Abstract Background: The coronavirus disease (COVID-19) pan-demic has greatly affected the dialysis community. The uremia caused by chronic kidney failure causes inflammation and immune suppression at the molecular level. 3 Immunosup-pression, which occurs in chronic kidney failure, can change the immune response to viral diseases. Dialysis patients appear to be at increased risk for viral transmission with relatively high mortality rates ranging from 11% to 30%. Aim of Study: To evaluate the importance of clinical and laboratory features for early detection and better management of Covid 19 patients under regular hemodialysis. Patients and Methods: We included a total of 120 hemo-dialysis patients who were allocated into two groups; Group 1 included 75 patients who did not develop covid infection, while Group 2 included the remaining 45 patients who devel-oped that serious infection. All patients were subjected to complete history taking, physical examination, radiological chest assessment (via X-ray and CT chest), as well as laboratory investigations (including CBC, d dimer, ferritin, and CRP). Results: There was an increased hemodialysis frequency in group 1 compared to group 2.96% of patients in group 1 had dialysis three time per week compared to 80% in Group 2. The used access did not show a significant difference between the two groups, as AVF was used in 92% and 93.3% of patients in the same groups respectively, while the remaining cases used a permanent catheter. NLR showed a significant rise in the group 2 (5.9 vs. 1.9 in group 1). CRP had median values of 3 and 98gm/dl in groups 1 and 2 respectively, with a significant increase in association with covid infection. Serum d-dimer had median values of 220 and 900 in groups 1 and 2 respectively, with a significant rise in patients with covid infection. Serum ferritin had median values of 137 and 480 in the groups 1 and 2 respectively, with a significant rise in association with covid infection. Conclusion: Covid infection is associated with a marked changes in the clinical and laboratory parameters in haemo-dialysis patients. It is associated with a marked deterioration of vital signs, decreased CBC parameters, and increased inflammatory markers.