COVID-19 and chronic renal disease: clinical characteristics and prognosis.
QJM
; 113(11): 799-805, 2020 Nov 01.
Article
in English
| MEDLINE | ID: covidwho-729194
ABSTRACT
BACKGROUND:
Patients on dialysis were susceptible to coronavirus disease 2019 (COVID-19) and were prone to severe clinical characteristics after infection; acute kidney injury was related to mortality in COVID-19 cases. Limited is known about the characteristics of COVID-19 patients with end-stage renal disease not requiring renal replacement therapy (RRT).AIM:
Evaluate clinical characteristics, course and outcomes of COVID-19 patients with chronic kidney disease (CKD) who did not require RRT and those on dialysis.DESIGN:
A two-center retrospective study.METHODS:
A total of 836 adult patients with COVID-19 (24 CKD not on dialysis; 15 dialysis-dependent CKD) were included. The study includes no patients with renal transplantation. Risk factors were explored.RESULTS:
CKD not requiring RRT is an independent risk factor for in-hospital death [adjusted odds ratio (aOR) 7.35 (95% CI 2.41-22.44)] and poor prognosis [aOR 3.01 (95% CI 1.23-7.33)]. Compared with COVID-19 cases without CKD, those with CKD not requiring RRT showed similar percentage of initial moderate cases (75.00% vs. 73.65%) but higher incidence of in-hospital neutrophilia (50.00% vs. 27.30%) or death (50.00% vs. 9.03%). The odds ratio of dialysis associated to mortality in CKD patients was 2.00 (95% CI 0.52-7.63), suggesting COVID-19 patients with dialysis-dependent CKD were at greater risk of in-hospital death. For COVID-19 patients with CKD not requiring RRT, statins reduced the risk of neutrophilia [OR 0.10 (95% CI 0.01-0.69)] while diuretics increased the risk of neutrophilia [OR 15.4 (95% CI 1.47-160.97)], although both showed no association to mortality.CONCLUSION:
COVID-19 patients with CKD presented high incidence of neutrophilia, poor prognosis and in-hospital death, with dialysis patients being more vulnerable.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Renal Dialysis
/
Coronavirus Infections
/
Severe Acute Respiratory Syndrome
/
Renal Insufficiency, Chronic
/
Hospitalization
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
English
Journal:
QJM
Journal subject:
Medicine
Year:
2020
Document Type:
Article
Affiliation country:
Qjmed
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