ABSTRACT
Objective: We aimed to describe clinical characteristics and course of chronic kidney disease patients with COVID-19 and to identify determinants of in-hospital mortality. Methods: Seventy-one chronic kidney disease patients with COVID-19 were enrolled. The primary endpoint was death from all causes discussed in this article. The relationship between mortality and demographic, clinical, and laboratory data were examined. Results: Of 71 patients, 29 (40.8%) died. Dead were older, were more likely to have low critical oxygen saturation (SpO(2)) and deterioration of renal function, and exhibited less favorable laboratory features, including higher neutrophils, neutrophil to lymphocyte ratio, and systemic immune-inflammation index, as well as a lower lymphocyte. Acute kidney injury rate was high (71.8%) and 23.5% needed dialysis. Disease outcome did not differ across baseline chronic kidney disease stages. Systemic immune-inflammation index had a higher prediction accuracy for in-hospital mortality (AUC = 0.732). Patients in the high systemic immune-inflammation index group were older, had higher peak Cr, higher rate of acute kidney injury (85.3% vs. 59.5%), severe disease (79.4% vs. 35.1%), and mortality (64.7% vs. 18.9%) compared to those in low systemic immune-inflammation index group. Older age (>72 years), SpO(2) <= 90%, high systemic immune-inflammation index, and severe acute kidney injury requiring dialysis were predictors of in-hospital mortality. Conclusion: Chronic kidney disease patients with COVID-19 had a high mortality rate associated with older age, acute kidney injury requiring dialysis, higher systemic immune-inflammation index, and lower SpO(2) . Systemic immune-inflammation index at admission may be used for early identification of those at risk. Interventions for optimal oxygenation, early attenuation of the inflammatory response, and prevention of acute kidney injury may improve the prognosis of chronic kidney disease patients with COVID-19.
ABSTRACT
Introduction: Neurological symptoms in SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infected patients and the course of COVID-19 in patients with neurological findings are determined. Material and methods: Inpatient cases aged =18 years, followed-up in clinical services for COVID-19 diagnosis are studied. Patients were visited on 04.20.2020 and examined for central nervous system (CNS), peripheral nervous system (PNS) manifestations and muscular injury, from onset of symptoms to hospitalization. Risk factors associated with the severity of COVID-19 and the comparison of variables in terms of existence of neurological findings including CNS and PNS findings were performed. Results: Overall, 133 (54%) of the 242 patients of the study were male, mean age was 56.82±16.35 (18-91) years. Of these, 128 (52%) cases were defined as severe COVID-19. Outstanding symptoms at the onset were cough (62.8%), fever (46.7%), dyspnea (45.9%), and tiredness (31%). Further, 82 (33.9%) cases showed neurological findings at the first admission. Of those with neurological symptoms, 25.6% had CNS, 16.1% had PNS, 1.7% had muscular symptoms. In patients with CNS manifestations, the most common symptoms were headache (20.6%) and dizziness (7.4%). Impaired taste was the most common manifestation of PNS (11.2%). Neurological symptoms showed no significant difference between severe and non-severe COVID-19 groups except impaired taste (significantly higher in non-severe group). During follow-up, 17 (7%) patients needed intensive care unit. Nine (3.6%) patients died. Conclusion: Frequency and variety of neurological findings in COVID-19 cases is too high to underestimate. Early diagnosis of these findings may prevent spread of COVID-19.