Disease severity and renal outcomes of patients with chronic kidney disease infected with COVID-19

Gur, Efrat; Levy, David L.; Topaz, Guy; Naser, Rawand; Wand, Ori; Kitay-Cohen, Yona; Benchetrit, Sydney; Sarel, Erez; Cohen-Hagai, Keren

doi:10.1007/s10157-022-02180-6

Cited by 9 publications

(9 citation statements)

References 37 publications

(48 reference statements)

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“…Recently, Gur et al observed that despite comparable disease severity at presentation, COVID-19 patients with CKD had significantly more AKI events and required more renal replacement therapy during hospitalization than control COVID-19 patients did. Thus, the odds ratio for AKI was 5.8 (95%CI 3.8–8.7; p < 0.001) in CKD group vs. control group [ 28 ]. In a recent meta-analysis, Cai et al found that chronic kidney disease was an independent risk factor for developing AKI in hospitalized COVID-19 patients, i.e., OR = 4.56 [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Infection in Chronic Kidney Disease Patients in Bulgaria: Risk Factors for Death and Acute Kidney Injury

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Lyubomirova

et al. 2022

JPM

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Regarding COVID-19 infection, Bulgaria has one of the lowest rates of vaccination in Europe, and its COVID-19-related mortality rate has been one of the highest in the European Union. Chronic kidney disease (CKD)-COVID-19 patients are at higher risk of developing acute kidney injury (AKI) and death after hospital admission. This single-center prospective cohort study from Bulgaria included 120 in-patient COVID-19 subjects of whom 70 had CKD and 50 normal renal function. Diabetes mellitus, hypertension, obesity, and cardiovascular disease were statistically more prevalent in the CKD group as compared to the non-CKD group. At admission, D-dimer, creatinine, and urea levels were significantly higher in the CKD group, whereas estimated glomerular-filtration rate was significantly lower as compared to the non-CKD patients. During hospitalization, 23 patients (19.1%) died, of which 19 were in the CKD group (p-value = 0.0096); in addition, 38 developed AKI (31.6%), of which 31 were in the CKD group (p-value = 0.0006). Using binary logistic regression, being male, having experienced AKI, and not having been treated with remdesivir were independent risk factors for COVID-19-induced mortality. Regarding risk of AKI, having had COVID-19-related symptoms for more than 6 days before admission, having CKD at baseline, and having not received remdesivir therapy were independent predictive factors for developing AKI after admission.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Infection in Chronic Kidney Disease Patients in Bulgaria: Risk Factors for Death and Acute Kidney Injury

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Rostaing

Lyubomirova

et al. 2022

JPM

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“…Recently, chronic kidney disease (CKD) emerged as one of the strongest risk factors for severe COVID-19 [ 4 , 5 , 6 , 7 ]. Indeed, patients with advanced CKD are at an increased risk of mortality from several causes, led by cardiovascular disease (CVD) and infections [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Growth Differentiation Factor 15 (GDF-15) Levels Associate with Lower Survival in Chronic Kidney Disease Patients with COVID-19

et al. 2022

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A cytokine storm drives the pathogenesis of severe COVID-19 infection and several biomarkers have been linked to mortality. Chronic kidney disease (CKD) emerged as a risk factor for severe COVID-19. We investigated the association between selected biomarkers and mortality in 77 patients hospitalized for COVID-19, and whether they differ in patients with eGFR higher and lower than 45 mL/min. The association between patients’ characteristics, plasma biomarkers and mortality was conducted by univariate logistic regression models and independent predictors of mortality were then used to create a multivariate prediction model through Cox regression. Patients with lower eGFR had a significant increase of GDF-15, CD-25 and RAGE, with higher plasma levels in non-survivors and in patients who needed ventilation. At univariate analysis, low and mid-low GDF-15 quartiles (<4.45 ng/mL) were associated with lower mortality risk, while mid-high and high quartiles (>4.45 ng/mL) were associated with higher mortality risk. Independent association between GDF-15 quartiles and mortality risk was confirmed in the Cox model and adjusted for eGFR, age, fever and dyspnea (HR 2.28, CI 1.53–3.39, p < 0.0001). The strength of the association between GDF-15 quartiles and mortality risk increased in patients with lower compared to higher eGFR (HR 2.53, CI 1.34–4.79 versus HR 1.99, CI 1.17–3.39). Our findings may suggest a further investigation of the effect of GDF-15 signaling pathway inhibition in CKD.

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“…MHD patients are immunocompromised and may have other risk-factors associated with their primary renal disease, such as older age, diabetes, hypertension, etc. As such, they were found to be at increased risk for severe disease and mortality [ 16 , 17 , 18 , 19 ]. Therefore, with the release of the SARS-CoV-2 mRNA vaccine, MHD patients were prioritized for vaccination.…”

Section: Introductionmentioning

confidence: 99%

Humoral Response to Hepatitis B and COVID-19 Vaccine among Maintenance Hemodialysis Patients

et al. 2022

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Maintenance hemodialysis (MHD) patients have impaired immunological responses to pathogens and vaccines. In this study, we compared the humoral response to HBV and COVID-19 vaccines in a cohort of MHD patients. Demographic and clinical characteristics of vaccine responders and non-responders were also compared, and the association between the humoral responses to both vaccines was evaluated. The cohort included 94 MHD patients who were vaccinated at least once for HBV and twice for COVID-19. Among the 94 patients, 28 (29.8%) did not develop protective titers to HBV. Hypertension, coronary heart disease, and heart failure were more common in non-responders. Among MHD patients, 85% had positive IgG anti-spike SARS-CoV-2 levels 6 months after two doses of BNT162b2 (Pfizer/Biotech) vaccine. Age and immunosuppressive therapy were the main predictors of humoral response to COVID-19 vaccine. We did not find any association between non-responders to HBV and non-responders to COVID-19 vaccine. There was no difference in IgG anti-spike titers between HBV responders and non-responders (505 ± 644 vs. 504 ± 781, p = 0.9) Our results suggest that reduced humoral response to hepatitis B is not associated with reduced response to COVID-19 vaccine. Different risk-factors were associated with poor immune response to HBV and to COVID-19 vaccines.

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Disease severity and renal outcomes of patients with chronic kidney disease infected with COVID-19

Cited by 9 publications

References 37 publications

COVID-19 Infection in Chronic Kidney Disease Patients in Bulgaria: Risk Factors for Death and Acute Kidney Injury

COVID-19 Infection in Chronic Kidney Disease Patients in Bulgaria: Risk Factors for Death and Acute Kidney Injury

Growth Differentiation Factor 15 (GDF-15) Levels Associate with Lower Survival in Chronic Kidney Disease Patients with COVID-19

Humoral Response to Hepatitis B and COVID-19 Vaccine among Maintenance Hemodialysis Patients

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