Clinical and laboratory markers of lung damage in SARS-CoV-2 infection (omicron variant) in patients with end-stage chronic kidney disease

Prior to the Omicron variant of SARS-CoV-2, COVID-19 was characterized by a severe course and unfavorable prognosis, including fatal outcomes, in a significant proportion of patients with end-stage chronic kidney disease undergoing renal replacement therapy via programmed hemodialysis. Since January 2022, the Omicron variant of SARS-CoV-2 has been the dominant strain in Russia and is associated with a low incidence of viral pulmonary lesions in infected individuals.
Objective. To identify clinical and laboratory predictors of viral pulmonary lesions caused by the Omicron variant of SARSCoV-2 in patients with end-stage chronic kidney disease. 
Material and methods. A retrospective analysis was conducted on 33 medical records of patients with end-stage chronic kidney disease undergoing programmed hemodialysis who contracted COVID-19 between January 2022 and February 2024. 
Results. Laboratory markers associated with viral pulmonary lesions in patients with end-stage chronic kidney disease and COVID-19 included hemoglobin ≤ 115 g/L, neutrophil count > 65%, monocyte count < 8%, absolute and relative eosinophil counts < 0.1 × 10⁹/L and < 2%, respectively, reduced albumin values, AST > 20 U/L, CRP > 50 mg/L, prothrombin activity < 100% (according to Quick’s method), and APTT ≥ 30 seconds. It was demonstrated that a body temperature of ≥ 37.2 °C during the first three days of hospitalization, an absolute eosinophil count < 0.1 × 10⁹/L, and a relative eosinophil count < 2% increased the risk of viral pulmonary lesions by 9 times.
Conclusion. Considering that COVID-19 caused by the Omicron variant of SARS-CoV-2 remains a significant threat to patients undergoing programmed hemodialysis, it is essential to predict the development of a generalized form of SARS-CoV-2 infection with pulmonary involvement in patients with end-stage chronic kidney disease. Early prediction will facilitate timely therapeutic adjustments and the planning of additional diagnostic evaluations.

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