Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease.
COVID-19
Chronic kidney disease
LEOSS
Predictive factor
SARS-CoV-2
Journal
Infection
ISSN: 1439-0973
Titre abrégé: Infection
Pays: Germany
ID NLM: 0365307
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
07
12
2020
accepted:
25
02
2021
pubmed:
15
4
2021
medline:
19
8
2021
entrez:
14
4
2021
Statut:
ppublish
Résumé
The ongoing pandemic caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2) has stressed health systems worldwide. Patients with chronic kidney disease (CKD) seem to be more prone to a severe course of coronavirus disease (COVID-19) due to comorbidities and an altered immune system. The study's aim was to identify factors predicting mortality among SARS-CoV-2-infected patients with CKD. We analyzed 2817 SARS-CoV-2-infected patients enrolled in the Lean European Open Survey on SARS-CoV-2-infected patients and identified 426 patients with pre-existing CKD. Group comparisons were performed via Chi-squared test. Using univariate and multivariable logistic regression, predictive factors for mortality were identified. Comparative analyses to patients without CKD revealed a higher mortality (140/426, 32.9% versus 354/2391, 14.8%). Higher age could be confirmed as a demographic predictor for mortality in CKD patients (> 85 years compared to 15-65 years, adjusted odds ratio (aOR) 6.49, 95% CI 1.27-33.20, p = 0.025). We further identified markedly elevated lactate dehydrogenase (> 2 × upper limit of normal, aOR 23.21, 95% CI 3.66-147.11, p < 0.001), thrombocytopenia (< 120,000/µl, aOR 11.66, 95% CI 2.49-54.70, p = 0.002), anemia (Hb < 10 g/dl, aOR 3.21, 95% CI 1.17-8.82, p = 0.024), and C-reactive protein (≥ 30 mg/l, aOR 3.44, 95% CI 1.13-10.45, p = 0.029) as predictors, while renal replacement therapy was not related to mortality (aOR 1.15, 95% CI 0.68-1.93, p = 0.611). The identified predictors include routinely measured and universally available parameters. Their assessment might facilitate risk stratification in this highly vulnerable cohort as early as at initial medical evaluation for SARS-CoV-2.
Identifiants
pubmed: 33851328
doi: 10.1007/s15010-021-01597-7
pii: 10.1007/s15010-021-01597-7
pmc: PMC8043429
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
725-737Investigateurs
Lukas Tometten
(L)
Kai Wille
(K)
Siegbert Rieg
(S)
Stefan Borgmann
(S)
Matthias Wettstein
(M)
Nora Isberner
(N)
Maria Ruethrich
(M)
Christoph Spinner
(C)
Claudia Raichle
(C)
Mark Neufang
(M)
Frank Hanses
(F)
Bernd Hohenstein
(B)
Sven Stieglitz
(S)
Norma Jung
(N)
Robert Bals
(R)
Sebastian Dolff
(S)
Joerg Schubert
(J)
Maximilian Worm
(M)
Christian Degenhardt
(C)
Timo Brandenburger
(T)
Julia Fuerst
(J)
Maria Vehreschild
(M)
Ulrich Keller
(U)
Martin Hower
(M)
Michael von Bergwelt-Baildon
(M)
Jessica Rueddel
(J)
Katja de With
(K)
Beate Gruener
(B)
Lukas Eberwein
(L)
Beate Schultheis
(B)
David Heigener
(D)
Wolfgang Guggemos
(W)
Helga Peetz
(H)
Lorenz Walter
(L)
Juergen Prattes
(J)
Katja Rothfuss
(K)
Kerstin Hellwig
(K)
Jacob Nattermann
(J)
Uta Merle
(U)
Daniel Droehmann
(D)
Dominic Rauschning
(D)
Gabriele Mueller-Joerger
(G)
Alexander Weidemann
(A)
Christiane Piepel
(C)
Annika Ritter
(A)
Gernot Beutel
(G)
Janina Trauth
(J)
Anette Friedrichs
(A)
Wolfgang Bethge
(W)
Joerg Janne Vehreschild
(JJ)
Lisa Pilgram
(L)
Melanie Stecher
(M)
Maximilian Schons
(M)
Carolin E M Jakob
(CEM)
Annika Classen
(A)
Sandra Fuhrmann
(S)
Bernd Franke
(B)
Nick Schulze
(N)
Fabian Prasser
(F)
Martin Lablans
(M)
Informations de copyright
© 2021. The Author(s).
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