COVID-19 Among US Dialysis Patients: Risk Factors and Outcomes From a National Dialysis Provider

Abstract

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Impact of Kidney Failure on the Severity of COVID-19

“…We did not demonstrate gender as a factor influencing the clinical status on admission and in-hospital mortality in CKD patients, and among those with severe renal failure, the death rate was nearly equal between females and males. Thus, the results of our study differ from other reports documenting a higher risk of severe course and COVID-19-related death rate in males [ 2 , 4 , 22 , 27 , 30 , 31 ].…”

“…We confirmed older age as an independent strong predictor for in-hospital mortality, which is in line with previous reports and calculations performed by GBD collaboration in patients with CKD [ 2 , 3 , 15 , 22 , 23 , 27 , 30 ]. On the contrary, Cai et al, in a meta-analysis of 12 studies including CKD patients, documented a higher mortality rate in those below 70 years compared to older patients, explaining this finding by the more frequent rate of the other comorbidities with stronger than CKD association with increased risk of death among the elderly [ 14 ].…”

“…Those parameters were increased in direct proportion to the degree of renal impairment and probably corresponded to a proinflammatory state. The high CRP concentration, the increased neutrophils, and the decreased platelet counts on admission were independently associated with a significantly higher in-hospital death rate in patients with CKD, which supported results from other studies [ 22 , 23 , 25 , 30 , 32 , 33 ]. Among comorbidities, arterial hypertension, ischemic heart disease, and malignancy were found to be independent negative predictors of 28-day survival and these findings, whereas diabetes and COPD were not.…”

Vaccine and the Need To Be Heard: Considerations for COVID-19 Immunization in ESKD

“…This holds true even compared to Medicare patients over age 85 who were hospitalized at the rate of 1,436 per 100,000 beneficiaries (4). With regard to mortality, COVID-19 associated mortality in ESKD patients is described as roughly 25% (5). Furthermore, ESKD patients with severe COVID-19 requiring admission to an intensive care unit (ICU), have a staggering 50% mortality at 28 days (6).…”

“…Although home dialysis patients do not face the same risks of dialysis in congregate settings, they are subject to the similar underlying comorbidities and have close contact with care partners. (5) The seroprevalence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) antibodies was between 8-9 percent in a large nationwide sample of ESKD patients in US (7). However, in New York State, seroprevalence rates among those receiving dialysis reached nearly 34% (7).…”