Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania.
Aged
COVID-19
/ diagnosis
Cause of Death
Comorbidity
Female
Hospital Mortality
Humans
Kidney Failure, Chronic
/ blood
Male
Middle Aged
Oxygen
/ blood
Patient Admission
Prognosis
Renal Dialysis
Retrospective Studies
Risk Factors
Romania
/ epidemiology
SARS-CoV-2
/ isolation & purification
Serum Albumin, Human
/ analysis
Severity of Illness Index
COVID-19
chronic hemodialysis
clinical features
mortality
Journal
Renal failure
ISSN: 1525-6049
Titre abrégé: Ren Fail
Pays: England
ID NLM: 8701128
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
entrez:
14
12
2020
pubmed:
15
12
2020
medline:
23
12
2020
Statut:
ppublish
Résumé
There is limited information about the clinical characteristics, treatment and outcome of maintenance hemodialysis patients with COVID-19. Moreover, regional differences are also conceivable since the extend and severity of outbreaks varied among countries. In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of 37 maintenance hemodialysis patients (median age 64 years, 51% men) hospitalized with COVID-19 from 24 March to 22 May 2020 as confirmed by real-time PCR. The most common symptoms at admission were fatigue (51%), fever (43%), dyspnea (38%) and cough (35%). There were 59% mild/moderate patients and 41% severe/critical patients. Patients in the severe/critical group had a significantly higher atherosclerotic burden since diabetic kidney disease and vascular nephropathies were the most common primary kidney diseases and eighty percent of them had coronary heart disease. Also, Charlson comorbidity score was higher in this group. At admission chest X-ray, 46% had ground-glass abnormalities. Overall, 60% patients received hydroxychloroquine, 22% lopinavir-ritonavir, 11% tocilizumab, 24% systemic glucocorticoids, and 54% received prophylactic anticoagulation. Seven (19%) patients died during hospitalization and 30 were discharged. The main causes of death were cardiovascular (5 patients) and respiratory distress syndrome (2 patients). In Cox regression analysis, lower oxygen saturation, anemia and hypoalbuminemia at admission were associated with increased mortality. In conclusion, we observed a high mortality rate among maintenance hemodialysis patients hospitalized for COVID-19. Anemia, lower serum albumin and lower basal oxygen saturation at admission were factors associated with poor prognosis.
Sections du résumé
BACKGROUND
BACKGROUND
There is limited information about the clinical characteristics, treatment and outcome of maintenance hemodialysis patients with COVID-19. Moreover, regional differences are also conceivable since the extend and severity of outbreaks varied among countries.
METHODS
METHODS
In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of 37 maintenance hemodialysis patients (median age 64 years, 51% men) hospitalized with COVID-19 from 24 March to 22 May 2020 as confirmed by real-time PCR.
RESULTS
RESULTS
The most common symptoms at admission were fatigue (51%), fever (43%), dyspnea (38%) and cough (35%). There were 59% mild/moderate patients and 41% severe/critical patients. Patients in the severe/critical group had a significantly higher atherosclerotic burden since diabetic kidney disease and vascular nephropathies were the most common primary kidney diseases and eighty percent of them had coronary heart disease. Also, Charlson comorbidity score was higher in this group. At admission chest X-ray, 46% had ground-glass abnormalities. Overall, 60% patients received hydroxychloroquine, 22% lopinavir-ritonavir, 11% tocilizumab, 24% systemic glucocorticoids, and 54% received prophylactic anticoagulation. Seven (19%) patients died during hospitalization and 30 were discharged. The main causes of death were cardiovascular (5 patients) and respiratory distress syndrome (2 patients). In Cox regression analysis, lower oxygen saturation, anemia and hypoalbuminemia at admission were associated with increased mortality.
CONCLUSIONS
CONCLUSIONS
In conclusion, we observed a high mortality rate among maintenance hemodialysis patients hospitalized for COVID-19. Anemia, lower serum albumin and lower basal oxygen saturation at admission were factors associated with poor prognosis.
Identifiants
pubmed: 33307933
doi: 10.1080/0886022X.2020.1853571
pmc: PMC7745841
doi:
Substances chimiques
Oxygen
S88TT14065
Serum Albumin, Human
ZIF514RVZR
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
49-57Références
JAMA. 2020 Apr 7;323(13):1239-1242
pubmed: 32091533
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
PLoS One. 2012;7(12):e50295
pubmed: 23227165
Intensive Care Med. 2020 May;46(5):846-848
pubmed: 32125452
J Nephrol. 2020 Apr;33(2):193-196
pubmed: 32207068
Ren Fail. 2020 Nov;42(1):393-397
pubmed: 32340507
Lancet. 2020 May 22;:
pubmed: 32450107
JAMA. 2012 Jun 20;307(23):2526-33
pubmed: 22797452
Kidney Int Rep. 2020 Apr 04;5(5):580-585
pubmed: 32292866
JAMA Cardiol. 2020 Jul 1;5(7):831-840
pubmed: 32219363
Nat Rev Nephrol. 2013 May;9(5):255-65
pubmed: 23507826
Europace. 2020 Mar 1;22(3):496-505
pubmed: 31965154
Diagnosis (Berl). 2020 May 26;7(2):91-96
pubmed: 32352401
Clin Biochem. 2020 Jul;81:9-12
pubmed: 32360479
N Engl J Med. 2003 May 15;348(20):1953-66
pubmed: 12690092
Kidney Int Rep. 2020 May 24;5(7):1095-1099
pubmed: 32642606
JAMA. 2020 Apr 28;323(16):1574-1581
pubmed: 32250385
Ann Intern Med. 2020 Aug 18;173(4):287-296
pubmed: 32459529
Ren Fail. 2020 Nov;42(1):950-957
pubmed: 32924707
JAMA. 2020 May 26;323(20):2089-2090
pubmed: 32320008
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
G Ital Nefrol. 2020 Apr 9;37(2):
pubmed: 32281756
J Med Virol. 2020 Oct;92(10):1875-1883
pubmed: 32441789
N Engl J Med. 2020 Jul 9;383(2):120-128
pubmed: 32437596
J Am Soc Nephrol. 2020 Jul;31(7):1387-1397
pubmed: 32385130
Am J Kidney Dis. 2001 Dec;38(6):1251-63
pubmed: 11728958
JAMA. 2020 Jun 23;323(24):2493-2502
pubmed: 32392282
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Ann Intern Med. 2020 Oct 20;173(8):672-675
pubmed: 32449883
JAMA. 2020 May 12;323(18):1824-1836
pubmed: 32282022
JAMA Intern Med. 2020 Jul 1;180(7):934-943
pubmed: 32167524
J Am Soc Nephrol. 2020 Jul;31(7):1398-1408
pubmed: 32482688
Kidney Int. 2020 Jul;98(1):27-34
pubmed: 32437770