Introduction: In December 2019, first Covid-19 disease cases were reported. The pandemic spread with 114.217.365 cases and 2.533014 deaths worldwide in March 2021, with 286.155 cases and 15.811 deaths in Ecuador. The aim of this work was to share COVID-19 disease impact on 700 chronic dialysis patients from Ecuadorian highlands, which represents almost 7% of Ecuadorian dialysis population, after one year of pandemic.

Materials and Methods: Observational-prospective-multicenter study on 700 Latin-American chronic dialysis patients of five different cities from Ecuadorian highlands. Patients were followed since February first, 2020 until 31 January 2021. Patients with COVID-19 symptoms were identified and diagnosis was made exclusively with positive nasopharyngeal swabs PCR testing. Oxygen saturation below 90% at presentation (LOS) classified disease presentation as severe, moderate if symptoms without LOS and asymptomatic if no symptoms. Hospital-stay, time until negative PCR, mortality and laboratory findings were collected.

Results: Two-hundred and five patients (29%) presented COVID-19 disease related symptoms; 115 patients tested positive (16%), 60% were men (p=0.03). Twenty-five patients died (22%). Mortality was related with age above 64 years old, saturation < 90% and severe disease presentation (p=0.03), previous pulmonary pathology and hospitalization (p=0.01). Hospitalization was needed in 74 patients (64%) with hospital stay 11 days (4-15), days until death during hospitalization of 12 days (4-19) and time until negative PCR 20 days (10-25). Symptomatic time was 16 days (11-26).

Conclusion: COVID-19 disease was more frequent in men and has added up to 22% of extra mortality to chronic dialysis population. Patients older than 64 years old, previous pulmonary pathology, LOS at presentation are at higher risk of mortality which demands a closer follow-up in this subgroup. Health care burden due to COVID-19 is high in dialysis population suggesting that vaccination programs must include dialysis patients and staff involved in their care to diminish mortality, infections and health care burden produced by the disease.