# Long-Term Outcomes of Chronic Hemodialysis Patients Following SARS-CoV-2 Infection

## TL;DR

This study examines long-term symptoms in hemodialysis patients after recovering from COVID-19 and finds diabetes is a key factor in persistent symptoms.

## Contribution

The study identifies diabetes as a significant predictor of long COVID in chronic hemodialysis patients.

## Key findings

- Diabetes was the main factor associated with long COVID in hemodialysis patients.
- Fatigue and anxiety were strongly linked to diabetes, while dyspnea was associated with obesity.
- Persistent symptoms like fatigue and anxiety were common among patients post-SARS-CoV-2 infection.

## Abstract

Introduction: The COVID-19 pandemic has had a significant impact on patients undergoing chronic hemodialysis (CHD). Several studies have explored the long-term outcomes of CHD patients who recovered from SARS-CoV-2 infection. This study aims to identify the factors associated with persistent symptoms (long COVID) among CHD patients.

Methods: We conducted a multicenter, descriptive, and analytical cohort study across nine hemodialysis centers (public, private, and nonprofit) in the city of Tangier. Data were collected through interviews with patients and a review of their medical records. Statistical analysis was performed using IBM SPSS Statistics version 25.

Results: Among 945 CHD patients, 163 had a documented SARS-CoV-2 infection, with a median age of 55 years (interquartile range (IQR): 43-67). The most frequently reported post-infection symptoms were fatigue (62%), anxiety (53%), arthralgia (40%), cough (33%), weight loss (29%), sleep perturbations (28%), anosmia (30%), dyspnea (25%), anorexia (24%), dysgeusia (18%), and concentration difficulties (16%). After adjusting for diabetes, obesity, oxygen therapy, hospitalization, and use of hydroxychloroquine or corticosteroids, diabetes emerged as the main factor for long COVID (OR = 3.8; 95% CI (1.5-9.6); p = 0.004). Fatigue was significantly associated with diabetes (OR = 2.9; 95% CI (1.3-6.5); p = 0.01) and female gender (OR = 2.1; 95% CI (1.02-4.2); p = 0.04). Anxiety was linked to diabetes (OR = 2.6; 95% CI (1.2-5.5); p = 0.01) and obesity (OR = 2.5; 95% CI (1.01-6.4); p = 0.04). Dyspnea was associated with obesity (OR = 4.0; 95% CI (1.4-10.4); p = 0.004).

Conclusion: Our study highlights the substantial prevalence of persistent post-COVID-19 symptoms among CHD patients. The findings emphasize the necessity of individualized long-term care in this high-risk group.