D Yang1,2, Y Xiao3, J Chen4, Y Chen1, P Luo5, Q Liu5, C Yang1, M Xiong1, Y Zhang1, X Liu1, H Chen1, A Deng4, K Huang1,2, B Cheng4, A Peng5. 1. Tongji School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China. 2. Tongji-Rongcheng Center for Biomedicine, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, China. 3. Department of Pharmacy, School of Pharmacy, Hubei University of Chinese Medicine, 16 Huangjiahu West Road, Hongshan District, Wuhan 430065, China. 4. Department of Pharmacy and the Center of Information, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, 26 Shengli Road, Wuhan 430021, Hubei, China. 5. Department of Urology, Medical Record Statistics, and Pharmacy, Wuhan Third Hospital and Tongren Hospital of Wuhan University, 241 Pengliuyang Road, Wuhan 430060, China.
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.
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-19patients with end-stage renal disease not requiring renal replacement therapy (RRT). AIM: Evaluate clinical characteristics, course and outcomes of COVID-19patients 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-19patients with dialysis-dependent CKD were at greater risk of in-hospital death. For COVID-19patients 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-19patients with CKD presented high incidence of neutrophilia, poor prognosis and in-hospital death, with dialysis patients being more vulnerable.
Authors: Dorota Zarębska-Michaluk; Jerzy Jaroszewicz; Magdalena Rogalska; Beata Lorenc; Marta Rorat; Anna Szymanek-Pasternak; Anna Piekarska; Aleksandra Berkan-Kawińska; Katarzyna Sikorska; Magdalena Tudrujek-Zdunek; Barbara Oczko-Grzesik; Beata Bolewska; Piotr Czupryna; Dorota Kozielewicz; Justyna Kowalska; Regina Podlasin; Krzysztof Kłos; Włodzimierz Mazur; Piotr Leszczyński; Bartosz Szetela; Katarzyna Reczko; Robert Flisiak Journal: J Clin Med Date: 2021-05-10 Impact factor: 4.241