nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2022-26-2-85-92nefr-2121Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSГЕМОДИАЛИЗ И COVID-19 (АНАЛИЗ ПЕРВОГО ГОДА ПАНДЕМИИ В Г. МАХАЧКАЛЕ)НEMODIALIASIS AND COVID-19 (ANALYSIS OF THE FIRST YEAR OF THE PANDEMIC IN MAKHACHKALA)https://orcid.org/0000-0002-8393-1235ГаджиеваП. Г.GadzhievaP. G.

Гаджиева Патиматзагра Гаджиевна, отделение гемодиализа, заведующая отделением

367000, Республика Дагестан, г. Махачкала, ул. Коркмаова, д. 9, кв. 9Тел.: 8-989-678-75-75

Gadzhieva Patimatzagra Gadzhievna, hemodialysis department, head of the department

367000, Republic of Dagestan, Makhachkala, Korkmaova str., 9, sq. 9Tel.: 8-989-678-75-75

gadjieva-05@mail.ruhttps://orcid.org/0000-0002-6389-8378АгалавоваЗ. А.AgalavovaZ. A.

Агалавова Зарема Алимурзаевна, отделение гемодиализа, врач-нефролог

367000, Республика Дагестан, г. Махачкала, ул. Гусаева, д. 4, кв. 3тел.: 8-989- 876-81-33

Agalavova Zarema Alimurzaevna, hemodialysis department, nephrologist

367000, Republic of Dagestan, Makhachkala, Gusaeva str., house 4, sq.3tel.: 8-989-876-81-33

agalavova67@mail.ruhttps://orcid.org/0000-0002-8840-5103ГаджиявдибироваМ. Д.GadzhiyavdibirovaM. J.

Гаджиявдибирова Мадина Джамалхановна, отделение гемодиализа, врач-нефролог

367026, Республика Дагестан, г. Махачкала, пр. им. Шамиля, д. 42, кв. 50Тел.: 8-988-442-46-71

Gadzhiyavdibirova Madina Jamalkhanovna, hemodialysis department, nephrologist

367026, Republic of Dagestan, Makhachkala, Shamil ave., 42, sq. 50Tel.: 8-988-442-46-71

madina19101966@mail.ruhttps://orcid.org/0000-0002-1211-2793ГасановаЛ. Б.GasanovaL. B.

Гасанова Лейла Билаловна, отделение гемодиализа, врач-нефролог

367027, Республика Дагестан, г. Махачкала, ул. Магомедтагирова, д. 180 «А», кв. 95тел.: 8-988-467-94-11

Hasanova Leila Bilalovna, hemodialysis department, nephrologist

367027, Republic of Dagestan, Makhachkala, Magomedtagirova str., 180 "A", sq. 95tel.: 8-988-467-94-11

Leila_gasanova@icloud.comРеспубликанская клиническая больница им. А.В. ВишневскогоРоссияA.V. Vishnevsky Republican Clinical HospitalRussian Federation20222406202226285=92Copyright © Гаджиева П.Г., Агалавова З.А., Гаджиявдибирова М.Д., Гасанова Л.Б., 20222022Гаджиева П.Г., Агалавова З.А., Гаджиявдибирова М.Д., Гасанова Л.Б.Gadzhieva P.G., Agalavova Z.A., Gadzhiyavdibirova M.J., Gasanova L.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/2121

ВВЕДЕНИЕ: больные, получающие лечение программным гемодиализом, входят в группу высокого риска по заболеваемости COVID-19. ЦЕЛЬ: анализ клинической картины, особенностей течения, факторов риска и возможностей терапии у больных COVID-19, получавших лечение программным гемодиализом в г.Махачкале. ПАЦИЕНТЫ И МЕТОДЫ: под наблюдением с апреля 2019 г. до апреля 2020 г. в ГБУ РД «РКБ» Махачкалы перепрофилированном для оказания медицинской помощи пациентам, инфицированным SARS-CoV-2, находились 162 пациента (87 мужчин и 75 женщин), получавших лечение ГД по поводу терминальной почечной недостаточности. Исследование было одноцентровым, ретроспективным и неконтролируемым. Конечной точкой наблюдения считали выписку пациента из стационара или смерть. Больные, продолжавшие лечение на момент окончания исследования, из него были исключены. РЕЗУЛЬТАТЫ. Инфицирование SARS-CoV-2 у 101 (62,3 %) больных было подтверждено результатами ПЦР, а у остальных – характерной картиной, определяемой при КТ органов грудной клетки. Летальный исход при COVID-19 у больных на ГД был ассоциирован с более тяжелым и распространенным поражением легких (КТ-3 и КТ-4), которое диагностировали достоверно чаще по сравнению с выжившими больными. У значительного числа больных с терминальной стадией ХБП, получавших лечение ГД, отличается тяжелым течением и неблагоприятным прогнозом. В связи с этим существует необходимость поиска эффективных и безопасных методов профилактики и лечения в группах повышенного риска инфицирования и тяжелого течения COVID-19. ЗАКЛЮЧЕНИЕ: пациенты с ХБП имеют повышенный риск развития тяжелой формы COVID-19. К этому могут предрасполагать сопутствующие сердечно-сосудистые заболевания и сахарный диабет. Учитывая наличие вакцины или одобренной терапии, нефрологи должны посоветовать пациентам с ХБП следовать рекомендациям социальной изоляции. 

BACKGROUND. Patients receiving treatment with programmed hemodialysis are at high risk for the incidence of COVID-19. THE AIM: to analyze the clinical picture, features of the course, risk factors and treatment options in COVID-19 patients treated with programmed hemodialysis in Makhachkala. PATIENTS AND METHODS. 162 patients (87 men and 75 women) were treated with HD for terminal renal failure were under observation in the GBU RD "RKB" of Makhachkala, repurposed to provide medical care to patients infected with SARS-CoV-2 from April 2019 to April 2020. The study was single-center, retrospective and uncontrolled. The end point of observation was considered to be the patient's discharge from the hospital or death. Patients who continued treatment at the end of the study were excluded from it. RESULTS. Infection with SARS-CoV-2 in 101 (62.3%) patients was confirmed by PCR results, and in the rest – by a characteristic pattern determined by CT of the chest organs. The fatal outcome of COVID-19 in patients with HD was associated with a more severe and widespread lung lesion (CT-3 and CT-4), which was diagnosed significantly more often compared to the surviving patients. In a significant number of patients with endstage CKD treated with HD, it is characterized by a severe course and an unfavorable prognosis. In this regard, there is a need to search for effective and safe methods of prevention and treatment in groups at increased risk of infection and severe COVID-19. CONCLUSION. Patients with CKD have an increased risk of developing severe COVID-19. Concomitant cardiovascular diseases and diabetes mellitus may predispose to this. Given the availability of a vaccine or approved therapy, nephrologists should advise patients with CKD to follow the recommendations of social isolation.

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The authors declare that there are no conflicts of interest present.