Outcomes of coronavirus 2019 infection in patients with chronic kidney disease: a systematic review and meta-analysis

Lin, Yi‐Chih; Lai, Tai‐Shuan; Lin, Shu; Chen, Ming-Fong; Chu, Tzong‐Shinn; Tu, Yu–Kang

doi:10.1177/2040622321998860

Cited by 6 publications

(5 citation statements)

References 70 publications

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“…In fact, once COVID-19 disease is established, CKD patients have high mortality rates because the disease severely affects their already impaired kidney function [ 4 ]. These figures consistently underscore the high vulnerability of CKD patients to COVID-19, related to multiple factors [ 26 , 27 ], and the need to protect this segment of the population.…”

Section: Discussionmentioning

confidence: 80%

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COVID-19 incidence and mortality in non-dialysis chronic kidney disease patients

et al. 2021

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Many studies reported a higher risk of COVID-19 disease among patients on dialysis or with kidney transplantation, and the poor outcome of COVID-19 in these patients. Patients in conservative management for chronic kidney disease (CKD) have received attention only recently, therefore less is known about how COVID-19 affects this population. The aim of this study was to provide evidence on COVID-19 incidence and mortality in CKD patients followed up in an integrated healthcare program and in the population living in the same catchment area. The study population included CKD patients recruited in the Emilia-Romagna Prevention of Progressive Renal Insufficiency (PIRP) project, followed up in the 4 nephrology units (Ravenna, Forlì, Cesena and Rimini) of the Romagna Local Health Authority (Italy) and alive at 1.01.2020. We estimated the incidence of COVID-19, its related mortality and the excess mortality within this PIRP cohort as of 31.07.2020. COVID-19 incidence in CKD patients was 4.09% (193/4,716 patients), while in the general population it was 0.46% (5,195/1,125,574). The crude mortality rate among CKD patients with COVID-19 was 44.6% (86/193), compared to 4.7% (215/4,523) in CKD patients without COVID-19. The excess mortality of March-April 2020 was +69.8% than the average mortality of March-April 2015–19 in the PIRP cohort. In a cohort mostly including regularly followed up CKD patients, the incidence of COVID-19 among CKD patients was strongly related to the spread of the infection in the community, while its lethality is associated with the underlying kidney condition and comorbidities. COVID-19 related mortality was about ten times higher than that of CKD patients without COVID. For this reason, it is urgent to offer a direct protection to CKD patients by prioritizing their vaccination.

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Section: Discussionmentioning

confidence: 80%

“…vulnerability of CKD patients to COVID-19, related to multiple factors [26,27], and the need to protect this segment of the population. Another way to look at the COVID-19 death toll on CKD patients is to examine the excess mortality.…”

Section: Plos Onementioning

confidence: 99%

COVID-19 incidence and mortality in non-dialysis chronic kidney disease patients

et al. 2021

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“…The advanced age and multiple comorbidities often prevalent in CKD patients might place these patients at higher risk of critical illness. A meta-analysis of the literature also demonstrated that patients with CKD alone had an increased association with all-cause mortality compared with those without CKD [ 13 ]. Data from a global health research network called TriNetX (Cambridge, MA) showed that the incidence of hospitalization, ventilation and mortality (risk ratios 1.4–1.5, 1.5–2.0 and 1.4–1.8, respectively) for COVID-19 were all higher in CKD patients than in those without CKD, even after enrolling KT patients [ 14 ].…”

Section: Covid-19 Pandemic and Ckd: The Higher Incidence Of Critical Illness And Acute Kidney Injury In Patients With Ckdmentioning

confidence: 99%

The Efficacy of COVID-19 Vaccines in Chronic Kidney Disease and Kidney Transplantation Patients: A Narrative Review

Hou

Kuo

2021

Vaccines

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The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic has posed a huge threat to global health because of its rapid spread and various mutant variants. Critical illness occurs in the elderly and vulnerable individuals, such as those with chronic kidney disease. The severity of SARS-CoV-2 infection is associated with the severity of chronic kidney disease (CKD)and even kidney transplantation (KT) because of the chronic use of immunosuppressive agents. To develop adaptive immunity against SARS-CoV-2, vaccination against the spike protein is important. Current phase III trials of vaccines against SARS-CoV-2 have not focused on a specific group of individuals, such as patients with CKD or those undergoing dialysis or kidney transplantation. Chronic use of immunosuppressive agents might disturb the immune response to the SARS-CoV-2 spike protein. On the basis of limited evidence, the immune compromised status of CKD patients might decrease neutralizing antibody development after a single dose of a specific vaccine. Boosting dosage more than the protocol might increase the titer of the neutralizing antibody in CKD patients. Further evidence is needed to understand the factors disturbing the immunogenicity of the SARS-CoV-2 vaccine, and CKD patients should receive the recommended dose of the SARS-CoV-2 vaccine due to their relatively immune compromised status.

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“…The coronavirus disease 2019 (COVID-19) pandemic significantly affected individuals suffering from chronic medical conditions, such as chronic kidney disease (CKD), in terms of risk of infection, morbidity, and mortality [ 1 ]. Individuals suffering from CKD were reported to be at high risk of COVID-19 infection due to their dependence on in-center dialysis treatment, which is a high-risk environment for the transmission of COVID-19 infection [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Booster Vaccine Hesitancy among Hemodialysis Patients in Saudi Arabia Using the Health Belief Model: A Multi-Centre Experience

et al. 2022

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Objective: Vaccination hesitance for the COVID-19 booster dosage among hemodialysis patients is an important barrier in reducing morbidity and mortality linked to COVID-19 infection. Hence, this study aimed to explore the predictors of the third (booster) dose of COVID-19 vaccine intention among CKD patients on hemodialysis from the Kingdom of Saudi Arabia (KSA). Methods: This study was a multi-center cross-sectional study conducted at four dialysis centers in KSA from 13 February 2022 to 21 June 2022. The data was collected by the nephrologist in charge of the unit using a structured study questionnaire, which consisted of four parts; socio-demographic and clinical variables, questions about COVID-19 infection and subjective assessment of health state, COVID-19 booster dose vaccination intention and confidence in vaccines and preferences, and a health belief model. The study population consisted of 179 hemodialysis patients. Results: Participants in the study had conflicting health beliefs about their vulnerability to COVID-19 infection and the severity of the COVID-19 infection. Study participants expressed positive health beliefs about the advantages of the COVID-19 booster dose, and reported less perceived obstacles in receiving the vaccine. The influence of cues on action among the study population was high. A total of 140 (78.2%) hemodialysis patients expressed their intention to receive the COVID-19 booster dose. Patients who reported poor health in the self-rating of their health status had a substantially higher definite intention to take the COVID-19 booster dose, according to the chi-square test (11.16, df = 3, p = 0.01). There was a significant association between the constructs in the HBM model and COVID-19 vaccine (booster) intention. Marital status (OR = 1.67, CI 1.07–2.58) was found to be the strongest predictors of a definite intention to receive a COVID-19 booster dose. Confidence in the locally manufactured vaccine (OR = 0.33, CI 0.17–0.60), education (OR = 0.62, CI 0.41–0.93), and rating of health status (OR = 0.43 CI 0.25–0.74) were the strongest significant correlates of having no definite intention to take the COVID-19 vaccination. Conclusions: HBM constructs were found to be significantly associated with vaccination intention, which can be considered while planning policies to promote COVID-19 booster vaccination among hemodialysis patients. The study results could be utilized in drafting policies to improve COVID-19 booster dose vaccination uptake among hemodialysis population.

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Outcomes of coronavirus 2019 infection in patients with chronic kidney disease: a systematic review and meta-analysis

Cited by 6 publications

References 70 publications

COVID-19 incidence and mortality in non-dialysis chronic kidney disease patients

COVID-19 incidence and mortality in non-dialysis chronic kidney disease patients

The Efficacy of COVID-19 Vaccines in Chronic Kidney Disease and Kidney Transplantation Patients: A Narrative Review

COVID-19 Booster Vaccine Hesitancy among Hemodialysis Patients in Saudi Arabia Using the Health Belief Model: A Multi-Centre Experience

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