Characteristics and mortality determinants of COVID-19 patients undergoing hemodialysis

Sipahi, Savaş; Dheir, Hamad; Toçoğlu, Aysel; Bektaş, Melike; Açıkgöz, Seyyid Bilal; Genç, Ahmed Cihad; Mutlu, Fuldem; Köroğlu, Mehmet; Erdem, Alı Fuat; Karabay, Oğuz

doi:10.3906/sag-2006-54

Cited by 11 publications

(11 citation statements)

References 14 publications

(25 reference statements)

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“…This is aligned with the French study from the Paris region that found an association between a CRP >175 mg/L and higher mortality [14]. This also concurs well with two studies one from Wuhan, China, and a second one from Turkey that identi ed a high CRP as predictor for higher mortality [28,29]. These studies found as well the low neutrophil/lymphocyte ratio as a predictor for death [28]; this was not con rmed in our patients.…”

Section: Discussionsupporting

confidence: 90%

“…In a Spanish caseseries, 77% of patients had fever (33% pneumonia), these results are similar in our population [30]. However, in one Turkish and one Chinese series, fever was found in 30% and 51.9% of 42 and 131 cases respectively [28,13]. Surprisingly, the Turkish patients had more cough and dyspnea than other populations although they had no difference in demographic factors.…”

Section: Discussionsupporting

confidence: 80%

“…The symptomatology described is consistent with several worldwide reports. Fever is the most frequent symptom, followed by dry cough, dyspnea and to a lesser degree diarrhea [30,28,23,31]. The rst reports of COVID-19 in dialysis emphasized the frequency of diarrhea [3] but it was not con rmed in larger samples.…”

Section: Discussionmentioning

confidence: 99%

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Age and Multimorbidities as Poor Prognostic Factors for COVID-19 in Hemodialysis: a Lebanese National Study

Aoun

Khalil

Mahfoud³

et al. 2020

Preprint

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BackgroundHemodialysis patients with COVID-19 have been reported to be at higher risk for death than the general population. Several prognostic factors have been identified in the studies from Asian, European or American countries. This is the first national Lebanese study assessing the factors associated with SARS-CoV-2 mortality in hemodialysis patients.MethodsThis is a cross-sectional study that included all chronic hemodialysis patients in Lebanon who were tested positive for SARS-CoV-2 from 31st March to 1st November 2020. Data on demographics, comorbidities, admission to hospital and outcome were collected retrospectively from the patients' medical records. A binary logistic regression analysis was performed to assess risk factors for mortality.ResultsA total of 231 patients were included. Mean age was 61.46 ± 13.99 years with a sex ratio of 128 males to 103 females. Around half of the patients were diabetics, 79.2% presented with fever. A total of 115 patients were admitted to the hospital, 59% of them within the first day of diagnosis. Hypoxia was the major reason for hospitalization. Death rate was 23.8% after a median duration of 6 (IQR, 2 to 10) days. Adjusted regression analysis showed a higher risk for death among older patients (odds ratio=1.038; 95% confidence interval: 1.013, 1.065), patients with heart failure (odds ratio=4.42; 95% confidence interval: 2.06, 9.49), coronary artery disease (odds ratio=3.27; 95% confidence interval: 1.69, 6.30), multimorbidities (odds ratio=1.593; 95% confidence interval: 1.247, 2.036), fever (odds ratio=6.66; 95% confidence interval: 1.94, 27.81), CRP above 100 mg/L (odds ratio=4.76; 95% confidence interval: 1.48, 15.30), and pneumonia (odds ratio=19.18; 95% confidence interval: 6.47, 56.83).ConclusionsThis national study identified older age, coronary artery disease, heart failure, multimorbidities, fever and pneumonia as risk factors for death in patients with COVID-19 on chronic hemodialysis. The death rate was comparable to other countries and estimated at 23.8%.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 80%

See 1 more Smart Citation

Age and Multimorbidities as Poor Prognostic Factors for COVID-19 in Hemodialysis: a Lebanese National Study

Aoun

Khalil

Mahfoud³

et al. 2020

Preprint

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“…Although Qatar has one of the lowest COVID-19-related mortality rates in the world (0.15%), the mortality rate among our dialysis patients was significantly higher (14.5%). Still, this remains lower than most international figures reported in Spain, Italy, and Turkey (Mortality rate of 30.4%, 40% and 13% respectively) [22][23][24].…”

Section: Discussionmentioning

confidence: 54%

Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study

et al. 2021

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Context Patients on maintenance dialysis are more susceptible to COVID-19 and its severe form. We studied the mortality and associated risks of COVID-19 infection in dialysis patients in the state of Qatar. Methods This was an observational, analytical, retrospective, nationwide study. We included all adult patients on maintenance dialysis therapy who tested positive for COVID-19 (PCR assay of the nasopharyngeal swab) during the period from February 1, 2020, to July 19, 2020. Our primary outcome was to study the mortality of COVID-19 in dialysis patients in Qatar and risk factors associated with it. Our secondary objectives were to study incidence and severity of COVID-19 in dialysis patients and comparing outcomes between hemodialysis and peritoneal dialysis patients. Patient demographics and clinical features were collected from a national electronic medical record. Univariate Cox regression analysis was performed to evaluate potential risk factors for mortality in our cohort. Results 76 out of 1064 dialysis patients were diagnosed with COVID-19 (age 56±13.6, 56 hemodialysis and 20 peritoneal dialysis, 56 males). During the study period, 7.1% of all dialysis patients contracted COVID-19. Male dialysis patients had double the incidence of COVID-19 than females (9% versus 4.5% respectively; p<0.01). The most common symptoms on presentation were fever (57.9%), cough (56.6%), and shortness of breath (25%). Pneumonia was diagnosed in 72% of dialysis patients with COVID-19. High severity manifested as 25% of patients requiring admission to the intensive care unit, 18.4% had ARDS, 17.1% required mechanical ventilation, and 14.5% required inotropes. The mean length of hospital stay was 19.2 ± -12 days. Mortality due to COVID-19 among our dialysis cohort was 15%. Univariate Cox regression analysis for risk factors associated with COVID-19-related death in dialysis patients showed significant increases in risks with age (OR 1.077, CI 95%(1.018–1.139), p = 0.01), CHF and COPD (both same OR 8.974, CI 95% (1.039–77.5), p = 0.046), history of DVT (OR 5.762, CI 95% (1.227–27.057), p = 0.026), Atrial fibrillation (OR 7.285, CI 95%(2.029–26.150), p = 0.002), hypoxia (OR: 16.6; CI 95%(3.574–77.715), p = <0.001), ICU admission (HR30.8, CI 95% (3.9–241.2), p = 0.001), Mechanical ventilation (HR 50.07 CI 95% (6.4–391.2)), p<0.001) and using inotropes(HR 19.17, CI 95% (11.57–718.5), p<0.001). In a multivariate analysis, only ICU admission was found to be significantly associated with death [OR = 32.8 (3.5–305.4), p = 0.002)]. Conclusion This is the first study to be conducted at a national level in Qatar exploring COVID-19 in a dialysis population. Dialysis patients had a high incidence of COVID-19 infection and related mortality compared to previous reports of the general population in the state of Qatar (7.1% versus 4% and 15% versus 0.15% respectively). We also observed a strong association between death related to COVID-19 infection in dialysis patients and admission to ICU.

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“…We cannot explain this increase for the term "amyloidosis." However, various studies have reported that the incidence of AKI in patients with COVID-19 is between 3 and 15% and this is associated with increased mortality (Zhou et al 2020;Sİpahİ et al 2020;Adapa et al 2020;Öztürk et al 2021). Also, AKI rates are 14.5-50% in patients with severe COVID-19 infection in the intensive care unit (Zhou et al 2020;Sİpahİ et al 2020;Adapa et al 2020;Öztürk et al 2021;Dirim et al 2021).…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on interest in renal diseases

Oto

Kardeş

Güller

et al. 2021

Environ Sci Pollut Res

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There is an information gap about the public’s interest in nephrological diseases in the COVID-19 era. The objective was to identify public interest in kidney diseases during the pandemic. In this infodemiology study, Google Trends was queried for a total of 50 search queries corresponding to a broad spectrum of nephrological diseases and the term “nephrologist.” Two time intervals of 2020 (March 15–July 4 and July 5–October 31) were compared to similar time intervals of 2016–2019 for providing information on interest in different phases of the pandemic. Compared to the prior 4 years, analyses showed significant decreases in relative search volume (RSV) in the majority (76%) of search queries on March 15–July 4, 2020 period. However, RSV of the majority of search queries (≈70%) on July 5–October 31, 2020 period was not significantly different from similar periods of the previous 4 years, with an increase in search terms of amyloidosis, kidney biopsy, hematuria, chronic kidney disease, hypertension, nephrolithiasis, acute kidney injury, and Fabry disease. During the early pandemic, there have been significant decreases in search volumes for many nephrological diseases. However, this trend reversed in the period from July 5 to October 31, 2020, implying the increased need for information on kidney diseases. The results of this study enable us to understand how COVID-19 impacted the interest in kidney diseases and demands/needs for kidney diseases by the general public during the pandemic.

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Characteristics and mortality determinants of COVID-19 patients undergoing hemodialysis

Cited by 11 publications

References 14 publications

Age and Multimorbidities as Poor Prognostic Factors for COVID-19 in Hemodialysis: a Lebanese National Study

Age and Multimorbidities as Poor Prognostic Factors for COVID-19 in Hemodialysis: a Lebanese National Study

Mortality and associated risk factors of COVID-19 infection in dialysis patients in Qatar: A nationwide cohort study

Impact of the COVID-19 pandemic on interest in renal diseases

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