Introduction
After more than one year of COVID-9 disease and 223.369.412 cases with 4.608.983 deaths worldwide and 504.781 cases with 32.391 deaths in Ecuador, massive vaccination programs have started with 5.619.227.616 vaccines applied worldwide nowadays. Vaccines have proven to be effective diminishing transmission, contagious rate, and disease severity in healthy population with standard vaccination schemes. Hemodialysis patients (HD) are highly comorbid and immunosupressed population, factors that have been related with less efficacy of regular vaccination schemes in this patients when compared with healthy population. Few is known about COVID-19 disease outcomes and efficacy of standard COVID-19 vaccination schemes on Latin American HD patients . The aim of this work was to share the effect of COVID-19 standard vaccination programs on COVID-19 disease impact and outcomes on 700 chronic dialysis patients from Ecuadorian highlands.
Methods
Observational-prospective-multicenter study on 700 Latin-American chronic dialysis patients of five different cities from Ecuadorian highlands. Patients were followed since February first, 2020 until August 2021. Patients with COVID-19 symptoms were identified and diagnosis was made exclusively with positive nasopharyngeal swabs PCR testing. Oxygen saturation below 90% at presentation (LOS) classified disease presentation as severe, moderate if symptoms without LOS and asymptomatic if no symptoms. Hospital-stay, mortality and laboratory findings were collected. Comparisons of disease outcomes were performed pre and post vaccination programs on studied population. Figure 1. shows the disease trend along follow-up with emphasis on pre and post vaccination program.
Results
A total of 308 patients (44%) presented COVID-19 disease related symptoms; 184 patients tested positive (26%), 60% were men (p=0.03). Forty-one patients with confirmed disease died (22%) along follow-up. After three months of completing vaccination programs, 9 patients (1.2%) got infected. Infected patients presented the disease after a median time of 32 days after completing vaccination scheme. Disease severity was mild in majority of patients, 2 patients died (1.1%) and there were no re-infections cases reported. There was a clear trend of declining cases and disease severity after vaccination programs were completed.
Conclusions
COVID-19 disease was more frequent in men with a 22% of mortality in those HD patients with confirmed disease. The high trend of COVID-19 disease incidence went downhill after completing standard vaccinations programs, however, positive and fatal cases were reported in vaccinated patients which could alert of a lack of response and efficacy of standard vaccination schemes on certain HD patients whose characteristics are needed to be explore and studied to adjust future vaccinations schemes in these growing population. Preventive measures must be encouraged strictly for at least one more month after completing vaccination scheme.
No conflict of interest