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Background: Covid-19 outbreak is found to be associated with increased levels mental health issues among the general population. The high prevalence of fatigue, anxiety and depression was also reported in patients on hemodialysis during Covid-19 pandemic as compared to pre-pandemic studies.

Aims: This article determines the level of fatigue, anxiety and depression due to the challenges faced by patients undergoing hemodialysis and their caregivers during the Covid-19 pandemic.

Methods: This descriptive cross-sectional study was carried out in hemodialysis unit of a tertiary care hospital over the period of 3 months from August to October 2021, using validated questionnaire consisted of Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) and Hospital Anxiety and Depression Scale (HADS). 

Results: Among 115 patients (age; mean 53.45 ± 13.9 S.D), fatigue was seen in 80%, anxiety in 67%, depression in 82.6%. While in their caregivers, the prevalence of fatigue was 73.6%, anxiety was 52.7%, depression was 59.1%. Logistic regression analysis showed that gender and challenges e.g. feeling additional burden while visiting the hospital and fear of getting infection and feeling of isolation/loneliness were the main risk predictors of fatigue, anxiety and depression in patients and their caregivers.

Conclusions: In Pakistan the prevalence of fatigue, anxiety and depression due to the challenges of Covid-19 pandemic was significantly high among patients undergoing hemodialysis and their caregivers as compared to pre-covid era. This study gives firm grounds for future researches, which should ascertain the suitable interventions to lessen the fatigue, anxiety, and depression due to the challenges of any future pandemic or epidemic among patients undergoing hemodialysis and their family members.