[Nutritional status and its relationship with COVID-19 prognosis in hemodialysis patients].

INTRODUCTION: among the groups most affected by the COVID-19 pandemic are patients undergoing chronic hemodialysis (HD) treatment due to their comorbidities, advanced age, impaired innate and adaptive immune function, and increased nutritional risk due to their underlying inflammatory state. All of these factors contribute to a higher risk of severe complications and worse outcomes compared to the general population when infected with SARS-CoV-2.

OBJECTIVE: the objective of this study was to describe the nutritional characteristics of and their potential association with the prognosis of COVID-19 in patients undergoing chronic HD treatment.

METHOD: a descriptive, retrospective, observational design. All cases of COVID-19 in patients undergoing chronic treatment at the Hemodialysis Unit of Hospital de Manises, Valencia, Spain, from the start of the pandemic to before vaccination were included.

RESULTS: a total of 189 patients were studied, who received chronic HD treatment in the hospital unit; 22 patients were diagnosed with COVID-19 (12 %) in that period. Mean age was 71 years; 10 were women; Charlson index was 6.59 points; 10 had diabetes mellitus; HD vintage was 51.6 months; 2 patients had previously received a currently non-functioning kidney transplant, 16 had an arteriovenous fistula as vascular access, and 6 had a central vascular access. The mean dialysis session time was 220.14 minutes and the initial value of the single dose of the Kt/V was 1.7; 16 patients had body composition measurement; the differences between the deceased and surviving groups in the serum levels of various variables related to nutritional status were analyzed, and significant differences, with p < 0.05, were found for triglycerides and ferritin.

CONCLUSIONS: higher body mass index and higher body fat content, along with lower baseline levels of triglycerides and ferritin, are significantly associated with higher COVID-19 mortality in patients on chronic hemodialysis. These findings suggest that the initial nutritional status of these patients can significantly influence the prognosis of SARSCoV-2 infection.