Abstract: TH-PO246
Hemoperfusion Is Associated with Reduced Mortality in Outpatient Maintenance Hemodialysis Patients with COVID-19
Session Information
- Hemodialysis, Hemodiafiltration, and Frequent Dialysis
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Author
- Lin, Wenjun, Department of Nephrology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai, China
Background
High mortality rates have been observed in patients with COVID-19 undergoing maintenance hemodialysis, potentially attributable to exacerbated inflammatory responses. Hemoperfusion, a therapeutic technique based on adsorption for removing inflammatory mediators, presents a promising therapeutic approach. However, its efficacy in improving outcomes for this patient population remains to be established.
Methods
This was a single-center retrospective cohort study conducted from December 7, 2022, to May 24, 2023, following the cancellation of the 'Dynamic Zero-COVID’ policy during the Omicron variant surge. Patients with COVID-19 were stratified based on their hemoperfusion treatment status. We investigated all-cause mortality as the primary outcome, using adjusted Cox regression analysis. The risk of hospitalization, our secondary outcome, was examined through logistic regression models.
Results
Among the 224 patients who met the eligibility criteria, 118 (52.7%) underwent hemoperfusion treatment. The cohort's mean age was 62.8 ± 13.1 years, predominantly male (71.0%), with 89.3% lacking prior immunity to SARS-CoV-2. Over a 120-day follow-up, 25 patients succumbed, with mortality rates of 18.9% (20 patients) in the control group compared to 4.2% (5 patients) in the hemoperfusion group (p=0.001). Hemoperfusion was significantly associated with a reduced risk of all-cause mortality (HR, 0.234; 95% CI, 0.079 to 0.696; p=0.012) and hospitalization (OR, 0.423; 95% CI, 0.196 to 0.917; p=0.029), compared to controls. Additionally, the hemoperfusion group exhibited significantly lower mean changes in CRP, D-dimer, and serum ferritin levels than the control group within one month after COVID-19.
Conclusion
Hemoperfusion treatment in patients with COVID-19 on maintenance hemodialysis was linked to a decreased risk of all-cause mortality and a reduced in early inflammatory markers. These findings suggest that hemoperfusion may be a beneficial therapeutic strategy for COVID-19 management in the hemodialysis population, meriting further exploration.