tetano
Editor, Senior Moderator
Kidney Int
. 2020 May 10;S0085-2538(20)30509-3.
doi: 10.1016/j.kint.2020.04.031. Online ahead of print.
COVID-19: Clinical Course and Outcomes of 36 Maintenance Hemodialysis Patients From a Single Center in Spain
Marian Goicoechea[SUP] 1 [/SUP], Luis Alberto S?nchez C?mara[SUP] 2 [/SUP], Nicol?s Mac?as[SUP] 3 [/SUP], Alejandra Mu?oz de Morales[SUP] 3 [/SUP], ?ngela Gonz?lez Rojas[SUP] 3 [/SUP], Arturo Bascu?ana[SUP] 3 [/SUP], David Arroyo[SUP] 3 [/SUP], Almudena Vega[SUP] 3 [/SUP], Soraya Abad[SUP] 3 [/SUP], Eduardo Verde[SUP] 3 [/SUP], Ana Mar?a Garc?a Prieto[SUP] 3 [/SUP], Ursula Verdalles[SUP] 3 [/SUP], Diego Barbieri[SUP] 3 [/SUP], Andr?s Felipe Delgado[SUP] 3 [/SUP], Javier Carbayo[SUP] 3 [/SUP], Antonia Mijaylova[SUP] 3 [/SUP], Ana P?rez de Jos?[SUP] 3 [/SUP], Rosa Melero[SUP] 3 [/SUP], Alberto Tejedor[SUP] 3 [/SUP], Patrocinio Rodriguez Benitez[SUP] 3 [/SUP], Ana P?rez de Jos?[SUP] 3 [/SUP], Maria Luisa Rodriguez Ferrero[SUP] 3 [/SUP], Fernando Anaya[SUP] 3 [/SUP], Manuel Rengel[SUP] 3 [/SUP], Daniel Barraca[SUP] 3 [/SUP], Jos? Lu?o[SUP] 3 [/SUP], In?s Aragoncillo[SUP] 4 [/SUP]
Affiliations
Abstract
SARS-CoV-2-pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), even less in patients on maintenance hemodialysis (MHD) therapy than in the general population. In this retrospective observational single-center study we analyzed the clinical course and outcomes of all MHD patients hospitalized with COVID-19 from March 12[SUP]th[/SUP] to April 10[SUP]th[/SUP], 2020 as confirmed by real time polymerase chain reaction. Baseline features, clinical course, laboratory data, and different therapies were compared between survivors and non-survivors to identify risk factors associated with mortality. Among the 36 patients, 11 (30.5%) died and 7 could 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 Liters/minute and radiological worsening. Significantly 11 out of those 18 patients (61.1%) died. None of the classical cardiovascular risk factors in the general population were associated with higher mortality. However, a longer time on hemodialysis (hazard ratio 1.008(95% confidence interval 1.001-1.015) per year), increased LDH levels (1.006(1.001-1.011), and lower lymphocyte count (0.996 (0.992-1.000) one week after clinical onset were all significantly associated with higher mortality risk. Thus, the mortality among hospitalized hemodialysis patients diagnosed with COVID-19 is high. Lymphopenia and increased LDH levels were associated with poor prognosis.
Keywords: Coronavirus; Covid-19; Hemodialysis; SARS-CoV-2; mortality.
. 2020 May 10;S0085-2538(20)30509-3.
doi: 10.1016/j.kint.2020.04.031. Online ahead of print.
COVID-19: Clinical Course and Outcomes of 36 Maintenance Hemodialysis Patients From a Single Center in Spain
Marian Goicoechea[SUP] 1 [/SUP], Luis Alberto S?nchez C?mara[SUP] 2 [/SUP], Nicol?s Mac?as[SUP] 3 [/SUP], Alejandra Mu?oz de Morales[SUP] 3 [/SUP], ?ngela Gonz?lez Rojas[SUP] 3 [/SUP], Arturo Bascu?ana[SUP] 3 [/SUP], David Arroyo[SUP] 3 [/SUP], Almudena Vega[SUP] 3 [/SUP], Soraya Abad[SUP] 3 [/SUP], Eduardo Verde[SUP] 3 [/SUP], Ana Mar?a Garc?a Prieto[SUP] 3 [/SUP], Ursula Verdalles[SUP] 3 [/SUP], Diego Barbieri[SUP] 3 [/SUP], Andr?s Felipe Delgado[SUP] 3 [/SUP], Javier Carbayo[SUP] 3 [/SUP], Antonia Mijaylova[SUP] 3 [/SUP], Ana P?rez de Jos?[SUP] 3 [/SUP], Rosa Melero[SUP] 3 [/SUP], Alberto Tejedor[SUP] 3 [/SUP], Patrocinio Rodriguez Benitez[SUP] 3 [/SUP], Ana P?rez de Jos?[SUP] 3 [/SUP], Maria Luisa Rodriguez Ferrero[SUP] 3 [/SUP], Fernando Anaya[SUP] 3 [/SUP], Manuel Rengel[SUP] 3 [/SUP], Daniel Barraca[SUP] 3 [/SUP], Jos? Lu?o[SUP] 3 [/SUP], In?s Aragoncillo[SUP] 4 [/SUP]
Affiliations
- PMID: 32437770
- DOI: 10.1016/j.kint.2020.04.031
Abstract
SARS-CoV-2-pneumonia emerged in Wuhan, China in December 2019. Unfortunately, there is lack of evidence about the optimal management of novel coronavirus disease 2019 (COVID-19), even less in patients on maintenance hemodialysis (MHD) therapy than in the general population. In this retrospective observational single-center study we analyzed the clinical course and outcomes of all MHD patients hospitalized with COVID-19 from March 12[SUP]th[/SUP] to April 10[SUP]th[/SUP], 2020 as confirmed by real time polymerase chain reaction. Baseline features, clinical course, laboratory data, and different therapies were compared between survivors and non-survivors to identify risk factors associated with mortality. Among the 36 patients, 11 (30.5%) died and 7 could 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 Liters/minute and radiological worsening. Significantly 11 out of those 18 patients (61.1%) died. None of the classical cardiovascular risk factors in the general population were associated with higher mortality. However, a longer time on hemodialysis (hazard ratio 1.008(95% confidence interval 1.001-1.015) per year), increased LDH levels (1.006(1.001-1.011), and lower lymphocyte count (0.996 (0.992-1.000) one week after clinical onset were all significantly associated with higher mortality risk. Thus, the mortality among hospitalized hemodialysis patients diagnosed with COVID-19 is high. Lymphopenia and increased LDH levels were associated with poor prognosis.
Keywords: Coronavirus; Covid-19; Hemodialysis; SARS-CoV-2; mortality.