COVID-19 in chronic hemodialysis patients: A report of 9 cases in Madrid, Spain

Merino, José Carlos de la Flor; Amado, Francisco Valga; Marschall, Alexander; Grávalos, Tania Linares; Canepa-Escaro, Fabrizio; Cicero, Elisa Ruiz; Sierra, Cristina Albarracín; Bayas, Gioconda Gallegos; Pozo, Miguel Rodeles del

doi:10.5414/cn110210

Cited by 3 publications

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“…The rst reports of COVID-19 in dialysis emphasized the frequency of diarrhea [3] but it was not con rmed in larger samples. 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].…”

Section: Discussionsupporting

confidence: 87%

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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: 87%

“…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%

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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Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 Cases

Merino

Valga

Marschall

et al. 2021

Case Reports in Nephrology

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Early reports have suggested that maintenance hemodialysis (MHD) patients could be more susceptible to a severe course of COVID-19. Among the therapeutic approaches, the use of drugs that reduce the cytokine storm characteristic of this disease has been proposed. Some dialyzers, such as the new generation of asymmetric cellulose triacetate (ATA) membranes, could favor the effective elimination of medium-sized molecules and other inflammatory mediators. In this case series, we describe in depth the clinical, analytical, and radiological details, therapeutic aspects, and outcomes of the case series of 10 MHD patients of our dialysis unit, who tested positive for SARS-CoV-2 from 5 October to 30 November 2020. Furthermore, we evaluate the removal of hyperinflammatory parameters with the ATA membrane in postdilution online hemodiafiltration (OL-HDF) in these patients through a variety of biomarkers of systemic inflammation from the diagnosis until stripping. Biochemical blood analysis was carried out at baseline and at days 7 and 14 after diagnosis, respectively. 50% of the patients presented COVID-19 pneumonia and required hospital admission. Median hospitalization time was 21 days. A total of 4 patients developed severe pneumonia (3 of them died) and 1 patient developed moderate pneumonia. Patients who died (n = 3) were more likely to present bilateral pneumonia (100% vs 14.3%) at diagnosis and less reduction in interleukin 6 (IL-6) at day 14, as compared to those who survived. The use of the ATA membrane could be considered a therapeutic option, due to its immunomodulatory effect in MHD patients with SARS-CoV-2 infection, especially at the beginning of the disease, where the inflammatory component is predominant.

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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. 2021

BMC Nephrol

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Background Hemodialysis 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. Methods This is an observational 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. Results A 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). Conclusions This 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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COVID-19 in chronic hemodialysis patients: A report of 9 cases in Madrid, Spain

Cited by 3 publications

References 0 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

Targeting Cytokine Storm in COVID-19: A Role of Online Hemodiafiltration with Asymmetric Cellulose Triacetate in Maintenance Hemodialysis Patients—A Report of 10 Cases

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

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