Long-lasting clinical symptoms 6 months after COVID-19 infection in the French national cohort of patients on dialysis

Background: Systematic reviews have shown a high prevalence of long-term persistent sequelae after COVID-19. The aim of this study was to describe the prevalence and risk factors associated with long-lasting clinical symptoms (LLCS) in survivors on chronic dialysis at 6 months after the onset of acute COVID-19 infection in the pre-vaccination period.
Methods: This national cohort study included all French patients on dialysis who had SARS-Cov-2 infection between March and December 2020 and who were alive and still on dialysis 6 months after infection. A form was filled in at 6 months concerning the presence of the following persistent symptoms: extreme fatigue, headache, muscle or weight loss of > 5%, respiratory sequelae, tachycardia, chest pain, joint or muscle pain, persistent anosmia or ageusia, diarrhea, sensory disorders, neuro-cognitive disorders, post-traumatic stress syndrome, depression, and anxiety.
Results: Complete survey results were available for 1217 patients (25.2% of those included); 216 (17.7%) had some LLCS. Probability of 6-month LLCS was higher in patients who were hospitalized in a medical or intensive care unit: OR 1.64 (95% CI 1.16-2.33) and 5.03 (2.94-8.61), respectively. Younger patients had a lower probability of LLCS. Each year on dialysis, as well as diabetes, overweight or obesity were associated with a higher probability of LLCS by 1.03 (1.01-1.06), 1.53 (1.08-2.17), 1.96 (1.10-3.52) and 2.35 (1.30-4.26), respectively.
Conclusions: This national study shows that at least one in six patients on dialysis who have COVID-19 will have LLCS. Systematic screening in dialysis patients would allow us to identify those who need more careful prevention and long-term care and to address them towards a rehabilitation pathway.