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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-8778392 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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