Abstract

Background: Chronic kidney disease (CKD) is associated with the increased risk of both outpatient and
inpatient pneumonia. This association is independent of comorbid diabetes, cardio-vascular disease (CVD),
asthma, and chronic obstructive airway disease. Dialysis patients are considered at risk groups for SARSCoV-2 infection; Short-term mortality in patients on chronic hemodialysis who were hospitalized with
COVID-19 was high. Outcomes in those requiring intensive care unit (ICU) and mechanical ventilation
management were poor .
Aim: This study mainly aimed to identify the prevalence, risk factors, severity and predictors of mortality
in Libyan hemodialysis patients infected with COVID- 19 .
Methods: In this retrospective cohort study, data of CKD patients on maintenance hemodialysis diagnosed
with COVID-19 infection from two large dialysis centers in Libya were collected and analyzed using SPSS
version 22 for .demographic, clinical and laboratory profiles .
Results: The data of 810 patients from two hemodialysis centers in Libya showed infection rate was 10.2
%, and the overall mortality was 26.5% (39/83) 47% of patients needed admission to ICU for supportive
mechanical ventilation (SPO2 ranged from 76-92%). The biochemical and laboratory data showed a
decreased mean absolute lymphocyte counts. a high neutrophil-lymphocyte ratio (NLR), and a mild
decrease in platelet counts. C-reactive protein (CRP), fibrinogen, ferritin, and D-dimer were also high at
admission. (22/83, 26.5%) of total patients, and (17/39) 43.6% of ICU patients died in less than 28 days
after COVID-19 diagnosis .
Conclusions: In CKD patients on maintenance hemodialysis diagnosed with COVID-19 infection; severity
of disease at presentation, need for invasive supportive mechanical ventilation, older age, raised serum
glutamic oxaloacetic transaminase, and lower level of albumin may have been valuable predictors of
mortality and poor outcomes