Effect of COVİD-19 infection on erythropoetin (EPO) resistance in chronic hemodialisis patients

Introduction:Chronic kidney disease (CKD) poses a substantial burden on global healthcare systems. Anemia, a prevalent complication in CKD, significantly compromises patients' quality of life and increases mortality rates. The COVID-19 pandemic has exacerbated the health challenges faced by individuals with CKD, particularly those reliant on hemodialysis (HD). This retrospective cohort study sought to elucidate the impact of COVID-19 infection on the efficacy of erythropoiesis-stimulating agents (ESAs) in managing renal anemia among HD patients. Methods:Eighty-nine patients undergoing regular HD and ESA therapy were retrospectively analyzed. Participants were classified into two groups: COVID-19 positive and negative (control). Laboratory parameters were compared between the groups, with a particular focus on pre- and post-infection values in the COVID-19 cohort. Erythropoietin sensitivity was quantified using the erythropoietin resistance index (ERI). Results:A marked elevation in ESA dosage and a concomitant increase in the ERI were observed in patients who had recovered from COVID-19. Furthermore, the COVID-19 group exhibited significantly higher levels of C-reactive protein (CRP), a sensitive marker of inflammation. Conclusion:Our findings indicate that COVID-19 infection may induce EPO resistance in HD patients.