FALLING PREVALENCE, MORTALITY AND SEVERITY OF COVID-19 AMONG PATIENTS ON MAINTENANCE HEMODIALYSIS IN ONE SELECTED PUBLIC HOSPITAL IN MYANMAR

Introduction:

Coronavirus disease 2019 (COVID-19) has caused worldwide pandemic disease since end of 2019. Patients on maintenance hemodialysis (MHD) are at high risk of contracting SARS-CoV-2 because they have low innate immunity as well as poor antibody response to COVID-19 vaccine. This study aimed to assess the prevalence, severity and mortality of COVID-19 infections among patients on maintenance hemodialysis over 5 years in No (1) Defense Services General Hospital (1,000 bedded) Mingaladon, Myanmar. 

Methods:

A hospital based observational study was conducted among patients on MHD who developed confirmed COVID-19 from January 2020 to August 2024. Data were collected by using standardized forms and analysis was done.

Results:

The over-all trend of prevalence of COVID-19 among maintenance HD was falling. The prevalence was ‘zero’ (0/81) in March 2020 First wave (wild type). In August 2020, Second wave (Alpha wave plus wild type), the prevalence was 22.2% (18/81); it rose to 52% (51/98) in July 2021 Third wave (Delta). Then, it dropped to 44% (33/75) in January 2022 Fourth wave (Omicron); and , it decreased to 39.5% (30/76) in December 2022 Fifth wave (Omicron Variant). It became half 14.3% (15/105) in 2023. In 2024 (till end of August) the prevalence was 3.6% (4/112). The number of severe cases were down trend over 5 years. In Second wave (Alpha wave plus wild type), half of the cases (9/18) were severe according to WHO classification and they required hospitalization; the death rate was 33.3% (6/18). In Third wave (Delta), nearly 30% (15/51) of them required oxygen and mortality rate was nearly 10% (5/51). In Fourth wave (Omicron), the percentage of severe cases dropped dramatically to 3% (1/33) and mortality rate was 3%(1/33). The figure remained stable in Fifth wave (Omicron Variant). In 2023, one case expired from septicemia following mild COVID-19. In 2024 (till end of August), none of the infected cases were severe and the survival rate was 100%. They received total 6 doses of vaccine till 2024; first dose of SARS-CoV-2 vaccine (Covishield) was given after second wave; second dose of SARSCoV2 vaccine (Covishield) was repeated after third wave; third and fourth doses of SARS-CoV-2 vaccine (Covaxin) were given after fourth wave; Sinopharm vaccine was given in July 2023; and, Pfiza vaccine was given in 2024. 

Conclusions:

The prevalence rate, severity of COVID-19 and mortality rate decreased after vaccination particularly after two doses and 3 doses of vaccine. Mortality rate decreased dramatically after two doses of vaccine; it became 3% following 2 doses and 3 doses of vaccine. After 4 doses and 6 doses of vaccination, the severity and mortality rate were negligible. The severity and mortality rate of COVID-19 among patients on MHD decreased with increasing number of vaccinations.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.