Risk Prediction of Pneumonia in Maintenance Hemodialysis Patients with COVID-19: A Single-center Retrospective Study in China (preprint)

ABSTRACT

Objective:  The infection rate and mortality of COVID-19 in hemodialysis patients are extremely high. In this study, we analyzed the risk prediction of pneumonia in Chinese’s hemodialysis patients with COVID-19.  Method: We conducted a retrospective analysis of maintenance hemodialysis patients with COVID-19 admitted to Peking University Third Hospital from December 1, 2022 to January 31, 2023. We collected demographic data, underlying diseases, dialysis treatment data, and laboratory test results of these patients; logistic regression and ROC curve were used to analyze the risk factors of pneumonia.  Results:  A total of 209 hemodialysis patients with COVID-19 were enrolled in this study, of whom 80(38.3%) had pneumonia and 129(61.7%) normal. Multivariate logistic analysis revealed that older age (OR=1.030, 95%CI 1.002~1.059, p=0.036), lower hemoglobin (OR=0.968, 95%CI 0.942~0.995, p=0.019), lower albumin (OR=0.834, 95%CI 0.738-0.943, p=0.004) were risk factors for pneumonia. Patients with age >65 years old, hemoglobin <115g/L or albumin <36.8g/L had a higher risk of pneumonia, and we combined the three indexes to predict the risk of pneumonia (P= elogit(P)    / 1+  elogit(P) , logit(P)=9.593 +0.031×Age (years old) -0.038×Hemoglobin (g/L) -0.210×Albumin (g/L)), drew the ROC curve with the risk P value (AUC=0.756, 95% CI 0.687~0.825, p<0.001), when P=0.575 was selected as the cut-off value, the sensitivity and specificity of the three indexes combined to predict pneumonia were 44.0% and 94.5% respectively.  Conclusion: Older age, anemia and hypoalbuminemia were risk factors for pneumonia in MHD patients. We could reduce the incidence of pneumonia and improve the prognosis of MHD patients by correcting anemia and hypoalbuminemia.