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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Society of Nephrology. Published by Elsevier Inc. 2020
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.
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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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