The impact of COVID-19 infection before the vaccination era on the hospitalized patients requiring hemodialysis: a single-center retrospective cohort

被引:1
|
作者
Petho, Akos Geza [1 ]
Kevei, Peter [2 ]
Juha, Mark [1 ]
Koczy, Agnes [1 ]
Ledo, Nora [1 ]
Tisler, Andras [1 ]
Takacs, Istvan [1 ]
Tabak, Adam G. [1 ,3 ,4 ,5 ]
机构
[1] Semmelweis Univ, Fac Med, Dept Internal Med & Oncol, Budapest, Hungary
[2] Fresenius Med Care Hungary, Hemodialys Unit, Budapest, Hungary
[3] Semmelweis Univ, Fac Med, Dept Epidemiol & Publ Hlth, Budapest, Hungary
[4] UCL, Dept Epidemiol & Publ Hlth, London, England
[5] UCL, Dept Epidemiol & Publ Hlth, 1-19 Torrington Pl, London WC1E 6BT, England
关键词
Hemodialysis; COVID-19; chronic kidney disease; mortality; anti-inflammatory factors; DIALYSIS PATIENTS; ERYTHROPOIETIN; PROGNOSIS; MORTALITY;
D O I
10.1080/0886022X.2023.2251593
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Due to effective vaccinations, the COVID-19 (coronavirus disease 2019) infection that caused the pandemic has a milder clinical course. We aimed to assess the mortality of hospitalized COVID-19 patients before the vaccination era. We investigated the mortality in those patients between 1 October 2020 and 31 May 2021 who received hemodialysis treatment [patients with previously normal renal function (nCKD), patients with chronic kidney disease previously not requiring hemodialysis (CKDnonHD), chronic kidney disease (CKD), and patients on regular hemodialysis (pHD)]. In addition, participants were followed up for all-cause mortality in the National Health Service database until 1 December 2021. In our center, 83 of 108 (76.9%) were included in the analysis due to missing covariates. Over a median of 26 (interquartile range 11-266) days of follow-up, 20 of 22 (90.9%) of nCKD, 23 of 24 (95.8%) of CKDnonHD, and 17 of 37 (45.9%) pHD patients died (p < 0.001). In general, patients with nCKD had fewer comorbidities but more severe presentations. In contrast, the patients with pHD had the least severe symptoms (p < 0.001). In a model adjusted for independent predictors of all-cause mortality (C-reactive protein and serum albumin), CKDnonHD patients had increased mortality [hazard ratio (HR) 1.91, 95% confidence interval (CI), 1.02-3.60], while pHD patients had decreased mortality (HR 0.41, 95% CI 0.20-0.81) compared to nCKD patients. After further adjustment for the need for intensive care, the difference in mortality between the nCKD and pHD groups became non-significant. Despite the limitations of our study, it seems that the survival of previously hemodialysis patients was significantly better.
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页数:10
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