Haemodialysis for COVID-19 patients admitted in cardiac ICU: a tertiary care centre study from Northern India.

Abstract

INTRODUCTION: COVID-19, initially thought to be a lung disease, is now known to have multisystem impact raising the unprecedented need for intensive care units and holistic treatment modalities, such as haemodialysis, more so ever in patients with compromised cardiac health. Objective - to study the impact of haemodialysis on COVID-19 patients with acute kidney injury (AKI) admitted in cardiac ICU. MATERIAL AND METHODS: A retrospective observational study in which data of COVID-19 positive patients admitted to cardiac ICU at a tertiary care centre with pre-existing cardiac co-morbidities, intervened with haemodialysis for AKI was collected from July 2020 to January 2022. RESULTS: Total 126 patients (survivors =79, non-survivors =47) were included. The percentage of patients with various pre-existing cardiac co-morbidities (ischemic, valvular, cardiomyopathies, and others) were more or less equally distributed between survivors and non-survivors. The non-survivors were older (p<0.001), had majority percentage of males (p=0.009), higher mean BMI, pulse rate, respiratory rate, and a lower mean systolic blood pressure, and lower SpO2 (p<0.001). The non-survivors had a higher mean TLC, NLR, D-dimer levels and lower mean platelet count (p<0.001). The non-survivors also had a higher mean blood urea, serum creatinine level (p<0.001), and potassium level (p=0.003). The survivors received significantly more haemodialysis sessions as compared to non-survivors (p<0.001). CONCLUSIONS: The study establishes haemodialysis as a boon for COVID-19 positive cardiac patients with added renal insult. Additionally, it suggests that, via early decision-making haemodialysis threshold be lowered and frequency increased for better outcome.

Keywords

• haemodialysis
• boon
• covid patients
• cardiac icu