Presentation and Outcomes of Patients with ESKD and COVID-19

Autor: Maya K. Rao, Jai Radhakrishnan, S. Ali Husain, Shelief Y Robbins-Juarez, Sumit Mohan, Jacob S. Stevens, Anthony M. Valeri, Wooin Ahn, Ali G. Gharavi
Rok vydání: 2020
Předmět:
Male
medicine.medical_treatment
030232 urology & nephrology
Comorbidity
Severity of Illness Index
Cohort Studies
Hospitals
University
0302 clinical medicine
Cause of Death
Outcome Assessment
Health Care
Prevalence
Hospital Mortality
030212 general & internal medicine
Cause of death
Age Factors
General Medicine
Middle Aged
Hospitalization
Intensive Care Units
Nephrology
Female
Hemodialysis
Coronavirus Infections
Rapid Communication
Cohort study
Adult
medicine.medical_specialty
Pneumonia
Viral
Risk Assessment
Vulnerable Populations
Statistics
Nonparametric
Peritoneal dialysis
03 medical and health sciences
Sex Factors
Renal Dialysis
Internal medicine
Severity of illness
medicine
Humans
Pandemics
Dialysis
Aged
Retrospective Studies
Infection Control
business.industry
COVID-19
Retrospective cohort study
medicine.disease
Survival Analysis
Kidney Failure
Chronic
New York City
business
Zdroj: J Am Soc Nephrol
ISSN: 1533-3450
1046-6673
Popis: Background The relative immunosuppression and high prevalence of comorbidities in patients with ESKD on dialysis raise concerns that they may have an elevated risk of severe coronavirus disease 2019 (COVID-19), but outcomes for COVID-19 in such patients are unclear. Methods To examine presentation and outcomes of COVID-19 in patients with ESKD on dialysis, we retrospectively collected clinical data on 59 patients on dialysis who were hospitalized with COVID-19. We used Wilcoxon rank sum and Fischer exact tests to compare patients who died versus those still living. Results Two of the study's 59 patients were on peritoneal dialysis, and 57 were on hemodialysis. Median age was 63 years, with high prevalence of hypertension (98%) and diabetes (69%). Patients who died were significantly older than those still living (median age, 75 versus 62 years) and had a higher median Charlson comorbidity index (8 versus 7). The most common presenting symptoms were fever (49%) and cough (39%); initial radiographs most commonly showed multifocal or bilateral opacities (59%). By end of follow-up, 18 patients (31%) died a median 6 days after hospitalization, including 75% of patients who required mechanical ventilation. Eleven of those who died had advanced directives against intubation. The remaining 41 patients (69%) were discharged home a median 8 days after admission. The median initial white blood cell count was significantly higher in patients who died compared with those still living (7.5 versus 5.7×103/μl), as was C-reactive protein (163 versus 80 mg/L). Conclusions The association of COVID-19 with high mortality in patients with ESKD on dialysis reinforces the need to take appropriate infection control measures to prevent COVID-19 spread in this vulnerable population.
Databáze: OpenAIRE
Externí odkaz: