% were living alone. Following the pandemic, 35% felt more anxious, with a higher incidence of anxiety in the rural unit (p=0.021). Half of them felt very limited in their relationships, and 29% were isolated from their families. In total, 98% of patients were satisfied with the staff support. The imposed preventive measures were perceived as very strict in 27% of the surveyed patients. The majority of the urban group were bothered for not eating during the session, and they felt significantly more stress than the rural group (p=0.001). The SARS-CoV-2 pandemic increased anxiety among hemodialysis patients from a rural setting. Stress was more prevalent in the urban group and most probably related to limitations in eating during sessions. The majority were satisfied with staff support.

Highlights

  • The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak was declared as a pandemic by the World Health Organization in March 2020 and has spread widely around the world

  • This study aimed to analyze the psychological impact of the COVID-19 pandemic on this frail population of HD patients and unveil the factors associated with poor mental health

  • Two patients had a social conflict. No patient from both centers suffered from COVID-19

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Summary

Introduction

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak was declared as a pandemic by the World Health Organization in March 2020 and has spread widely around the world. In an internet survey of adults (n >1400) from the United States (US) in April 2020, psychological distress, including depression, hopelessness, and nervousness, was present in 14 percent of surveyed individuals [4]. Another recent survey suggested that the prevalence of depressive symptoms in the US was more than 3-fold higher during COVID-19 compared to the pre-COVID-19 pandemic era [5]

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