INITIAL IMPACT OF THE COVID-19 PANDEMIC ON THE CARE PROFILE FOR CRITICALLY-ILL PATIENTS ON HEMODIALYSIS

Gallota, Claudia; Viana, Tatiana Garcia; Augusto, Fabiana da Silva; Genovese, Regina Elena; Balda, Carlos Alberto; Carneiro, Ieda Aparecida

doi:10.1590/ce.v28i0.87467

Brasil

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

ORIGINAL ARTICLE • Cogit. Enferm. 28 • 2023 • https://doi.org/10.1590/ce.v28i0.91093 linkcopy

INITIAL IMPACT OF THE COVID-19 PANDEMIC ON THE CARE PROFILE FOR CRITICALLY-ILL PATIENTS ON HEMODIALYSIS

Authorship SCIMAGO INSTITUTIONS RANKINGS

HIGHLIGHTS

1. Often, critically ill patients with COVID-19 progress to kidney dysfunction.
2. In 2020, there were more hemodialysis sessions when compared to 2019.
3. COVID-19 was the main cause of entry into hemodialysis.

ABSTRACT

Objective: to compare the care profile for critically-ill patients on hemodialysis before and during the COVID-19 pandemic.

Method: an observational study carried out in a hospital from São Paulo, Brazil. The participants were critically-ill patients on hemodialysis hospitalized in 2019 and 2020. The data were collected from documents of hemodialysis sessions and from medical records. Chi-square, Mann-Whitney, Shapiro-Wilk and Fisher’s Exact tests were used for comparisons (p<0.05).

Results: a total of 212 sessions were performed with 50 patients in 2019 and 873 sessions with 171 patients in 2020. In 2019, the patients were referred to intensive care and hemodialysis after 4.62 ± 6.38 and 17.26 ± 24.53 days, respectively, and in 2020 these periods corresponded to 2.21 ± 3.63 and 10.24 ± 11.99 days. There were more deaths in 2020 (p=0.01) and among patients with COVID-19 (p=0.014).

Conclusion: more hemodialysis sessions were observed in 2020 when compared to pre-pandemic times, an unknown situation in the first months of the pandemic.

DESCRIPTORS: Critical Care; Acute Kidney Injury; Renal Failure; Renal Dialysis; COVID-19

	2019	2020	p
Number of participants, n (%)	50 (100)	171 (100)
Gender, n (%)
Male	32 (64)	110 (64.3)	0.966 ^a
Female	18 (36)	61 (35.7)
Diagnosis at admission, n (%)
Acute kidney disorders	15 (30)	45 (26.3)	0.606^a
Sepsis	14 (28)	26 (15.2)	0.039^a
COVID-19	0 (0)	114 (66.7)	<0.001^a
Surgery	6 (12)	8 (4.7)	0.093^a
Trauma	2 (4)	5 (2.9)	1.000^a
Comorbidities, n (%)
Arterial hypertension	34 (68)	135 (78.9)	0.108^a
Diabetes	32 (64)	77 (45)	0.018^a
Nephropathies	40 (80)	92 (53.8)	0.001^a
Heart diseases	16 (32)	51 (29.8)	0.768^a
Gastroenteropathies	15 (30)	16 (9.4)	<0.001^a
Neuropathies	13 (26)	27 (15.8)	0.099^a
Pneumopathies	2 (4)	10 (5.9)	0.738^a

	2019	2020	p
Number of cases per month, n (%)
April	11 (22)	22 (12.9)	0.179^a
May	11 (22)	38 (22.2)	0.979^a
June	15 (30)	51 (29.8)	0.986^a
July	13 (26)	60 (35.1)	0.384^a
Number of dialysis sessions, n (%)	212 (100)	873 (100)
Days on dialysis, Mean ± SD	17.10 ± 20.60	10.06 ± 10.04	0.002^b
Type of dialysis - First session, n (%)
Conventional hemodialysis	47 (94)	142 (83)	0.014^a
Slow hemodialysis	2 (4)	29 (17)
Peritoneal dialysis	1 (2)	0 (0)
Dialysis frequency - First week, n (%)
Daily	3 (6)	84 (49.1)	<0.001^a
Every other day	45 (90)	47 (27.5)
Random days according to exams	2 (4)	40 (23.4)
Dialysis frequency - Last week, n (%)
Daily	0 (0)	56 (32.7)	<0.001^a
Every other day	48 (96)	68 (39.8)
Random days according to exams	2 (4)	47 (27.5)
Complications during the sessions, n (%)
System coagulation	10 (4.7)	17 (1.9)	0.056^a
Hemodynamic instability	3 (1.4)	39 (4.5)	0.014^a
Cardiopulmonary arrest	0 (0)	6 (0.7)	0.304^a
Hematoma in arteriovenous fistula	1 (0.5)	2 (0.2)	1.000^a
Outcome, n (%)
Hospital discharge	28 (56)	61 (35.7)	0.010^a
Death - Total	22 (44)	110 (64.3)
Death within 14 days of intensive care	4 (18.2)	39 (35.4)	0.238^a
Death within 28 days of intensive care	7 (31.8)	27 (24.5)	0.591^a
Death after 28 days of intensive care	11 (50)	44 (21.8)	0.586^a

vertical_align_top file_download show_chart

more_horizclose
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Universidade Federal do Paraná Av. Prefeito Lothário Meissner, 632, Cep: 80210-170, Brasil - Paraná / Curitiba, Tel: +55 (41) 3361-3755 - Curitiba - PR - Brazil
E-mail: cogitare@ufpr.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

Acessibilidade / Reportar erro

[TFN7] a. Chi-square test

[TFN8] b. Mann Whitney Test

[TFN9] Source: The authors (2021).