Age and multimorbidities as poor prognostic factors for COVID-19 in hemodialysis: a Lebanese national study

Aoun, Mabel; Khalil, Rabab; Mahfoud, Walid; Fatfat, Haytham; Khalil, Line Bou; Alameddine, Rashad; Afiouni, N; Ibrahim, Issam; Hassan, Mohamad; Zarzour, Haytham; Jebai, Ali; Khalil, Nina Mourad; Tawil, Luay; Mechref, Zeina; Imad, Zuhair El; Chamma, Fadia; Khalil, A. M.; Zeidan, Sandy; Ghoul, Balsam El; Dahdah, Georges; Mouawad, Sarah; Azar, Hiba; Chahine, Kamal Abou; Kallab, Siba; Moawad, Bashir; Fawaz, Ahmad; Homsi, Joseph; Tabaja, Carmen; Delbani, Maya; Kallab, Rami; Hoballah, Hassan; Haykal, W.J.; Fares, Najat; Rahal, Walid; Mroueh, Wael; Youssef, Mohammed; Rizkallah, Jamale; Sebaaly, Ziad; Dfouni, Antoine; Ghosn, Norma; Nawfal, Nagi; Jaoude, Walid Abou; Maroun, T; Bassil, Nabil; Beaini, Chadia; Haddad, Boutros; Moubarak, Elie; Rabah, Houssam; Attieh, Amer; Finianos, Serge; Chelala, Dania

doi:10.1186/s12882-021-02270-9

Cited by 12 publications

(15 citation statements)

References 31 publications

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“…Nephrologists who participated in the previous national study on COVID-19 prevalence in HD were contacted to include their patients. 3 Only 5 nephrologists from 2 units performed serological testing in their patients following vaccination. The HD patients of these 2 units, Saint-George Ajaltoun and Bhannes hospitals, Lebanon, were finally included.…”

Section: Study Settingmentioning

confidence: 99%

“…Once infected, their mortality rate reached 20-25% in several national and global reports. [1][2][3] This led nephrology societies across the globe to call for effective preventive measures in these patients as well as to put them on priority lists for vaccination against COVID-19. [4][5][6][7] Despite the urgent need to vaccinate HD patients, this comorbid population is known to have low immunity and poor response to vaccines.…”

Section: Introductionmentioning

confidence: 99%

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Factors predictive of anti-spike antibody titers after COVID-19 vaccination in hemodialysis patients

Aoun¹,

Kahwaji²,

Sleilaty³

et al. 2022

Adv Clin Exp Med

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Background. Hemodialysis (HD) patients have a high prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mortality, but they may have a weak response to coronavirus disease 2019 (COVID-19) vaccines.Objectives. This study aimed to evaluate factors predictive of humoral response in HD patients vaccinated against SARS-CoV-2 infection. Materials and methods. This is a 2-center observational study including HD patients who received the BNT162b2 mRNA vaccine followed by serological measurements 20 days and 4 weeks after the 1 st and 2 nd dose, respectively. Healthy controls were included. Anti-spike antibody was measured using the chemiluminescent immunoassay (CLIA) method. The quantile regression analysis was performed to assess factors associated with anti-spike antibody titers.Results. Seventy-two HD patients and 22 healthy controls were included. Mean age of dialysis patients and controls was 72.5 ±11.5 years and 45.7 ±17.4 years, respectively. In the HD group, median levels of anti-spike antibody were 3 (interquartile range (IQR): 0.5−26) UI/mL and 391 (IQR: 55−1642) UI/mL after the 1 st and 2 nd dose, respectively, with response rates of 62.5% and 96.7%. The median level of the anti-spike antibody after the 1 st dose in previously infected patients was 8571 (IQR: 2586−19147) UI/mL. There was a significant correlation between anti-spike antibody levels after the 2 nd dose and age and anti-hepatitis B surface (HBs) antibody and serum albumin levels (Spearman's rho: r = −0.289, p < 0.001; r = 0.357, p = 0.027; r = 0.317; p = 0.026, respectively). The regression analysis showed a significant association of previous infection and anti-Hbs antibody level with anti-spike antibody level after the 1 st dose of vaccine (p < 0.001). After a 5-month follow-up, 2 vaccinated patients contracted COVID-19.Conclusions. This study showed a response rate of 96.7% to 2 doses of BNT162b2 mRNA vaccine in HD patients and 100% to a single dose in previously infected patients. The level of anti-spike antibody can be predicted by age, anti-Hbs antibodies, serum albumin, and previous infection. Despite the immunization of patients, preventive measures should be maintained in all dialysis units.

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Section: Study Settingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factors predictive of anti-spike antibody titers after COVID-19 vaccination in hemodialysis patients

Aoun¹,

Kahwaji²,

Sleilaty³

et al. 2022

Adv Clin Exp Med

Self Cite

View full text Add to dashboard Cite

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“…Of the non-duplicate 9850 articles, 8274 were ineligible after screening the titles and abstracts, and 1017 articles were excluded after full-text reviews. This resulted in 559 articles that were appropriate for inclusion in the systematic review, and 542 of them were also included in the meta-analysis [ 3 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , …”

Section: Resultsmentioning

confidence: 99%

Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis

et al. 2022

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This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I2, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis (n = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.

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“…Regarding multimorbidity of underlying conditions that increase the risk of severe COVID-19, it was present in 21.8% of the study population, with a male predominance (p < 0.001). This may suggest that, in Portugal, approximately 2 out of every 10 individuals with chronic diseases are at increased risk of premature death attributed to COVID-19, considering the already known association between multimorbidity and mortality by COVID-19 [19,20,[27][28][29].…”

Section: Discussionmentioning

confidence: 99%

Sociodemographic and Clinical Determinants of Multimorbidity of Underlying Conditions That Increase the Risk of Severe Illness from COVID-19 in Chronic Adult Individuals

Prazeres

Castro

Teixeira

2022

BioMed

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Multimorbid patients represent a special population of vulnerable individuals who suffer from two or more long-term conditions. They are a very prevalent group with an increased risk of death from COVID-19. The present study aimed to identify the sociodemographic and clinical determinants of multimorbidity of underlying conditions that increase the risk of severe COVID-19 in chronic adult individuals by analyzing data from the Portuguese National Health Survey 2019. The inclusion sample consisted of 7859 adult residents in Portugal who had at least one chronic condition. The health conditions considered for multimorbidity were CKD, COPD, heart conditions, diabetes mellitus, obesity, and smoking. In Portugal, approximately 6 out of every 10 individuals with chronic diseases suffer from one or more conditions that are on the list of those at increased risk of severe COVID-19 disease, and approximately 2 out of every 10 individuals have multimorbidity. Obesity and diabetes are the most frequent risk factors. Timely interventions (e.g., regular medical follow-up for preventive health services and health information) targeting multimorbidity in males and individuals with low educational levels, a poor health status, and low functionality may help to reduce the risk of severe COVID-19 and post-COVID-19 sequelae, and to improve health in a large proportion of the population.

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Age and multimorbidities as poor prognostic factors for COVID-19 in hemodialysis: a Lebanese national study

Cited by 12 publications

References 31 publications

Factors predictive of anti-spike antibody titers after COVID-19 vaccination in hemodialysis patients

Factors predictive of anti-spike antibody titers after COVID-19 vaccination in hemodialysis patients

Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis

Sociodemographic and Clinical Determinants of Multimorbidity of Underlying Conditions That Increase the Risk of Severe Illness from COVID-19 in Chronic Adult Individuals

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