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Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection

Introduction: The determinants of COVID-19 mortality are well-characterized in the general population. Less numerous and inconsistent data are among the maintenance hemodialysis (HD) patients, who are the population most at risk of an unfavorable prognosis. Methods: In this retrospective cohort stud...

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Autores principales: Tylicki, Leszek, Puchalska-Reglińska, Ewelina, Tylicki, Piotr, Och, Aleksander, Polewska, Karolina, Biedunkiewicz, Bogdan, Parczewska, Aleksandra, Szabat, Krzysztof, Wolf, Jacek, Dębska-Ślizień, Alicja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778392/
https://www.ncbi.nlm.nih.gov/pubmed/35053983
http://dx.doi.org/10.3390/jcm11020285
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author Tylicki, Leszek
Puchalska-Reglińska, Ewelina
Tylicki, Piotr
Och, Aleksander
Polewska, Karolina
Biedunkiewicz, Bogdan
Parczewska, Aleksandra
Szabat, Krzysztof
Wolf, Jacek
Dębska-Ślizień, Alicja
author_facet Tylicki, Leszek
Puchalska-Reglińska, Ewelina
Tylicki, Piotr
Och, Aleksander
Polewska, Karolina
Biedunkiewicz, Bogdan
Parczewska, Aleksandra
Szabat, Krzysztof
Wolf, Jacek
Dębska-Ślizień, Alicja
author_sort Tylicki, Leszek
collection PubMed
description Introduction: The determinants of COVID-19 mortality are well-characterized in the general population. Less numerous and inconsistent data are among the maintenance hemodialysis (HD) patients, who are the population most at risk of an unfavorable prognosis. Methods: In this retrospective cohort study we included all adult HD patients from the Pomeranian Voivodeship, Poland, with laboratory-confirmed SARS-CoV-2 infection hospitalized between 6 October 2020 and 28 February 2021, both those who survived, and also those who died. Demographic, clinical, treatment, and laboratory data on admission, were extracted from the electronic medical records of the dedicated hospital and patients’ dialysis unit, and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with 3-month all-cause mortality. Results: The 133 patients (53.38% males) aged 73.0 (67–79) years, with a median duration of hemodialysis of 42.0 (17–86) months, were included in this study. At diagnosis, the majority were considered to have a mild course (34 of 133 patients were asymptomatic, another 63 subjects presented mild symptoms), while 36 (27.07%) patients had low blood oxygen saturation and required oxygen supplementation. Three-month mortality was 39.08% including an in-hospital case fatality rate of 33.08%. Multivariable logistic regression showed that the frailty clinical index of 4 or greater (OR 8.36, 95%CI 1.81–38.6; p < 0.01), D-Dimer of 1500 ng/mL or greater (6.00, 1.94–18.53; p < 0.01), and CRP of >118 mg/L at admission (3.77 1.09–13.01; p = 0.04) were found to be predictive of mortality. Conclusion: Very high 3-month all-cause mortality in hospitalized HD patients was determined mainly by frailty. High CRP and D-dimer levels upon admission further confer mortality risk.
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spelling pubmed-87783922022-01-22 Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection Tylicki, Leszek Puchalska-Reglińska, Ewelina Tylicki, Piotr Och, Aleksander Polewska, Karolina Biedunkiewicz, Bogdan Parczewska, Aleksandra Szabat, Krzysztof Wolf, Jacek Dębska-Ślizień, Alicja J Clin Med Article Introduction: The determinants of COVID-19 mortality are well-characterized in the general population. Less numerous and inconsistent data are among the maintenance hemodialysis (HD) patients, who are the population most at risk of an unfavorable prognosis. Methods: In this retrospective cohort study we included all adult HD patients from the Pomeranian Voivodeship, Poland, with laboratory-confirmed SARS-CoV-2 infection hospitalized between 6 October 2020 and 28 February 2021, both those who survived, and also those who died. Demographic, clinical, treatment, and laboratory data on admission, were extracted from the electronic medical records of the dedicated hospital and patients’ dialysis unit, and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with 3-month all-cause mortality. Results: The 133 patients (53.38% males) aged 73.0 (67–79) years, with a median duration of hemodialysis of 42.0 (17–86) months, were included in this study. At diagnosis, the majority were considered to have a mild course (34 of 133 patients were asymptomatic, another 63 subjects presented mild symptoms), while 36 (27.07%) patients had low blood oxygen saturation and required oxygen supplementation. Three-month mortality was 39.08% including an in-hospital case fatality rate of 33.08%. Multivariable logistic regression showed that the frailty clinical index of 4 or greater (OR 8.36, 95%CI 1.81–38.6; p < 0.01), D-Dimer of 1500 ng/mL or greater (6.00, 1.94–18.53; p < 0.01), and CRP of >118 mg/L at admission (3.77 1.09–13.01; p = 0.04) were found to be predictive of mortality. Conclusion: Very high 3-month all-cause mortality in hospitalized HD patients was determined mainly by frailty. High CRP and D-dimer levels upon admission further confer mortality risk. MDPI 2022-01-06 /pmc/articles/PMC8778392/ /pubmed/35053983 http://dx.doi.org/10.3390/jcm11020285 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tylicki, Leszek
Puchalska-Reglińska, Ewelina
Tylicki, Piotr
Och, Aleksander
Polewska, Karolina
Biedunkiewicz, Bogdan
Parczewska, Aleksandra
Szabat, Krzysztof
Wolf, Jacek
Dębska-Ślizień, Alicja
Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection
title Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection
title_full Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection
title_fullStr Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection
title_full_unstemmed Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection
title_short Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection
title_sort predictors of mortality in hemodialyzed patients after sars-cov-2 infection
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8778392/
https://www.ncbi.nlm.nih.gov/pubmed/35053983
http://dx.doi.org/10.3390/jcm11020285
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