Clinical Characteristics and Early Outcomes of Hospitalized COVID-19 Patients with End-Stage Kidney Disease in Saudi Arabia

Abstract

Background The prognosis of the novel coronavirus disease 2019 (COVID-19) may be poor in patients with end-stage kidney disease (ESKD). Limited information is available on the clinical characteristics and outcomes of such patients in Arab countries. The present study aimed to address this gap. Methods This retrospective cohort study included 101 patients with ESKD who were hospitalized for COVID-19 between May 1, 2020 and December 31, 2020 at King Fahad Central Hospital (single center), Jazan Province, Saudi Arabia. Chi-square test, independent samples t -test, Mann–Whitney U -test, and Cox regression were performed in the statistical analysis. Results Of the 101 hospitalized COVID-19 patients with ESKD, 20 patients died (19.8%). Patients aged ≥ 65 years had a significant mortality risk. Mortality was higher in male patients (70%) than in female patients (30%). The most common comorbidities were hypertension (88%), diabetes mellitus (47%), and heart disease (17%). The presence of diabetes and cardiovascular diseases along with ESKD increased the mortality risk [relative risk (RR) = 6.5 and RR = 3.8, respectively]. The most frequently reported clinical symptoms were fever (50%), shortness of breath (41%), and cough (35%). In total, 17% of the patients were admitted to the intensive care unit and required mechanical ventilation. Most patients had bilateral lung infiltrates (88%). Hemoglobin levels and platelet counts were significantly lower in the deceased patients than in the surviving ones. Moreover, compared with the surviving patients, higher degree of lymphocytopenia, neutrophilia, ferritin, D-dimer, blood urea nitrogen, and aspartate transaminase were detected in the deceased patients. Septic shock (20%) and respiratory failure (19%) were the most prevalent complications resulting in death. Conclusion COVID-19 patients with ESKD have an increased risk of poor outcomes and mortality. The mortality risk increases with an increase in age and the presence of other comorbidities, such as diabetes and cardiovascular disease. Elevated levels of inflammatory markers correlate with disease severity and are associated with in-hospital mortality in this population.

Clinical Characteristics, Outcomes and Prognostic Factors for Critical Illness in Hospitalized COVID-19 Patients in Saudi Arabia: A Retrospective Cohort Study

“…Different rates have been reported from different localities in Saudi Arabia as Riyadh (4.27%), 93 Mecca (2.7%), 94 Jazan (19%). 95 Moreover, variable rates were reported worldwide. Higher rates of mortality were observed in European and American countries.…”

Prognosis of COVID-19 in the middle eastern population, knowns and unknowns

“…High D-dimer levels, neutrophilia, lymphocytopenia, and high blood urea nitrogen levels were also significant risk factors for death in this population. The most common complications resulting in death were septic shock, respiratory failure, and respiratory distress syndrome ( Hakami et al, 2021 ). As for the symptoms, the most commonly reported were fever, shortness of breath, and cough.…”

“…As for the symptoms, the most commonly reported were fever, shortness of breath, and cough. The majority of the patients were admitted to the hospital general ward with 17% only requiring ICU and intubation ( Hakami et al, 2021 ). Al Maghrabi et al reported four cases of fully vaccinated solid organ transplants (three renal and one liver), infected with SARS-CoV-2.…”

Predictors of Poor Outcome among Critically Ill COVID-19 Patients: A Nationally Representative Sample of the Saudi Arabian Population

“…Several studies set in SA have described the clinical characteristics of COVID-19 patients, though most of them were limited by small sample size [ 16 , 17 ]. The overall mortality rate among critically ill patients in SA was estimated to range between 25% and 42% and was higher among patients on mechanical ventilation [ 18 , 19 ].…”