Less Frequency Hemodialysis and COVID-19

The novel coronavirus disease (COVID-19), also known as COVID-19 (and SARS-Cov2) by the World
Health Organization, is a rapidly evolving pandemic. The outbreak is expected to infect a
large portion of the world population, and a case fatality rate of 1-3% represents a
significant mortality and healthcare burden. In common with other viral diseases, mortality
is higher in elderly patients with high comorbidity.

The impressive figures of transmission in different communities underline the need for
reorganization of efforts to limit contagion, particularly in crowded settings. Hemodialysis
centres represents a specific setting in which many patients are repeatedly treated in the
same area at the same time.

Dialysis patients constitute a susceptible population because of their older age, high
comorbidity burden and their less efficient immune system. Therefore, they are more prone to
develop severe infectious diseases than the general population.. Moreover, if infected, the
requirements of specialized resources and staff is further complicated by requirements for
isolation, control and prevention, putting healthcare systems under additional strain.
Therefore, all measures to slow and to control unmanageably high incidence rates must be
taken very seriously.

The routine treatment usually requires three dialysis sessions per week Further, some
patients must travel long distances to the dialysis centre. One option to reduce the higher
risk of these patients is to reduce the frequency of dialysis sessions.However, the potential
benefits of reduced risk may be associated with higher interdialytic weight gain and
inadequate dialysis, Two factors that increase the risk of mortality. Furthermore, the impact
of reduced frequency on Anemia and Nutrition have not been extensively studied.