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Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study

BACKGROUND: In an ESRD subset of patients, COVID-19 infection is associated with increased disease burden and higher mortality rates. METHODS: We conducted a retrospective single-center cohort study in which 43 ESRD patients had a diagnosis of COVID-19. Association of risk factors with mortality was...

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Autores principales: Kazmi, Samia, Alam, Ashar, Salman, Beena, Saeed, Faiza, Memon, Shoukat, Chughtai, Javeria, Ahmed, Shahzad, Tariq, Sobia, Imtiaz, Salman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8256095/
https://www.ncbi.nlm.nih.gov/pubmed/34234514
http://dx.doi.org/10.2147/IJNRD.S310035
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author Kazmi, Samia
Alam, Ashar
Salman, Beena
Saeed, Faiza
Memon, Shoukat
Chughtai, Javeria
Ahmed, Shahzad
Tariq, Sobia
Imtiaz, Salman
author_facet Kazmi, Samia
Alam, Ashar
Salman, Beena
Saeed, Faiza
Memon, Shoukat
Chughtai, Javeria
Ahmed, Shahzad
Tariq, Sobia
Imtiaz, Salman
author_sort Kazmi, Samia
collection PubMed
description BACKGROUND: In an ESRD subset of patients, COVID-19 infection is associated with increased disease burden and higher mortality rates. METHODS: We conducted a retrospective single-center cohort study in which 43 ESRD patients had a diagnosis of COVID-19. Association of risk factors with mortality was assessed by chi-square test and logistic regression analysis. Data were collected on a structured performa which included variables like age, gender, comorbid conditions, drug history, clinical presentation, hemodynamic status and laboratory parameters. Outcome variables were recovery and death. All patients received standard treatment for COVID-19 according to hospital protocols, along with hemodialysis and continuous renal replacement therapy (CRRT) when needed. RESULTS: Those most affected were found to be male, 25 (58.1%), while the number of females affected was 18 (41.9%). The most frequent comorbid condition was hypertension (HTN), seen in 35 (81.4%) patients; however, thromboembolic complications were very few in these patients. The mortality rate in our study was 25.6%, and the population most susceptible to poor outcomes in the ESRD subgroup was elderly people (45.5%), while younger patients recovered the most from COVID-19 (53.1%). Hypoalbuminemia, leukocytosis, lymphopenia and raised LDH were also found to be associated with death in ESRD patients suffering from COVID-19 (81.8, 72.7, 100 and 100%, respectively). In multivariate logistic regression analysis, we found that the odds ratio of dying from COVID-19 was 19.5 times higher in patients aged >65 years as compared to patients aged 18–50 years (p=0.039). Similarly, patients with a high TLC were 24.1 times more likely to die than patients with a normal TLC (p=0.008). CONCLUSION: In our center, the mortality rate of ESRD patients affected with COVID-19 disease was 25.6%, and older age, leukocytosis, lymphopenia, hypoalbuminemia and high LDH were significantly associated with mortality.
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spelling pubmed-82560952021-07-06 Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study Kazmi, Samia Alam, Ashar Salman, Beena Saeed, Faiza Memon, Shoukat Chughtai, Javeria Ahmed, Shahzad Tariq, Sobia Imtiaz, Salman Int J Nephrol Renovasc Dis Original Research BACKGROUND: In an ESRD subset of patients, COVID-19 infection is associated with increased disease burden and higher mortality rates. METHODS: We conducted a retrospective single-center cohort study in which 43 ESRD patients had a diagnosis of COVID-19. Association of risk factors with mortality was assessed by chi-square test and logistic regression analysis. Data were collected on a structured performa which included variables like age, gender, comorbid conditions, drug history, clinical presentation, hemodynamic status and laboratory parameters. Outcome variables were recovery and death. All patients received standard treatment for COVID-19 according to hospital protocols, along with hemodialysis and continuous renal replacement therapy (CRRT) when needed. RESULTS: Those most affected were found to be male, 25 (58.1%), while the number of females affected was 18 (41.9%). The most frequent comorbid condition was hypertension (HTN), seen in 35 (81.4%) patients; however, thromboembolic complications were very few in these patients. The mortality rate in our study was 25.6%, and the population most susceptible to poor outcomes in the ESRD subgroup was elderly people (45.5%), while younger patients recovered the most from COVID-19 (53.1%). Hypoalbuminemia, leukocytosis, lymphopenia and raised LDH were also found to be associated with death in ESRD patients suffering from COVID-19 (81.8, 72.7, 100 and 100%, respectively). In multivariate logistic regression analysis, we found that the odds ratio of dying from COVID-19 was 19.5 times higher in patients aged >65 years as compared to patients aged 18–50 years (p=0.039). Similarly, patients with a high TLC were 24.1 times more likely to die than patients with a normal TLC (p=0.008). CONCLUSION: In our center, the mortality rate of ESRD patients affected with COVID-19 disease was 25.6%, and older age, leukocytosis, lymphopenia, hypoalbuminemia and high LDH were significantly associated with mortality. Dove 2021-06-30 /pmc/articles/PMC8256095/ /pubmed/34234514 http://dx.doi.org/10.2147/IJNRD.S310035 Text en © 2021 Kazmi et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Kazmi, Samia
Alam, Ashar
Salman, Beena
Saeed, Faiza
Memon, Shoukat
Chughtai, Javeria
Ahmed, Shahzad
Tariq, Sobia
Imtiaz, Salman
Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study
title Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study
title_full Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study
title_fullStr Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study
title_full_unstemmed Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study
title_short Clinical Course and Outcome of ESRD Patients on Maintenance Hemodialysis Infected with COVID-19: A Single-Center Study
title_sort clinical course and outcome of esrd patients on maintenance hemodialysis infected with covid-19: a single-center study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8256095/
https://www.ncbi.nlm.nih.gov/pubmed/34234514
http://dx.doi.org/10.2147/IJNRD.S310035
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