Clinical Manifestations and Mortality Predictors of COVID-19 in Patients Undergoing Chronic Hemodialysis: A Retrospective Cohort Study from Romania.

Background/

Objectives

Patients undergoing chronic hemodialysis are at increased risk of severe COVID-19 outcomes. This study aimed to evaluate the clinical characteristics and prognostic factors associated with mortality in hemodialysis patients infected with SARS-CoV-2.

Methods

We conducted a retrospective study including 130 chronic hemodialysis patients diagnosed with COVID-19 and admitted to a nephrology unit between March 2020 and April 2021. Demographic data, comorbidities, clinical manifestations, hospitalization duration, and outcomes were analyzed using univariate and multivariate statistical methods.

Results

The cohort was predominantly male (64.6%), with a mean age of 64.0 ± 13.9 years. The mean hospitalization duration was 13.6 ± 9.7 days. Cardiovascular disease, chronic respiratory disease, dyspnea at presentation, and hospital-origin admission were significantly associated with mortality. While diabetes mellitus and hypertension were highly prevalent, they did not independently predict mortality after adjustment. Overall mortality was 34.6%, particularly among older patients with multiple comorbidities.

Conclusions

COVID-19 infection is associated with substantial morbidity and mortality among patients on chronic hemodialysis. Early identification of high-risk patients based on clinical presentation and comorbidity profile may support timely intervention and improved outcomes in this vulnerable population.