ABSTRACT
Background: Diabetes mellitus (DM) seems to be conveying increased risk in Coronavirus disease-2019 (COVID-19). We aimed to evaluate the effect of glycemic control on the risk of prevalence and mortality in diabetic COVID-19 patients. Materials and Methods: In this retrospective observational study, the data from diabetic patients admitted to our hospital with the diagnosis of COVID-19 between March 2020 and March 2021 were reviewed. The demographic, clinical, laboratory, and radiological data, and the course and outcomes were recorded. Results: The records of 352 diabetic patients were compared to 333 non-diabetic controls. The mean age of 184 male and 168 female patients was 63.7 +/- 13.0 (30-91). The length of hospital stay, rate of Intensive care unit (ICU) admission, and mortality were higher in the diabetic population compared to the non-diabetic counterparts. ICU admission and mortality rates were significantly higher in the group with HbA1c higher than 7%. The rate of ICU admission and mortality was significantly higher in participants with elevated HbA1cConclusions: Uncontrolled DM is among detrimental comorbidities contributing to the severity of SARS-CoV-2 infection and good control of serum glucose levels will improve prognosis in COVID-19. The diabetic population with poor glycemic control succumbed more to COVID-19.
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Background: Coronavirus disease 2019 is a life-threatening disease, especially in patients with kidney failure. In this study, we aimed to investigate whether there is a difference in the frequency of coronavirus disease 2019 in hemodialysis and peritoneal dialysis patients and to contribute to the process of deciding on the type of dialysis in patients who will start dialysis treatment. Methods: We included patients who had at least 3 months of dialysis treatment between March 11, 2020, and November 30, 2020. Demographic characteristics and comorbidities were recorded. Results: In our study, 130 dialysis patients, 75 of whom were male, were evaluated. The mean age of the patients on dialysis was 54.8 +/- 14.7 years. Twenty-eight (22%) of 130 dialysis patients were peritoneal dialysis patients. The mean age of peritoneal dialysis patients was 54.1 +/- 14 years. A total of 102 (78%) patients were hemodialysis patients. The mean age of hemodialysis patients was 54.9 +/- 14.9 years. The most common accompanying disease in all patients was hypertension (62%). Among the patients who received dialysis treatment in our center, the number of patients diagnosed with coronavirus disease 2019 was 16 (12%). Coronavirus disease 2019 was detected in 16% (16/102) of hemodialysis patients, whereas it was not detected in peritoneal dialysis patients (P =.002). Conclusion: The frequency of coronavirus disease 2019 was significantly higher in hemodialysis patients. Peritoneal dialysis appears to be more advantageous in patients who will start dialysis during the pandemic period.
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Objective: Patients with coronavirus 2019 (COVID-19), the disease caused by infection with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), frequently have comorbidities and this is thought to be a risk factor for poorer outcomes. The aim of this study was to determine the prevalence and effect of comorbidities on the severity and prognosis of patients hospitalized with a diagnosis of COVID-19.
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Background: The prognostic factors for COVID-19 in patients with chronic kidney disease (CKD) are uncertain. We conducted a propensity score-matched study to compare clinical and prognostic features between hospitalized COVID-19 patients with and without CKD. Methods: Patients with estimated creatinine clearance below 60 ml/min/1.73 m2 for more than three months, were included in the CKD group. Fifty-six patients and the propensity score-matched fifty-six control patients were followed-up at least 15 days or until death after diagnosis of COVID-19. All demographic data and diagnostic and therapeutic methods were evaluated. The endpoints were all-cause mortality and acute kidney injury (AKI). Results: Patient and control groups were reviewed retrospectively over a median follow-up of 44 days (IQR, 36-52 days) after diagnosis of COVID-19. Patients in the CKD group had higher intensive care unit follow-up and mortality rates than the other group, but these results did not reach statistical significance (16 [28.6%] vs. 19 [33.9%];p=0.54 and 11 [19.6%] vs. 16 [28.6%], p=0.269, respectively). The frequency of AKI was significantly higher in predialysis patients with CKD compared to the other group (8 [14.3%] vs. 5 [45.5%];p<0.001), but there was no significant difference between the groups in terms of cytokine release syndrome and respiratory failure (13 [23.2%] vs. 8 [14.2%];p=0.226, 25 [44.6%] vs. 22 [39.3%], p=0.566, respectively). Multivariate logistic regression analysis revealed that respiratory failure (39.283 [95% CI, 7.296 to 211.519;P<0.001] and AKI (10.961 [95% CI, 1.688 to 71.186;P=0.012] were independent risk factors for the mortality. Conclusions: The prognosis of COVID-19 in patients with CKD is worse than non-uremic patients. Also, AKI and respiratory failure are independent risk factors for mortality.
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Background: Management of COVID-19 in kidney transplant recipients (KTR) should include treatment of infection and regulation of immunosuppression but there is no consensus on this issue yet. In this study, we aimed to describe our experience in KTR with COVID-19. Methods: In this retrospective cohort study, we included KTR who diagnosed with COVID-19 from five centers. The patients were categorized into two groups for the analysis. Patients had respiratory failure and multiple organ dysfunctions were defined as severe pneumonia. All other cases were classified as moderate pneumonia. The primary endpoint was all-cause mortality. Results: 40 patients (20 female) were reviewed over a median follow-up of 32 days (IQR, 14-51 days) after COVID-19. 5 patients died during the follow-up. The frequency of graft dysfunction was similar between groups (n=12 and n=2;p=0.615, respectively). The frequency of previous induction (n=18 and n=7;p=0.016, respectively) and rejection therapy (n=4 and n=3;p=0.023, respectively) was significantly increased in the group with severe pneumonia compared to the moderate pneumonia group. None of the patients using cyclosporine A developed severe pneumonia. Also, multivariate logistic regression analysis revealed that previous anti-rejection therapy (9.75 [95% CI, 1.223 to 77.724;P=0.032]) was the independent predictor for mortality. Conclusions: COVID-19 more commonly causes moderate or severe pneumonia in KTR. Immunosuppression should be carefully reduced in KTR. Induction therapy with lymphocyte depleting agents should be carefully avoided in KTR during the pandemic period.