How are patients with previous kidney failure, undergoing hemodialysis or kidney transplant affected in COVID-19 Disease? In a study, 37 of 230 hemodialysis patients and 4 of 33 personnel were diagnosed with COVID-19. Deaths were mostly due to cardiovascular, cerebrovascular events and hyperkalemia. It was stated that patients showed milder symptoms and pneumonia findings were less common in hemodialysis patients. In the study, the level of inflammatory cytokines was found to be lower in hemodialysis patients. For this reason, it has been interpreted that immunosuppression in dialysis patients may protect against cytokine storm. In a study in Italy, 20 kidney transplant patients, 21 dialysis patients, and 5 compensated chronic kidney failure patients were followed up with the diagnosis of COVID 19. 19/20 of the patients with kidney transplant, 17/21 of those under dialysis, and 4/5 of those with chronic renal failure were given antiviral treatment and hydroxylauroquine, respectively. Dexamethasone was used in 11 transplant patients, 4 dialysis patients, 1 CRF patients, and tocilizumab 6 transplant patients and 1 dialysis patients. 5 of the transplant and dialysis patients and 2 of the chronic kidney patients died. In the article, it is recommended that these patients should be followed up primarily by the nephrology department. Apart from this, treatment is aimed at viral replication and cytopathic effect (Chloroquine, Lopinavir/ritonavir, Darunavir/ritonavir, Darunavir/cobicistat) and 7-10 days after the onset of symptoms associated with progressive lung involvement, oxygen support required period, cytokine release or hyperinflammation (cytokine). Immunosuppressive drugs have been recommended during the storm.

In general, patients under kidney transplant and dialysis are a more susceptible group to infections. The reasons for this are that these patients are immunosuppressive due to their primary disease and that they have frequent hospital/health institution themes. There are protection and control measures for this group both in the world and in our country. During the epidemic, it is recommended that patients receiving dialysis at home should follow up by phone rather than coming to the health institution for control, and health personnel should minimize home visits. It is recommended that patients be followed up in dialysis centers or during their follow-up in a separate area and with minimal contact. The Ministry of Health guide emphasizes the education of patients and staff in dialysis centers, questioning the symptoms of patients and their relatives, wearing a mask, and patient and contact follow-up. It is recommended that patients or healthcare personnel with COVID 19 compatible findings do not come to the dialysis area, inform their situation by phone, be directed to the appropriate center if necessary, have circulation space in the dialysis units, and comply with the cleaning rules.