Coronavirus Disease 2019 in Patients With End-Stage Kidney Disease on Hemodialysis in Guatemala

• Published in: Kidney international reports Vol. 6; no. 4; pp. 1110 - 1117
• Main Authors: Sosa, Regina, Garcia, Pablo, Cipriano, Ever O., Hernández, Agualuz, Hernández, Elmer E., Chavez, Paola I., Manchinelli, Angélica, Morales, Oscar A., Flores, Lourdes E., Romero, Hair J., Raquec, Yulany, Sapón, Byron F., Soch, Kevin E., Anand, Shuchi, Sánchez-Polo, Vicente
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2021; Elsevier
• Subjects: CKD; Clinical Research; COVID-19; dialysis; ESKD; global health; Guatemala; hemodialysis; COVID-19; dialysis; global health; ESKD; Guatemala; hemodialysis; CKD
• ISSN: 2468-0249; 2468-0249
• DOI: 10.1016/j.ekir.2021.01.028

Coronavirus disease 2019 (COVID-19) is public health concern across the world. Data on the epidemiology among patients on hemodialysis in Latin America and low- and middle-income countries are limited.
Using electronic medical records from the second largest dialysis network in Guatemala, we performed a retrospective analysis of all adult patients on hemodialysis with the diagnosis of COVID-19 to estimate incidence of infection and to describe the demographics, comorbidities, and outcomes. We stratified incidence rate by region. We reviewed data from May 1 to July 31, 2020, with outcome data ascertained up to August 28, 2020.
Of 3201 patients undergoing hemodialysis, 325 patients were diagnosed with COVID-19 (incidence rate 102/1000 patients on hemodialysis, compared with 3/1000 in the general population). Incidence was higher in the Central region (207/1000) and lowest in the Southeast region (33/1000), and unlike in the general population, the incidence was lower in Guatemala City. The mean age of patients diagnosed with COVID-19 was 51.1 years (standard deviation [SD] 14.8 years), and 84 (25.8%) were female. The median length of hospital stay was 12 days (interquartile range [IQR] 10–16 days). Two hundred twenty-nine (69.8%) of the patients recovered, 90 patients died (27.7%), and 6 (1.8%) patients were still in the hospital at the time of last follow-up.
The incidence of diagnosed COVID-19 in Guatemalan patients on hemodialysis was much higher than reported in the general population, with outcomes similar to those described in high-income countries. Rural regions had higher incidence rates than the major metropolitan area.
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