Effect of vaccination on clinical outcomes in COVID-19 positive chronic kidney disease patients on haemodialysis

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) resulted in high mortality worldwide, with significantly higher mortality among patients with comorbidities including chronic kidney disease (CKD). Vaccines were developed against COVID-19 and it was given emergency approval because of the associated high mortality. There are only few studies on the efficacy of vaccine in CKD patients on haemodialysis. Effect of vaccination on clinical outcomes in COVID-19 positive CKD patients on haemodialysis was studied. Materials and methods: In this retrospective study on CKD patients on haemodialysis with confirmed COVID-19 infection, comparison was done on the clinical outcomes between the vaccinated and unvaccinated population. Results: Of the 104 patients, 74 patients were vaccinated against COVID-19 and 30 were unvaccinated. The study population received either covishield (50) or covaxin (24) which were the approved vaccines in India at that time. Among the vaccinated group 15 (20%) needed invasive mechanical ventilation and 16 (53%) in the unvaccinated group (P value 0.001). There were 16 (22%) deaths in the vaccinated group and 15 (50%) in the unvaccinated group with a significantly higher mortality in the unvaccinated group (P value 0.005). 11 (21%) patients on covishiled and 4 (18%) on covaxin needed invasive mechanical ventilation and there were 12 (24%) deaths in the covishield group and 4 (18%) in covaxin group. Conclusion: Severity of disease and mortality is less in vaccinated CKD patients on haemodialysis compared to unvaccinated reiterating the importance of vaccination against COVID-19 in high risk patients.

Keywords

• covid-19
• vaccine
• chronic kidney disease
• haemodialysis
• inflammatory markers
• mechanical ventilation