Int J Clin Pract . Characteristics and Outcomes of Hospitalized Older Patients with Chronic Kidney Disease and COVID-19: A Multicenter Nationwide Controlled Study

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Int J Clin Pract


. 2021 Jun 4;e14428.
doi: 10.1111/ijcp.14428. Online ahead of print.
Characteristics and Outcomes of Hospitalized Older Patients with Chronic Kidney Disease and COVID-19: A Multicenter Nationwide Controlled Study


Savas Ozturk ^{1 2} , Kenan Turgutalp ³ , Mustafa Arici ⁴ , Mahmut Gok ⁵ , Mahmud Islam ⁶ , Mehmet Riza Altiparmak ⁷ , Zeki Aydin ⁸ , Baris Doner ⁹ , Necmi Eren ¹⁰ , Erkan Sengul ¹¹ , Serhat Karadag ² , Tuba Elif Ozler ¹² , Hamad Dheir ¹³ , Irem Pembegul ¹⁴ , Dilek Guven Taymez ¹⁵ , Garip Sahin ¹⁶ , Serkan Bakirdogen ¹⁷ , Murside Esra Dolarslan ¹⁸ , Zeki Soypacaci ¹⁹ , Ender Hur ²⁰ , Ekrem Kara ²¹ , Taner Basturk ²² , Melike Betul Ogutmen ²³ , Numan Gorgulu ²⁴ , Idris Sahin ²⁵ , Mehmet Deniz Ayli ²⁶ , Zubeyde Serhan Tuglular ²⁷ , Gulizar Sahin ⁵ , Bulent Tokgoz ²⁸ , Halil Zeki Tonbul ²⁹ , Alaattin Yildiz ³⁰ , Siren Sezer ³¹ , Ali Riza Odabas ³² , Kenan Ates ³³



Affiliations

• PMID: 34085352
• DOI: 10.1111/ijcp.14428

Abstract

Objective: Older adults with comorbidities have been reported to be at higher risk for adverse outcomes of Coronavirus disease 2019(COVID-19). The characteristics of COVID-19 in older patients and its clinical outcomes in different kidney disease groups are not well known.
Methods: Data were retrieved from a national multicentric database supported by Turkish Society of Nephrology, which consists of retrospectively collected data between April 17, 2020, and December 31, 2020. Hospitalized patients aged 18 years or older with confirmed COVID-19 diagnosis suffering from stage 3-5 chronic kidney disease(CKD) or on maintenance hemodialysis(HD) treatment were included in the database. Non-uremic hospitalized patients with COVID-19 were also included as the control group.
Results: We included 879 patients [388(44.1%) female, median age: 63(IQR:50-73) years]. The percentage of older patients in the CKD group was 68.8%(n=188/273), in HD group was 49.0%(n=150/306) and in the control group was 30.4%(n=70/300). Comorbidities were higher in the CKD and HD groups. The rate of presentation with severe-critical disease was higher in the older CKD and HD groups (43.6%, 55.3%, 16.1%, respectively). Among older patients, the intensive care unit(ICU) admission rate was significantly higher in the CKD and HD group than in the control group (38.8%, 37.3%, and 15.7%, respectively). In-hospital mortality or death and/or ICU admission rates in the older group were significantly higher in the CKD (29.3% and 39.4%) and HD group (26.7% and 30.1%) compared to the control group (8.6% and 17.1%). In the multivariate analysis, in-hospital mortality rates in CKD and HD groups were higher than control group [Hazard ratio(HR): 4.33([95% confidence interval(CI): 1.53-12.26] and HR: 3.09(95%CI: 1.04-9.17), respectively].
Conclusion: Among older COVID-19 patients, in-hospital mortality is significantly higher in those with stage 3-5 CKD and on maintenance HD than older patients without CKD regardless of demographic characteristics, comorbidities, clinical and laboratory data on admission.

Keywords: Chronic Kidney Disease; Covid-19; Hemodialysis; Older; Outcome.