{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:49:00Z","timestamp":1785408540866,"version":"3.56.0"},"reference-count":63,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Oradea"},{"id":[{"id":"https:\/\/ror.org\/00wzhv093","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Hemodialysis (HD) patients represented a highly vulnerable population during the COVID-19 pandemic, both clinically and psychologically. Data regarding acute anxiety requiring pharmacologic treatment in this setting are limited. The aim of the study was to assess factors influencing clinical evolution, psycho-emotional disturbances reflected by \u201cde novo\u201d anxiolytic use, and vital prognosis of hospitalized COVID-19 patients on HD. Materials and Methods: The study included 211 patients followed between 2020 and 2023 (149 were COVID-19 positive and 80 required hospitalization) and comprised two sequential phases: an in-hospital phase during COVID-19, in which disease severity factors, in-hospital mortality, and the requirement for de novo anxiolytic therapy were assessed, and a follow-up phase, which evaluated overall mortality and the impact of vaccination on long-term outcomes. Results. Hospitalized patients were older, had lower dialysis adequacy, and a lower rate of COVID-19 vaccination. Severe COVID-19, associated with elevated inflammatory markers, prolonged hospitalization, and an increased need for anxiolytic therapy to control acute psychopathological disturbances, was significantly more frequent in patients with underlying oncological comorbidities. Patients who died from COVID-19 during hospitalization were older (69.364 \u00b1 1.973 vs. 66.426 \u00b1 1.546, p = 0.239), predominantly male (66.69% vs. 48.93%, p = 0.064), had similar BMI (26.836 \u00b1 1.120 vs. 26.909 \u00b1 0.943, p = 0.961), and had shorter duration on HD (5.182 \u00b1 4.733 vs. 7.383 \u00b1 6.060, p = 0.085). Patients who received anxiolytic therapy during hospitalization for COVID-19 were younger, predominantly male, and had a longer dialysis vintage as well as a higher body mass index. Although the de novo need for anxiolytics during COVID hospitalization was associated with multiple parameters in the linear regression analysis, the multivariable regression model showed a significant and strong association only with corticosteroid therapy (OR = 16.403, 95% CI = 4.433\u201362.111, p &lt; 0.001). COVID-19 vaccination was associated with a significant reduction in mortality risk, with vaccinated patients exhibiting a 58% lower hazard of death compared with unvaccinated individuals (HR = 0.42; 95% CI: 0.28\u20130.62; p &lt; 0.001). Conclusions: COVID-19 in HD patients is a multidimensional pathology, in which clinical severity and preventive strategies, such as vaccination, significantly influence survival. Acute anxiety requiring pharmacologic intervention was highly prevalent in hospitalized HD patients with COVID-19, but was not associated with worse survival (p = 0.903). Psychological burden should be recognized as an important component of care in this population.<\/jats:p>","DOI":"10.3390\/medicina62040744","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T11:38:26Z","timestamp":1776080306000},"page":"744","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Psychological Impact of COVID-19 on Maintenance Hemodialysis Patients: Hospitalization Burden, De Novo Anxiolytic Use, and Long-Term Survival"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0879-1903","authenticated-orcid":false,"given":"Ioana Adela","family":"Ratiu","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Nephrology Department, Emergency Clinical Hospital Bihor County, 12 Corneliu Coposu Street, 410469 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danut","family":"Dejeu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Surgery Department, Emergency Clinical Hospital Bihor County, 12 Corneliu Coposu Street, 410469 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozana","family":"Hocopan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina","family":"Moisa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Cristian","family":"Bako","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Nephrology Department, Emergency Clinical Hospital Bihor County, 12 Corneliu Coposu Street, 410469 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicu","family":"Olariu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Division of Nephrology, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Center for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Pal","sequence":"additional","affiliation":[{"name":"Nephrology Department, Emergency Clinical Hospital Bihor County, 12 Corneliu Coposu Street, 410469 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edy","family":"Hagi-Islai","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, Victor Babe\u015f Street, No. 8, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anamaria","family":"Ratiu","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, Victor Babe\u015f Street, No. 8, 400012 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirela","family":"Indries","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Infectious Diseases Department, Emergency Clinical Hospital Bihor County, 410087 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7514-172X","authenticated-orcid":false,"given":"Elena Emilia","family":"Babe\u0219","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Cardiology Department, Emergency Clinical Hospital Bihor County, 65 Gheorghe Doja Street, 410169 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian Adrian","family":"Ratiu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania"},{"name":"Discipline of Oral Implantology, Dentistry Department, Faculty of Medicine and 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