Outcomes of patients with end-stage kidney disease hospitalized with COVID-19: A single-center experience from Eastern India

Aruna Acharya, H. Naik, Rohit Gaude
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Abstract

Aim: This study aimed to describe the clinical characteristics, survival outcome, and its correlation with biochemical parameters in coronavirus disease-2019 (COVID-19)-infected patients with end-stage kidney disease (ESKD). Materials and Methods: A prospective observational study was on hospitalized patients with confirmed COVID-19 infection from September 1, 2020 to October 31, 2020. Data related to demographics, baseline history of comorbid conditions, dialysis-specific data, details on hospital admissions, COVID-19 treatment regimen, laboratory investigations, computed tomography (CT) severity score, COVID-19 Reporting and Data System score, and clinical outcomes (improved/death), duration of hospital stay, oxygen/vasopressor support were collected. Results: A total of 216 ESKD patients with COVID-19 infection were included in this study. The median age was 48.0 years (74.5% men, 25.5% women). Severe acute respiratory infection (44.7%), hypertension (28.2%), and type 2 diabetes mellitus (22.4%) were the most common comorbidities. Elevated levels of serum creatinine (9.3 mg/dL) and blood urea nitrogen (84.8 mg/dL) were observed in the patients with COVID-19 infection. The change in mean levels of serum creatinine and estimated glomerular filtration rate from baseline to post-treatment was significant (0.9 [95% CI: 0.7, 1.1; P < 0.001] and 3.4 [95% CI: 3.2, 3.6; P < 0.001], respectively). Approximately, 79.6% (n = 172) of patients improved post-treatment. Serum creatinine (1.786, 95% CI: 1.031, 3.095; 0.039) and ferritin levels (51.959, 95% CI: 7.901, 341.685; P < 0.001) remained significantly and independently associated with survival. The median time to clinical survival was 17.0 days. Conclusion: Serum creatinine and ferritin levels were independently associated with survival.
因COVID-19住院的终末期肾病患者的预后:来自印度东部的单中心研究
目的:本研究旨在描述冠状病毒病-2019 (COVID-19)感染终末期肾病(ESKD)患者的临床特征、生存结局及其与生化指标的相关性。材料与方法:对2020年9月1日至2020年10月31日住院的新冠肺炎确诊患者进行前瞻性观察研究。收集与人口统计学、合并症的基线病史、透析特异性数据、住院详情、COVID-19治疗方案、实验室调查、计算机断层扫描(CT)严重程度评分、COVID-19报告和数据系统评分、临床结果(改善/死亡)、住院时间、氧气/血管加压剂支持相关的数据。结果:共纳入216例ESKD合并COVID-19感染患者。中位年龄为48.0岁(男性74.5%,女性25.5%)。严重急性呼吸道感染(44.7%)、高血压(28.2%)和2型糖尿病(22.4%)是最常见的合并症。COVID-19感染患者血清肌酐(9.3 mg/dL)和尿素氮(84.8 mg/dL)升高。从基线到治疗后,平均血清肌酐水平和估计肾小球滤过率的变化是显著的(0.9 [95% CI: 0.7, 1.1;P < 0.001]和3.4 [95% CI: 3.2, 3.6;P < 0.001])。约79.6% (n = 172)的患者在治疗后得到改善。血清肌酐(1.786,95% CI: 1.031, 3.095;0.039)和铁蛋白水平(51.959,95% CI: 7.901, 341.685;P < 0.001)仍然与生存率显著且独立相关。中位临床生存期为17.0天。结论:血清肌酐和铁蛋白水平与生存独立相关。
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