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COVID-19 and Renal Failure - Adding Insult to Injury? Israel's Experience Based on Nationwide Retrospective Cohort Study.
Kuniavsky, Michael; Doenyas-Barak, Keren; Goldschmidt, Nethanel; Huppert, Amit; Bronshtein, Olga; Rosenfelder, Chana; Freedman, Laurence S; Niv, Yaron.
  • Kuniavsky M; Division of Quality and Safety, Ministry of Health, 39 Yirmeyahu Street, 446724, Jerusalem, Israel. michael.kuniavsky@moh.gov.il.
  • Doenyas-Barak K; Department of Nephrology, Shamir Medical Center, Tel Aviv University, Tel Aviv, Israel.
  • Goldschmidt N; Division of Quality and Safety, Ministry of Health, 39 Yirmeyahu Street, 446724, Jerusalem, Israel.
  • Huppert A; Unit of Bio-Statistics, Gertner Institute, Sheba Medical Center, Ramat Gan, Israel.
  • Bronshtein O; Division of Quality and Safety, Ministry of Health, 39 Yirmeyahu Street, 446724, Jerusalem, Israel.
  • Rosenfelder C; Division of Quality and Safety, Ministry of Health, 39 Yirmeyahu Street, 446724, Jerusalem, Israel.
  • Freedman LS; Unit of Bio-Statistics, Gertner Institute, Sheba Medical Center, Ramat Gan, Israel.
  • Niv Y; Division of Quality and Safety, Ministry of Health, 39 Yirmeyahu Street, 446724, Jerusalem, Israel.
J Gen Intern Med ; 37(12): 3128-3133, 2022 09.
Article in English | MEDLINE | ID: covidwho-1919972
ABSTRACT

INTRODUCTION:

Renal failure (RF) is a risk factor for mortality among hospitalized patients. However, its role in COVID-19-related morbidity and mortality is inconclusive. The aim of the study was to determine whether RF is a significant predictor of clinical outcomes in COVID-19 hospitalized patients based on a retrospective, nationwide, cohort study.

METHODS:

The study sample consisted of patients hospitalized in Israel for COVID-19 in two periods. A random sample of these admissions was selected, and experienced nurses extracted the data from the electronic files. The group with RF on admission was compared to the group of patients without RF. The association of RF with 30-day mortality was investigated using a logistic regression model.

RESULTS:

During the two periods, 19,308 and 2994 patients were admitted, from which a random sample of 4688 patients was extracted. The 30-day mortality rate for patients with RF was 30% (95% confidence interval (CI) 27-33%) compared to 8% (95% CI 7-9%) among patients without RF. The estimated OR for 30-day mortality among RF versus other patients was 4.3 (95% CI 3.7-5.1) and after adjustment for confounders was 2.2 (95% CI 1.8-2.6). Furthermore, RF patients received treatment by vasopressors and invasive mechanical ventilation (IMV) more frequently than those without RF (vasopressors 17% versus 6%, OR = 2.8, p<0.0001; IMV 17% versus 7%, OR = 2.6, p<0.0001).

DISCUSSION:

RF is an independent risk factor for mortality, IMV, and the need for vasopressors among patients hospitalized for COVID-19 infection. Therefore, this condition requires special attention when considering preventive tools, monitoring, and treatment.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Renal Insufficiency / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Asia Language: English Journal: J Gen Intern Med Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: S11606-022-07722-y

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Renal Insufficiency / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Asia Language: English Journal: J Gen Intern Med Journal subject: Internal Medicine Year: 2022 Document Type: Article Affiliation country: S11606-022-07722-y