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Article

Incidence and Clinical Impacts of COVID-19 Infection in Patients with Hemodialysis: Systematic Review and Meta-Analysis of 396,062 Hemodialysis Patients

1
Department of Nephrology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
2
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
3
School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
4
Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
5
Department of Nephrology and Kidney Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
6
Department of Cardiology, Chang Gung Memorial Hospital, Keelung 204, Taiwan
*
Author to whom correspondence should be addressed.
Healthcare 2021, 9(1), 47; https://doi.org/10.3390/healthcare9010047
Received: 1 December 2020 / Revised: 30 December 2020 / Accepted: 30 December 2020 / Published: 5 January 2021
Hemodialysis (HD) patients are highly susceptible to COVID-19 infection. However, comprehensive assessments of current evidence regarding COVID-19 in HD patients remain incomplete. We systematically searched PUBMED and EMBASE for articles published on incidence or mortality of COVID-19 infection in HD patients until September 2020. Two independent researchers extracted data and study-level risk of bias across studies. We conducted meta-analysis of proportions for incidence and mortality rate. Study heterogeneity and publication bias were assessed. A total of 29 articles with 3261 confirmed COVID-19 cases from a pool of 396,062 HD patients were identified. Incidence of COVID-19 in these HD patients was 7.7% (95% CI: 5.0–10.9%; study heterogeneity: I2 = 99.7%, p < 0.001; risk of publication bias, Egger’s test, p < 0.001). Overall mortality rate was 22.4% (95% CI: 17.9–27.1%; study heterogeneity: I2 = 87.1%, p < 0.001; risk of publication bias, Egger’s test: p = 0.197) in HD patients with COVID-19. Reported estimates were higher in non-Asian than Asian countries. Quality of study may affect the reported incidence but not the mortality among studies. Both incidence and mortality of COVID-19 infection were higher in HD patients. Available data may underestimate the real incidence of infection. International collaboration and standardized reporting of epidemiological data should be needed for further studies. View Full-Text
Keywords: COVID-19; hemodialysis; incidence; meta-analysis; mortality; systematic review COVID-19; hemodialysis; incidence; meta-analysis; mortality; systematic review
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MDPI and ACS Style

Chen, C.-Y.; Shao, S.-C.; Chen, Y.-T.; Hsu, C.-K.; Hsu, H.-J.; Lee, C.-C.; Sun, C.-Y.; Chen, Y.-C.; Hung, M.-J.; Wu, I.-W. Incidence and Clinical Impacts of COVID-19 Infection in Patients with Hemodialysis: Systematic Review and Meta-Analysis of 396,062 Hemodialysis Patients. Healthcare 2021, 9, 47. https://doi.org/10.3390/healthcare9010047

AMA Style

Chen C-Y, Shao S-C, Chen Y-T, Hsu C-K, Hsu H-J, Lee C-C, Sun C-Y, Chen Y-C, Hung M-J, Wu I-W. Incidence and Clinical Impacts of COVID-19 Infection in Patients with Hemodialysis: Systematic Review and Meta-Analysis of 396,062 Hemodialysis Patients. Healthcare. 2021; 9(1):47. https://doi.org/10.3390/healthcare9010047

Chicago/Turabian Style

Chen, Chun-Yu, Shih-Chieh Shao, Yih-Ting Chen, Cheng-Kai Hsu, Heng-Jung Hsu, Chin-Chan Lee, Chiao-Yin Sun, Yung-Chan Chen, Ming-Jui Hung, and I-Wen Wu. 2021. "Incidence and Clinical Impacts of COVID-19 Infection in Patients with Hemodialysis: Systematic Review and Meta-Analysis of 396,062 Hemodialysis Patients" Healthcare 9, no. 1: 47. https://doi.org/10.3390/healthcare9010047

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