LAUSR

Abstract Introduction COVID-19 represents a serious threat to patients on maintenance dialysis. The clinical setting, mortality rate and prognostic factors in these patients have not been well established. Methods We included all dialyzed patients with COVID-19 referred to our dialysis center between March 11 and April 11, 2020. Data were obtained through the review of the medical records and were censored at the time of data cutoff, on May 11, 2020. Results Forty-four patients on maintenance dialysis with COVID-19 were referred to our dialysis unit during the COVID-19 epidemic. Median age was 61 years IQR [51.5-72.5]. 65.9% were men. Comorbidities included hypertension (97.7%), diabetes mellitus (50%), chronic cardiac (38.6%) and respiratory (27.3%) diseases. Initial symptoms were fever (79.5%), shortness of breath (29.5%), cough (43.2%), and diarrhea (13.6%). Three profiles of severity were distinguished based on the WHO progression scale. Forty-one (93.2%) were hospitalized and only three were maintained on outpatient hemodialysis. Thirty-three (75%) patients required oxygen therapy, including 15 (45.5%) who were referred to the intensive care unit. Overall, 27.3% of patients died, and 58.5% were discharged from hospital, including only two (13.3%) of those admitted to the intensive care unit. By multivariate analysis, cough, thrombopenia < 120 G/L, LDH level greater than 2 times the upper limit of normal, and blood CRP > 175 mg/L were significantly associated with death. Conclusion A major outbreak of COVID-19 occurred in the Paris Region, and spread among dialyzed patients. Our study underscores the severity of COVID-19 in these patients and identified prognostic markers.