COVID-19 increases mortality in hemodialysis patients: exploring links with inflammation and telomere attrition.

Autor: Milosevic T; Laboratory Diagnostics Service, Zvezdara Clinical Hospital Center, Dimitrija Tucovica 161, Belgrade, 11120, Serbia. tamaramedbio@gmail.com.; Department of Hematology and Cytological Diagnostics of Fluids Laboratory Diagnostics Service Zvezdara Clinical Hospital Center, Dimitrija Tucovica 161, Belgrade, 11120, Serbia. tamaramedbio@gmail.com., Naumovic R; Clinical Department of Nephrology and Metabolic Disorders with Dialysis 'Prof. Dr. Vasilije Jovanovic', Zvezdara Clinical Hospital Center, Dimitrija Tucovica 161, Belgrade, 11120, Serbia.; Faculty of Medicine, University of Belgrade, dr Subotica 8, Belgrade, 11000, Serbia., Sopic M; Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia., Vekic J; Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia., Guzonjic A; Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia., Pesic S; Clinical Department of Nephrology and Metabolic Disorders with Dialysis 'Prof. Dr. Vasilije Jovanovic', Zvezdara Clinical Hospital Center, Dimitrija Tucovica 161, Belgrade, 11120, Serbia., Miljkovic-Trailovic M; Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia., Kotur-Stevuljevic J; Faculty of Pharmacy, Department for Medical Biochemistry, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia.
Jazyk: angličtina
Zdroj: Molecular biology reports [Mol Biol Rep] 2024 Aug 27; Vol. 51 (1), pp. 938. Date of Electronic Publication: 2024 Aug 27.
DOI: 10.1007/s11033-024-09879-7
Abstrakt: Background and Objective: An increased risk of mortality and hospitalization was consistently demonstrated in hemodialysis (HD) patients affected by pandemic coronavirus infection (COVID-19). In this study, we analyzed parameters that may impact mortality in COVID-19 HD patients, including neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), C-reactive protein (CRP), COVID-19 disease status and telomere length in peripheral blood cells (TL).
Materials and Methods: A total of 130 chronic hemodialysis patients were enrolled and followed up for 18 months. Patients were categorized into groups based on their COVID-19 disease history and subsequent data about their survival status at the end of the study. Routine laboratory parameters were assessed using standard automated methods and TL was determined using the modified Cawthon method. Survival predictors were analyzed using Kaplan-Meier analysis.
Results: Deceased patients (30%) were older with higher body mass index (BMI), higher levels of LDH, NLR index, CRP and lower TL and lymphocytes count compared to survivors. Kaplan-Meier survival analysis showed six parameters were significant mortality predictors in the following order of significance: COVID-19 history, 2-years cardiovascular mortality risk score, NLR, TL, CRP, LDH. Using binary logistic regression analysis Summary risk score, a combination of these six parameters revealed as the best predictor of patient's survival in this group of parameters (log rank 25.4, p < 0.001).
Conclusion: Compared to the general population, the mortality rate among HD patients persists at a higher level despite advancements in HD technology and patient care. The situation has been exacerbated by COVID-19, by significant increase in mortality rate among these patients.
(© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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