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Role of the inflammatory activity in haemodialysis patients with COVID-19

Objectives: It is known that haemodialysis (HD) patients are older and have more co-morbidities, and therefore they are very susceptible against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Inflammatory activity plays an important role in coronavirus disease 2019 (COVID-19), and the intensity of inflammatory response makes the severity of COVID-19 worse. Biomarkers related to infection such as procalcitonin (PCT), C-reactive protein (CRP), ferritin, albumin, troponin I, D-dimer, white blood cell (WBC), neutrophil, lymphocyte, and platelet play an important role in the inflammatory response of COVID-19. Our objective is to compare these biomarkers between healthy individuals with COVID-19 (HI-COVID-19) and haemodialysis (HD) patients (HP-COVID-19).
Methods: 50 patients diagnosed with COVID-19 were included in this cross-sectional and monocentric retrospective study. The population of this study was separated into two groups: Group 1 consisted of HI-COVID-19 (n=27), and Group 2 consisted of HP-COVID-19 (n=23). Demographic data, basic clinical characteristics, and laboratory tests were recorded during the application. Group 2 participants were chosen from those whose biomarkers such as ferritin (<200 ng/mL), CRP, PCT, ferritin, albumin, D-dimer, troponin I, WBC, neutrophil, lymphocyte, and platelet were within the normal range three months before (prior to having COVID-19).
Findings: When Group 2 and Group 1 were compared in terms of gender, age, presence of lung uptake, and fever, there was no difference. Five HP-COVID-19 patients lost their lives. There were no deaths in the other group. There was a statistically significant difference. Comorbid diseases such as diabetes mellitus (DM), coronary artery disease (CAD), and hypertension (HT) were significantly higher in Group 2. It was observed that CRP, PCT, troponin I, D-dimer, and ferritin from biochemical parameters were higher in Group 2, and platelet and albumin were higher in Group 1. Although WBC and neutrophil elevations and low lymphocytes were detected in Group 2, it was statistically not significant. Tocilizumab and convalescent plasma use were significantly higher in Group 2.
Conclusions: The strength of inflammatory activity in HP-COVID-19 can be estimated by observing serum levels of biomarkers such as CRP, PCT, ferritin, albumin, D-dimer, troponin I, WBC, neutrophil, lymphocyte, and platelet.