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COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is a lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), and even less is available in patients on maintenance hemodialysis th...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Society of Nephrology. Published by Elsevier Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211728/ https://www.ncbi.nlm.nih.gov/pubmed/32437770 http://dx.doi.org/10.1016/j.kint.2020.04.031 |
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author | Goicoechea, Marian Sánchez Cámara, Luis Alberto Macías, Nicolás Muñoz de Morales, Alejandra Rojas, Ángela González Bascuñana, Arturo Arroyo, David Vega, Almudena Abad, Soraya Verde, Eduardo García Prieto, Ana María Verdalles, Úrsula Barbieri, Diego Delgado, Andrés Felipe Carbayo, Javier Mijaylova, Antonia Acosta, Adriana Melero, Rosa Tejedor, Alberto Benitez, Patrocinio Rodriguez Pérez de José, Ana Rodriguez Ferrero, María Luisa Anaya, Fernando Rengel, Manuel Barraca, Daniel Luño, José Aragoncillo, Inés |
author_facet | Goicoechea, Marian Sánchez Cámara, Luis Alberto Macías, Nicolás Muñoz de Morales, Alejandra Rojas, Ángela González Bascuñana, Arturo Arroyo, David Vega, Almudena Abad, Soraya Verde, Eduardo García Prieto, Ana María Verdalles, Úrsula Barbieri, Diego Delgado, Andrés Felipe Carbayo, Javier Mijaylova, Antonia Acosta, Adriana Melero, Rosa Tejedor, Alberto Benitez, Patrocinio Rodriguez Pérez de José, Ana Rodriguez Ferrero, María Luisa Anaya, Fernando Rengel, Manuel Barraca, Daniel Luño, José Aragoncillo, Inés |
author_sort | Goicoechea, Marian |
collection | PubMed |
description | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is a lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), and even less is available in patients on maintenance hemodialysis therapy than in the general population. In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of all maintenance hemodialysis patients hospitalized with COVID-19 from March 12th to April 10th, 2020 as confirmed by real-time polymerase chain reaction. Baseline features, clinical course, laboratory data, and different therapies were compared between survivors and nonsurvivors to identify risk factors associated with mortality. Among the 36 patients, 11 (30.5%) died, and 7 were able to be discharged within the observation period. Clinical and radiological evolution during the first week of admission were predictive of mortality. Among the 36 patients, 18 had worsening of their clinical status, as defined by severe hypoxia with oxygen therapy requirements greater than 4 L/min and radiological worsening. Significantly, 11 of those 18 patients (61.1%) died. None of the classical cardiovascular risk factors in the general population were associated with higher mortality. Compared to survivors, nonsurvivors had significantly longer dialysis vintage, increased lactate dehydrogenase (490 U/l ± 120 U/l vs. 281 U/l ± 151 U/l, P = 0.008) and C-reactive protein levels (18.3 mg/dl ± 13.7 mg/dl vs. 8.1 mg/dl ± 8.1 mg/dl, P = 0.021), and a lower lymphocyte count (0.38 ×10(3)/µl ± 0.14 ×10(3)/µl vs. 0.76 ×10(3)/µl ± 0.48 ×10(3)/µl, P = 0.04) 1 week after clinical onset. Thus, the mortality among hospitalized hemodialysis patients diagnosed with COVID-19 is high. Certain laboratory tests can be used to predict a worsening clinical course. |
format | Online Article Text |
id | pubmed-7211728 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | International Society of Nephrology. Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-72117282020-05-11 COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain Goicoechea, Marian Sánchez Cámara, Luis Alberto Macías, Nicolás Muñoz de Morales, Alejandra Rojas, Ángela González Bascuñana, Arturo Arroyo, David Vega, Almudena Abad, Soraya Verde, Eduardo García Prieto, Ana María Verdalles, Úrsula Barbieri, Diego Delgado, Andrés Felipe Carbayo, Javier Mijaylova, Antonia Acosta, Adriana Melero, Rosa Tejedor, Alberto Benitez, Patrocinio Rodriguez Pérez de José, Ana Rodriguez Ferrero, María Luisa Anaya, Fernando Rengel, Manuel Barraca, Daniel Luño, José Aragoncillo, Inés Kidney Int Article Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is a lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), and even less is available in patients on maintenance hemodialysis therapy than in the general population. In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of all maintenance hemodialysis patients hospitalized with COVID-19 from March 12th to April 10th, 2020 as confirmed by real-time polymerase chain reaction. Baseline features, clinical course, laboratory data, and different therapies were compared between survivors and nonsurvivors to identify risk factors associated with mortality. Among the 36 patients, 11 (30.5%) died, and 7 were able to be discharged within the observation period. Clinical and radiological evolution during the first week of admission were predictive of mortality. Among the 36 patients, 18 had worsening of their clinical status, as defined by severe hypoxia with oxygen therapy requirements greater than 4 L/min and radiological worsening. Significantly, 11 of those 18 patients (61.1%) died. None of the classical cardiovascular risk factors in the general population were associated with higher mortality. Compared to survivors, nonsurvivors had significantly longer dialysis vintage, increased lactate dehydrogenase (490 U/l ± 120 U/l vs. 281 U/l ± 151 U/l, P = 0.008) and C-reactive protein levels (18.3 mg/dl ± 13.7 mg/dl vs. 8.1 mg/dl ± 8.1 mg/dl, P = 0.021), and a lower lymphocyte count (0.38 ×10(3)/µl ± 0.14 ×10(3)/µl vs. 0.76 ×10(3)/µl ± 0.48 ×10(3)/µl, P = 0.04) 1 week after clinical onset. Thus, the mortality among hospitalized hemodialysis patients diagnosed with COVID-19 is high. Certain laboratory tests can be used to predict a worsening clinical course. International Society of Nephrology. Published by Elsevier Inc. 2020-07 2020-05-11 /pmc/articles/PMC7211728/ /pubmed/32437770 http://dx.doi.org/10.1016/j.kint.2020.04.031 Text en © 2020 International Society of Nephrology. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Goicoechea, Marian Sánchez Cámara, Luis Alberto Macías, Nicolás Muñoz de Morales, Alejandra Rojas, Ángela González Bascuñana, Arturo Arroyo, David Vega, Almudena Abad, Soraya Verde, Eduardo García Prieto, Ana María Verdalles, Úrsula Barbieri, Diego Delgado, Andrés Felipe Carbayo, Javier Mijaylova, Antonia Acosta, Adriana Melero, Rosa Tejedor, Alberto Benitez, Patrocinio Rodriguez Pérez de José, Ana Rodriguez Ferrero, María Luisa Anaya, Fernando Rengel, Manuel Barraca, Daniel Luño, José Aragoncillo, Inés COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain |
title | COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain |
title_full | COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain |
title_fullStr | COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain |
title_full_unstemmed | COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain |
title_short | COVID-19: clinical course and outcomes of 36 hemodialysis patients in Spain |
title_sort | covid-19: clinical course and outcomes of 36 hemodialysis patients in spain |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211728/ https://www.ncbi.nlm.nih.gov/pubmed/32437770 http://dx.doi.org/10.1016/j.kint.2020.04.031 |
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