Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study.

IF 2.1 Q2 UROLOGY & NEPHROLOGY

International Journal of Nephrology and Renovascular Disease Pub Date : 2021-06-30 eCollection Date: 2021-01-01 DOI:10.2147/IJNRD.S310035

Samia Kazmi, Ashar Alam, Beena Salman, Faiza Saeed, Shoukat Memon, Javeria Chughtai, Shahzad Ahmed, Sobia Tariq, Salman Imtiaz

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引用次数: 4

Abstract

Background: In an ESRD subset of patients, COVID-19 infection is associated with increased disease burden and higher mortality rates.

Methods: We conducted a retrospective single-center cohort study in which 43 ESRD patients had a diagnosis of COVID-19. Association of risk factors with mortality was assessed by chi-square test and logistic regression analysis. Data were collected on a structured performa which included variables like age, gender, comorbid conditions, drug history, clinical presentation, hemodynamic status and laboratory parameters. Outcome variables were recovery and death. All patients received standard treatment for COVID-19 according to hospital protocols, along with hemodialysis and continuous renal replacement therapy (CRRT) when needed.

Results: Those most affected were found to be male, 25 (58.1%), while the number of females affected was 18 (41.9%). The most frequent comorbid condition was hypertension (HTN), seen in 35 (81.4%) patients; however, thromboembolic complications were very few in these patients. The mortality rate in our study was 25.6%, and the population most susceptible to poor outcomes in the ESRD subgroup was elderly people (45.5%), while younger patients recovered the most from COVID-19 (53.1%). Hypoalbuminemia, leukocytosis, lymphopenia and raised LDH were also found to be associated with death in ESRD patients suffering from COVID-19 (81.8, 72.7, 100 and 100%, respectively). In multivariate logistic regression analysis, we found that the odds ratio of dying from COVID-19 was 19.5 times higher in patients aged >65 years as compared to patients aged 18-50 years (p=0.039). Similarly, patients with a high TLC were 24.1 times more likely to die than patients with a normal TLC (p=0.008).

Conclusion: In our center, the mortality rate of ESRD patients affected with COVID-19 disease was 25.6%, and older age, leukocytosis, lymphopenia, hypoalbuminemia and high LDH were significantly associated with mortality.

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ESRD患者维持性血液透析感染COVID-19的临床过程和结局:一项单中心研究

背景:在ESRD患者亚群中，COVID-19感染与疾病负担增加和死亡率升高相关。方法:我们对43例诊断为COVID-19的ESRD患者进行了回顾性单中心队列研究。采用卡方检验和logistic回归分析评估危险因素与死亡率的相关性。数据收集包括年龄、性别、合并症、用药史、临床表现、血流动力学状态和实验室参数等变量。结果变量为恢复和死亡。所有患者都根据医院方案接受了COVID-19的标准治疗，并在需要时进行血液透析和持续肾脏替代治疗(CRRT)。结果:男性发病最多，25例(58.1%)，女性发病18例(41.9%)。最常见的合并症是高血压(HTN)，有35例(81.4%);然而，这些患者的血栓栓塞并发症非常少。我们的研究死亡率为25.6%，ESRD亚组中最易发生不良预后的人群是老年人(45.5%)，而年轻患者从COVID-19中恢复最多(53.1%)。低白蛋白血症、白细胞增多、淋巴细胞减少和LDH升高也被发现与患有COVID-19的ESRD患者的死亡相关(分别为81.8、72.7、100和100%)。在多因素logistic回归分析中，我们发现65岁以上患者死于COVID-19的比值比是18-50岁患者的19.5倍(p=0.039)。同样，TLC高的患者死亡的可能性是TLC正常患者的24.1倍(p=0.008)。结论:本中心合并COVID-19疾病的ESRD患者死亡率为25.6%，年龄增大、白细胞增多、淋巴细胞减少、低白蛋白血症和高LDH与死亡率显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Nephrology and Renovascular Disease UROLOGY & NEPHROLOGY-

CiteScore

3.90

自引率

5.00%

发文量

审稿时长

16 weeks

期刊介绍： International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.