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Background: Carbapenemase-producing Enterobacterales (CPE) poses a significant challenge to infection control in healthcare settings. Active screening is recommended to prevent intra-hospital CPE transmission. Methods: CPE screening was initiated at a 660-bed hospital in South Korea in September 2018, targeting patients previously colonized/infected or admitted to outside healthcare facilities (HCFs) within 1 month. Universal intensive care unit (ICU) screening was performed at the time of admission. After a hospital-wide CPE outbreak in July-September 2019, the screening program was enhanced by extending the indications (admission to any HCF within 6 months, receipt of hemodialysis) with weekly screening of ICU patients. The initial screening method was changed from screening cultures to the Xpert Carba-R assay. The impact was assessed by comparing the CPE incidence per 1000 admissions before (phase 1, September 2018-August 2019) and after instituting the enhanced screening program (phase 2, September 2019-December 2020). Results: A total of 13,962 (2,149 and 11,813 in each phase) were screened as indicated, among 49,490 inpatients, and monthly screening compliance increased from 18.3 to 93.5%. Compared to phase 1, the incidence of screening positive patients increased from 1.2 to 2.3 per 1,000 admissions (P = 0.005) during phase 2. The incidence of newly detected CPE patients was similar (3.1 vs. 3.4, P = 0.613) between two phases, but the incidence of hospital-onset CPE patients decreased (1.9 vs. 1.1, P = 0.018). A significant decrease was observed (0.5 to 0.1, P = 0.014) in the incidence of patients who first confirmed CPE positive through clinical cultures without a preceding positive screening. Compared to phase 1, the median exposure duration and number of CPE contacts were also markedly reduced in phase 2: 10.8 days vs. 1 day (P < 0.001) and 11 contacts vs. 1 contact (P < 0.001), respectively. During phase 2, 42 additional patients were identified by extending the admission screening indications (n = 30) and weekly in-ICU screening (n = 12). Conclusions: The enhanced screening program enabled us to identify previously unrecognized CPE patients in a rapid manner and curtailed a hospital-wide CPE outbreak. As CPE prevalence increases, risk factors for CPE colonization can broaden, and hospital prevention strategies should be tailored to the changing local CPE epidemiology. [ABSTRACT FROM AUTHOR]

Background Scrub typhus and severe fever with thrombocytopenia syndrome (SFTS) are the 2 most common tick-borne infectious diseases in Korea. Every year, an increasing number of cases are reported, which is a public health concern. Therefore, we aimed to investigate the prevalence of SFTS–scrub typhus coinfection in patients with SFTS. Methods Clinical samples were collected from 129 patients with SFTS. One-step reverse-transcription polymerase chain reaction (PCR) was performed to identify the SFTS virus (SFTSV), and real-time PCR followed by nested PCR was performed to detect the Orientia tsutsugamushi gene for scrub typhus. Phylogenetic analysis was conducted to confirm the evolutionary relationships among different species. Results Among 129 SFTS cases, 2 patients with SFTSV were positive for O. tsutsugamushi with a prevalence of coinfection of 1.6% (95% confidence interval,.001–.06). Phylogenetic analysis confirmed these as O. tsutsugamushi strain Boryong. Conclusions Our study found that 1.6% of patients were coinfected with SFTS and scrub typhus infection. We believe that this information will add a new dimension to clinical diagnosis, which should be considered for better public health management. Further research is needed to better understand the ecological transmission dynamics and geographical distribution of SFTSV and O. tsutsugamushi in endemic countries. [ABSTRACT FROM AUTHOR]

Optimal preparation is recommended for patients with advanced chronic kidney disease to minimize complications during dialysis initiation. This study evaluated the effects of planned dialysis initiation on survival in patients undergoing incident hemodialysis and peritoneal dialysis. Patients newly diagnosed with end-stage kidney disease who started dialysis were enrolled in a multicenter prospective cohort study in Korea. Planned dialysis was defined as dialysis therapy initiated with permanent access and maintenance of the initial dialysis modality. A total of 2892 patients were followed up for a mean duration of 71.9 ± 36.7 months and 1280 (44.3%) patients initiated planned dialysis. The planned dialysis group showed lower mortality than the unplanned dialysis group during the 1st and 2nd years after dialysis initiation (1st year: adjusted hazard ratio [aHR] 0.51; 95% confidence interval [CI] 0.37–0.72; P < 0.001; 2nd year: aHR 0.71; 95% CI 0.52–0.98, P = 0.037). However, 2 years after dialysis initiation, mortality did not differ between the groups. Planned dialysis showed a better early survival rate in hemodialysis patients, but not in peritoneal dialysis patients. Particularly, infection-related mortality was reduced only in patients undergoing hemodialysis with planned dialysis initiation. Planned dialysis has survival benefits over unplanned dialysis in the first 2 years after dialysis initiation, especially in patients undergoing hemodialysis. It improved infection-related mortality during the early dialysis period. [ABSTRACT FROM AUTHOR]

The waiting time for deceased donor kidney transplants (DDKT) is increasing. We evaluated DDKT prognosis according to the pretransplant dialysis vintage. A total of 4117 first-time kidney transplant recipients were enrolled from a prospective nationwide cohort in Korea. DDKT recipients were divided into tertiles according to pretransplant dialysis duration. Graft failure, mortality, and composite were compared between DDKT and living donor kidney transplant (LDKT) recipients. Pretransplant dialysis vintage was longer annually in DDKT recipients. In the subdistribution of the hazard model for the competing risk, the first tertile did not show an increased risk of graft failure compared with LDKT recipients; however, the second and third tertile groups had an increased risk of graft failure compared to LDKT recipients (adjusted hazard ratio [aHR] 3.59; 95% confidence interval [CI] 1.69–7.63; P < 0.001; aHR 2.37; 95% CI 1.06–5.33; P = 0.037). All DDKT groups showed a significantly higher risk of patient death than LDKT, with the highest risk in the third tertile group (aHR 11.12; 95% CI 4.94–25.00; P < 0.001). A longer pretransplant dialysis period was associated with a higher risk of the composite of patient death and graft failure in DDKT recipients. DDKT after a short period of dialysis had non-inferior results on graft survival compared with LDKT. [ABSTRACT FROM AUTHOR]

Background: Although non-teaching community hospitals form the majority of healthcare providers in South Korea, there is limited data on antibiotic usage in them. To evaluate the pattern of antibiotic usage and its appropriateness in hospitals with < 400 beds in South Korea. Methods: A multicentre retrospective study was conducted in 10 hospitals (six long-term care hospitals, three acute care hospitals, and one orthopaedic hospital), with < 400 beds in South Korea. We analysed patterns of antibiotic prescription in 2019, and their appropriateness in the participating hospitals. For the evaluation of the appropriateness of the prescription, 25 patients under antibiotic therapy were randomly selected at each hospital, over two separate periods. Due to the heterogeneity of their characteristics, the orthopaedics hospital was excluded from the analysis. Results: The most commonly prescribed antibiotics in long-term care hospitals was fluoroquinolone, followed by beta-lactam/beta-lactamase inhibitor (anti-pseudomonal). In acute care hospitals, these were third generation cephalosporin, followed by first generation cephalosporin, and second generation cephalosporin. The major antibiotics that were prescribed in the orthopedics hospital was first generation cephalosporin Only 2.3% of the antibiotics were administered inappropriately. In comparison, 15.3% of patients were prescribed an inappropriate dose. The proportion of inappropriate antibiotic prescriptions was 30.6% of the total antibiotic prescriptions. Conclusions: The antibiotic usage patterns vary between non-teaching community hospitals in South Korea. The proportion of inappropriate prescriptions exceeded 30% of the total antibiotic prescriptions. [ABSTRACT FROM AUTHOR]

In South Korea, one-dose varicella vaccination was introduced to the National Immunization Program in 2005, but varicella outbreaks have continued to occur. Therefore, a two-dose vaccination strategy is considered. We developed an age-structured deterministic compartment model using Korean population projection data. The impact of adding a second dose of varicella vaccine on varicella and herpes zoster (HZ) epidemiology was assessed under four different vaccine effectiveness (VE) scenarios (base, moderate, lowest, highest) and the optimal timing of the second vaccine dose (18 months, 4, 5, or 6 years of age) was examined over the period 2020–2065. A two-dose vaccination schedule reduced the cumulative varicella incidence by > 90% compared to no vaccination, regardless of the VE. The additional reduction attributable to a second dose compared to a single dose was greatest (82%) with the lowest VE scenario. A second dose at 6 years of age reduced the varicella incidence at a population level, whereas a second dose at 18 months of age reduced the varicella incidence primarily in the target birth cohorts. Routine vaccination at the age of 18 months with a catch-up vaccination of 6-year-olds was the optimal strategy for birth cohort and population-level control. HZ incidence continued to increase under no vaccination scenario, which represents the effect of aging population. Under a two-dose scenario, the additional increase in HZ incidence attributable to the reduced exogenous boosting was small relative to a one-dose scenario and a further reduction in HZ cases was observed. A two-dose varicella vaccination schedule would significantly reduce varicella and HZ incidence in the long term. A second dose at the age of 18 months with a catch-up vaccination of 6-year-olds would be optimal for controlling varicella in South Korea. [ABSTRACT FROM AUTHOR]

In South Korea where the tuberculosis (TB) burden is intermediate, the risk of in-hospital transmission of TB remains high. We conducted a retrospective cohort study of 244 inpatients diagnosed with pulmonary TB (2015–2018) to evaluate the impact of the Xpert MTB/RIF assay (Xpert) screening on timely isolation. TB screening was performed with smear microscopy and a polymerase chain reaction test, and the Xpert was additionally used from November 2016. Among all patients with pulmonary TB, the median time-to-isolation was significantly reduced (22.6 vs. 69.7 h; p < 0.001) and segmented regression analysis adjusting for the time trend showed a reduction in time-to-isolation with the introduction of the Xpert (− 39.3 h; 95% CI − 85.6, 7.0; p = 0.096). Among 213 patients who were timely screened (≤ 72 h after admission), time-to-isolation decreased significantly (− 38.2 h; 95% CI − 70.6, − 5.8; p = 0.021) with the introduction of the Xpert, and its decreasing trend continued. The Xpert provided a shorter turnaround time (4.8 vs. 49.1 h; p < 0.001) and higher sensitivity (76.6% vs. 47.8%; p < 0.001) than smear microscopy. Thus, the Xpert can be a useful screening test for pulmonary TB in real-life hospital settings with an intermediate TB burden. [ABSTRACT FROM AUTHOR]

Background: Various factors can affect renal and patient outcome in idiopathic membranous nephropathy (iMN). We aimed to identify predictors of renal and patient survival in patients with iMN, with a special focus on outcomes among older patients. Methods: We retrieved data on 1,776 patients (mean age 53.0 ± 14.7 years; 1,075 [60.5%] males) diagnosed with iMN from the Korean GlomeruloNEphritis sTudy (KoGNET), a database compiled from 18 centers in Korea. Results: The cohort included 428 (24.1%) patients over 65 years old. Compared to younger patients, this group had lower hemoglobin and serum albumin levels, a higher incidence of nephrotic-range proteinuria, and higher prevalences of hypertension and diabetes. At last follow-up, complete or partial remission rates were not significantly different between the older and younger groups. Older age (HR: 0.98, 95%CI: 0.97–0.99), elevated hemoglobin (HR: 0.82, 95%CI: 0.72–0.93), high serum albumin (HR: 0.66, 95%CI: 0.44–0.99), and a high estimated glomerular filtration rate (HR: 0.96, 95%CI: 0.95–0.97) at biopsy were good predictors of renal outcomes. Significant risk factors for patient survival were older age (HR: 1.04, 95%CI: 1.01–1.10) and hypertension at biopsy (HR: 2.76, 95%CI: 1.30–5.90). Conclusions: Older patients with iMN had favorable renal outcomes, but poor patient survival, compared to younger patients. Prognostic information on outcomes in this study might be helpful for optimizing the management of patients with iMN. [ABSTRACT FROM AUTHOR]

There is a high risk of fracture after kidney transplantation (KT). Recipients of KT are susceptible to persistent hyperparathyroidism and other disorders of bone and mineral metabolism. However, the risk factors for fractures after KT remain uncertain. The aim of the present study was to investigate the risk factors for fracture after KT. A total of 941 recipients of KT were enrolled from a multicenter observational cohort study in Korea from 2012 to 2016. The biochemical markers were measured at the time of KT, then annually for 5 years following KT. All fracture events were recorded. A Cox proportional hazards analysis was performed to calculate hazard ratios (HR) for the association of risk factors with fractures. Twenty-two fractures had occurred in 20 patients during the study period. Baseline and serial changes of mineral and bone biochemical markers were similar between fracture and nonfracture patient groups. Among the total study population, 104 patients were diagnosed with osteoporosis and 422 patients were diagnosed with osteopenia in a pretransplant bone mineral density test. In a multivariate Cox analysis, pretransplant osteoporosis (HR = 11.76; 95% confidence interval [CI], 2.28-60.69; P =. 003) and pretransplant osteopenia (HR = 5.21; 95% CI, 1.15-23.57; P =. 032) were independent risk factors for fracture in recipients of KT. Pretransplant osteoporosis and osteopenia were independent risk factors for fracture after KT. More careful monitoring of bone mineral density before and after KT might be beneficial to predict the risk for fracture after KT. • Twenty out of 941 patients had fractures in the Korean cohort study for Outcome in Patients With Kidney Transplantation. • Pretransplant osteoporosis and osteopenia were risk factors for fracture in kidney transplantation. • Mineral and bone biochemical marker changes were not related to fracture. [ABSTRACT FROM AUTHOR]

Background Increasing prevalence of mupirocin-resistant Staphylococcus aureus have been reported, and chlorhexidine resistance has become an issue. This study aimed to investigate the prevalence of mupirocin and chlorhexidine resistance in both colonized and infection causing Staphylococcus aureus in children, and find factors associated with increased virulence. Methods S taphylococcus aureus, isolated from children <18 years old admitted at a single center, were collected prospectively from August 2017 to July 2018. The isolates underwent multilocus sequence typing and were screened for genes causing chlorhexidine resistance (qac A/B), quaternary ammonium resistance (smr), mupirocin resistance (ileS mutation, Mup A, Mup B), and Pantone Valentine Leucocidin (pvl) toxin. Results During the study period, a total of 49 non-duplicate isolates were included, of which 69.4% (n = 34) were Methicillin-resistant Staphylococcus aureus (MRSA). Of the colonizers (n = 25), the most common sequence type was ST 72 (68.0%), whereas among pathogens (n = 24), ST 72 (29.2%) and ST 89 (29.2%) were most prevalent. Pathogens in this study caused abscess formation (n = 3), sepsis (n = 4), and skin infections such as cellulitis and omphalitis (n = 17). Mupirocin resistance was found in 16.0% among colonizers vs. 45.8% among pathogens (P = 0.023). High-level mupirocin resistance was more common (n = 3/25, 12.0%) than low-level mupirocin resistance (n = 1/25, 4.0%) in colonizers, whereas, pathogens had similar rates of low-level (25.0%) and high-level (n = 20.8%) mupirocin resistance. PVL toxin gene was more frequently found in colonizers than pathogens (64.0% vs. 33.3%, P = 0.032), and all isolates had quaternary ammonium resistance genes. Chlorhexidine resistance gene was found in only 3 MRSA isolates colonized in the nares of preterm infants. All were SCCmec type 4, however, two were ST 72, spa type t1054, which had high -level mupirocin resistance and PVL toxin gene. Conclusion A PVL toxin gene-positive MRSA which had genes causing mupirocin and chlorhexidine resistance were found in the nasal carriages of preterm infants. These stains may cause failure of MRSA eradication in hospital settings, using conventional methods of nasal mupirocin application and chlorhexidine bathing. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Background: The incidence of many chronic diseases is increasing rapidly in South Korea. Rheumatoid arthritis is a chronic disease for which treatment by both doctors and long-term self-care by patients is deemed very important for successful disease management. Purpose: This study is designed to examine and identify the factors influencing self-care competence in Korean women with rheumatoid arthritis. Methods: A cross-sectional descriptive design was employed. Participants included 132 women aged 20 years or older who were visiting rheumatoid arthritis outpatient clinics at hospitals in Seoul and Gyeonggi-do, South Korea. Measures included a demographics form, Self-as-Carer Inventory, Korean Activities of Daily Living scale, Visual Analogue Scale, Mishel Uncertainty in Illness Scale–Community Form, and Self-esteem Scale. Results: The analyses illustrated the significance of the prediction model (F = 21.744, p <.001). The value of the adjusted R 2 was set at.401, corresponding to 40.1% explanatory power. Uncertainty (β = −.43) and self-esteem (β =.26) were identified as having the most influence on self-care competence in Korean women with rheumatoid arthritis. Conclusions/Implications for Practice: This cross-sectional study yielded preliminary evidence that nursing interventions that reduce uncertainty and improve self-esteem in Korean women with rheumatoid arthritis are necessary to promote the self-care competence of this vulnerable population. Healthcare professionals should recognize uncertainty and self-esteem as factors that influence self-care competence in Korean women with rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Background: The incidence of many chronic diseases is increasing rapidly in South Korea. Rheumatoid arthritis is a chronic disease for which treatment by both doctors and long-term self-care by patients is deemed very important for successful disease management. Purpose: This study is designed to examine and identify the factors influencing self-care competence in Korean women with rheumatoid arthritis. Methods: A cross-sectional descriptive design was employed. Participants included 132 women aged 20 years or older who were visiting rheumatoid arthritis outpatient clinics at hospitals in Seoul and Gyeonggi-do, South Korea. Measures included a demographics form, Self-as-Carer Inventory, Korean Activities of Daily Living scale, Visual Analogue Scale, Mishel Uncertainty in Illness Scale–Community Form, and Self-esteem Scale. Results: The analyses illustrated the significance of the prediction model (F = 21.744, p <.001). The value of the adjusted R 2 was set at.401, corresponding to 40.1% explanatory power. Uncertainty (β = −.43) and self-esteem (β =.26) were identified as having the most influence on self-care competence in Korean women with rheumatoid arthritis. Conclusions/Implications for Practice: This cross-sectional study yielded preliminary evidence that nursing interventions that reduce uncertainty and improve self-esteem in Korean women with rheumatoid arthritis are necessary to promote the self-care competence of this vulnerable population. Healthcare professionals should recognize uncertainty and self-esteem as factors that influence self-care competence in Korean women with rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Background: Immunosuppression non-adherence in kidney transplant recipients (KTRs) not only increases the risk of medical intervention due to acute rejection and graft loss but burdens the socioeconomic system in the form of increased healthcare costs. An aggressive preemptive effort by healthcare professionals, geared to ensure adherence to immunosuppressants in KTRs, is significant and imperative.Methods/design: This study was designed as a prospective, open-label, multicenter, randomized controlled study aimed at evaluating the efficacy and stability of an information and communication technology (ICT)-based centralized monitoring system in boosting medication adherence in KTRs. One hundred fourteen KTRs registered throughout the year 2017 to 2018 are randomized into either the ICT-based centralized home monitoring system or to ambulatory follow-up. The planned follow-up duration is 6 months. The ICT-based centralized home monitoring system described consists of a smart pill box equipped with personal identification system, a home monitoring system, an electronic Case Report Form (eCRF) system, and a comprehensive clinical trial management system (CTMS). It alerts both patients and medical staff with texts and pill box alarms if there is a dosage/dosing time error or a missed dose. Medication adherence and transplant outcomes for the follow-up period are compared between the two groups, while patient satisfaction as well as the stability and cost-effectiveness of the ICT-based monitoring system are to be evaluated.Discussion: This on-going study is expected to determine if consistent use of the ICT-based centralized monitoring system described could maximize mediation adherence and subsequently enhance transplant outcomes in KTRs. Further, it would lay the foundation for successful implementation of this ICT-based monitoring system for effective management of medication adherence in KTRs.Trials Registration: ClinicalTrials.gov, Identifier: NCT03136588 . Registered on 20 April 2017. [ABSTRACT FROM AUTHOR]

Background Electrocardiogram (ECG) and signal-averaged ECG (SAECG) are important as diagnostic tools in arrhythmogenic right ventricular cardiomyopathy (ARVC). The aim of this study was to investigate changes in follow-up ECGs and SAECGs in patients with ARVC. Methods We collected 185 follow-up ECGs from 38 patients and 35 follow-up SAECGs from 18 patients during a mean follow-up period of 64 ± 36 months. Results On baseline ECG and SAECG, epsilon waves, T-wave inversion (TWI), and terminal activation delay (TAD) of QRS ≥55 ms in right precordial leads, and late potentials (LPs) were observed in six (16%), 11 (29%), 13 (34%), and 23 (68%) patients, respectively. During the follow-up period, 15 (39%) patients had 18 changes in ECG and/or SAECG features included in modified Task Force Criteria (TFC) of ARVC. Two patients developed new epsilon waves, and another two patients had dynamic epsilon waves. Newly developed TAD of QRS ≥55 ms was observed in two patients and disappeared in one patient. Eight patients, seven with and one without TWI in V1-V3 or beyond, showed dynamic changes. LP developed in three patients. One patient with dynamic change of TWI and another patient with dynamic change of epsilon wave and TAD of QRS ≥55 ms could not satisfy the modified TFC during follow-up. Conclusions Follow-up ECGs and SAECGs showed changes in 39% of patients with ARVC. Larger studies with a longer follow-up period are needed to investigate the clinical implications of changes in follow-up ECG and SAECG. [ABSTRACT FROM AUTHOR]

Background SFTS and scrub typhus have similar clinical features and difficult to differentiate. Thus, a study to develop a scoring system to differentiate between two diseases in a clinical setting before the confirmation of laboratory results was reported by Kim et al. However, the statistical power could be low because of low numbers of cases (21 SFTS, 91 scrub typhus), our study analyzed by increasing the number of cases to overcome these limitations. Methods We retrospectively collected data from 183 SFTS and 178 scrub typhus patients who visited the 21 hospitals in South Korea between October, 2013 and November, 2017. The study protocol was approved by the IRB of each institution. SFTS was diagnosed through detection of SFTS viral RNA using RT–PCR. Scrub typhus was diagnosed either detection of 56-kDa antigen of O. tsutsugamushi using nested PCR or ≥ 4 fold rise in IgM or IgG titer using indirect IFA. Statistical analyses were performed by using SPSS and Medcalc. Results To differentiate SFTS from scrub typhus, we applied the scoring system proposed by Kim et al. After multivariable logistic regression, altered mental status, leukopenia, prolonged aPTT, and normal CRP(≤ 1.0 mg/dL) were significantly associated with SFTS compared with scrub typhus. Each variable was scored by 1 point, with a total score of 0–4 points, the optimal cutoff value was > 1 for the ROC curve. A score > 1 had 92% sensitivity, 96% specificity for diagnosis of SFTS, with a ROC AUC of 0.974. Because the sensitivity was less than 95%, we changed the normal CRP criteria to ≤ 3.0 mg/dL. The modified scoring system had 97% sensitivity, 96% specificity for diagnosis of SFTS, with an AUC of 0.983, and it showed a statistically higher accuracy than original scoring system (P = 0.0487). In this study, four factors for predicting SFTS were newly developed: leukopenia, prolonged aPTT, normal CRP (≤3.0 mg/dL), and elevated CK (>1,000 IU/L). Our study scoring system had 97% sensitivity, 98% specificity for diagnosis of SFTS, with an AUC of 0.992, and it showed a statistically higher accuracy than original scoring system (P = 0.0308). Conclusion In conclusion, we can easily differentiate SFTS from scrub typhus by using our scoring system of leukopenia, prolonged aPTT, normal CRP, and elevated CK in the endemic area. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Patients with advanced chronic kidney disease (CKD) or who are on hemodialysis (HD) could have increased susceptibility to the 2019 coronavirus disease (COVID-19) given their pre-existing comorbidities, older age, compromised immune system, and regular visits to populated outpatient dialysis centers. This study included 14 consecutive patients on HD or with advanced CKD who initiated HD after being diagnosed with laboratory-confirmed COVID-19 from February to April 2020 in hospitals throughout Daegu, South Korea. The included patients, 42.9% of whom were men, had a mean age of 63.5 years. Four patients had a history of contact with a patient suffering from COVID-19. The most common symptom was cough (50.0%), followed by dyspnea (35.7%). The mean time from symptom onset to diagnosis and admission was 2.6 and 3.5 days, respectively. Patients exhibited lymphopenia and elevated inflammatory markers, including C-reactive protein and ferritin. Chest radiography findings showed pulmonary infiltration in 10 patients. All patients underwent regular HD in a negative pressure room and received antiviral agents. Four patients received mechanical ventilation and continuous renal replacement therapy at a median duration of 14.0 and 8.5 days, respectively. One patient underwent extracorporeal membrane oxygenation for three days. Among the 14 patients included, two died due to acute respiratory distress syndrome, nine were discharged from the hospital, and three remained hospitalized. Despite the high-risk conditions associated with worse outcomes, patients on HD did not exhibit extremely poor overall COVID-19 outcomes perhaps due to early diagnosis, prompt hospitalization, and antiviral therapy. [ABSTRACT FROM AUTHOR]