Clinical features of novel coronavirus infection (omicron variant) in patients with end-stage kidney disease

BACKGROUND: Before the emergence of the omicron variant, novel coronavirus infection in patients with end-stage kidney disease was characterized by a severe course and poor prognosis. Since January 2022, the omicron variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been the most prevalent strain in Russia. This strain is associated with uncommon virus-induced lung injury and significantly lower hospitalization and mortality rates compared to previous variants.

AIM: This study aimed to assess the course of the omicron variant of SARS-CoV-2 in patients with end-stage kidney disease.

METHODS: The retrospective cohort study included 33 medical records of patients with end-stage kidney disease who had been treated for novel coronavirus infection at the Infectious Diseases Clinic of Kirov Military Medical Academy and Botkin Clinical Infectious Diseases Hospital between January 2022 and February 2024. Following a comprehensive analysis of the medical records, the patients were divided into two groups. Group 1 included 12 patients with novel coronavirus infection in the form of acute respiratory viral infection without lung involvement. Group 2 comprised 21 patients with virus-induced lung injury.

RESULTS: The omicron variant of SARS-CoV-2 frequently caused lung injury, including acute respiratory failure, in patients with end-stage kidney disease. The early stages of inpatient treatment for this group of patients were characterized by fever (≥ 37.2°C), tachycardia (≥ 90 bpm), National Early Warning Score ≥ 4, and prolonged viral shedding (12 [10; 18] vs 9 [7,5; 9,5] days, p = 0.002).

CONCLUSION: The high prevalence of comorbidities and frequent occurrence of virus-induced lung injury leading to acute respiratory failure underscore a unique cohort of patients with end-stage kidney disease requiring programmed hemodialysis and highlight the ongoing challenge of novel coronavirus infection, even during the spread of the omicron variant of SARS-CoV-2.