Mabel Aoun1,2, Rabab Khalil3, Walid Mahfoud4, Haytham Fatfat5, Line Bou Khalil6, Rashad Alameddine7, Nabil Afiouni8, Issam Ibrahim9, Mohamad Hassan10, Haytham Zarzour11, Ali Jebai12, Nina Mourad Khalil12, Luay Tawil13, Zeina Mechref14, Zuhair El Imad14, Fadia Chamma15, Ayman Khalil16, Sandy Zeidan17, Balsam El Ghoul17, Georges Dahdah17, Sarah Mouawad18,19, Hiba Azar18,19, Kamal Abou Chahine20, Siba Kallab21, Bashir Moawad21, Ahmad Fawaz22, Joseph Homsi23, Carmen Tabaja24, Maya Delbani24, Rami Kallab25, Hassan Hoballah26, Wahib Haykal27, Najat Fares28, Walid Rahal29, Wael Mroueh30, Mohammed Youssef31, Jamale Rizkallah32, Ziad Sebaaly32, Antoine Dfouni33, Norma Ghosn33, Nagi Nawfal34, Walid Abou Jaoude35, Nadine Bassil35,36, Therese Maroun35,36, Nabil Bassil35,36, Chadia Beaini37, Boutros Haddad28, Elie Moubarak38, Houssam Rabah3, Amer Attieh9, Serge Finianos18,19, Dania Chelala18,19. 1. Department of Nephrology, Saint-George Hospital Ajaltoun, Ajaltoun, Lebanon. aounmabel@yahoo.fr. 2. Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon. aounmabel@yahoo.fr. 3. Makassed General Hospital, Beirut, Lebanon. 4. Saydet Zghorta Hospital, Zgharta, Lebanon. 5. Mounla Hospital, Tripoli, Lebanon. 6. Mount-Lebanon Hospital, Hazmiyeh, Lebanon. 7. Orange Nassau Hospital, Tripoli, Lebanon. 8. Islamic Hospital, Tripoli, Lebanon. 9. Youssef Akkar Hospital, Halba, Lebanon. 10. Dar Al-Chifae Hospital, Tripoli, Lebanon. 11. Zahraa Hospital, Jnah, Lebanon. 12. Bahman Hospital, Beirut, Lebanon. 13. Siblin Governmental Hospital, Sebline, Lebanon. 14. Ain Wazein Medical Village, Ain Wazein, Lebanon. 15. Serhal Hospital, Beirut, Lebanon. 16. Iklim Hospital, Mazboud, Lebanon. 17. Centre Hospitalier du Nord, Zghorta, Lebanon. 18. Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon. 19. Hotel-Dieu de France Hospital, Beirut, Lebanon. 20. Beqaa Hospital, Zahlé, Lebanon. 21. Abou Jaoude Hospital, Jal el Dib, Lebanon. 22. Labib Hospital, Sidon, Lebanon. 23. Khoury Hospital, Zahle, Lebanon. 24. Hammoud Hospital University Medical Center, Sidon, Lebanon. 25. FMC Hospital, Mejdlaya, Lebanon. 26. Sahel Hospital, Haret Hreik, Lebanon. 27. Beit Chabeb Hospital, Beit Chabeb, Lebanon. 28. Saint-Georges Orthodoxe Hospital, Beirut, Lebanon. 29. Rahal Hospital, Akkar, Lebanon. 30. Jabal Amel Hospital, Tyre, Lebanon. 31. Dinnieh Hospital, Dinnieh, Lebanon. 32. Haroun Hospital, Zalka, Lebanon. 33. Centre Hospitalier Universitaire Notre Dame de Secours Hospital, Byblos, Lebanon. 34. Sacre-Coeur Hospital, Baabda, Lebanon. 35. Middle-East Institute of Health, Bsalim, Lebanon. 36. Saint-Joseph Hospital, Dora, Lebanon. 37. Bellevue Medical Center, Mansourieh, Lebanon. 38. Hayek Hospital, Al Hayek, Lebanon.
Abstract
BACKGROUND: Hemodialysis patients with COVID-19 have been reported to be at higher risk for death than the general population. Several prognostic factors have been identified in the studies from Asian, European or American countries. This is the first national Lebanese study assessing the factors associated with SARS-CoV-2 mortality in hemodialysis patients. METHODS: This is an observational study that included all chronic hemodialysis patients in Lebanon who were tested positive for SARS-CoV-2 from 31st March to 1st November 2020. Data on demographics, comorbidities, admission to hospital and outcome were collected retrospectively from the patients' medical records. A binary logistic regression analysis was performed to assess risk factors for mortality. RESULTS: A total of 231 patients were included. Mean age was 61.46 ± 13.99 years with a sex ratio of 128 males to 103 females. Around half of the patients were diabetics, 79.2% presented with fever. A total of 115 patients were admitted to the hospital, 59% of them within the first day of diagnosis. Hypoxia was the major reason for hospitalization. Death rate was 23.8% after a median duration of 6 (IQR, 2 to 10) days. Adjusted regression analysis showed a higher risk for death among older patients (odds ratio = 1.038; 95% confidence interval: 1.013, 1.065), patients with heart failure (odds ratio = 4.42; 95% confidence interval: 2.06, 9.49), coronary artery disease (odds ratio = 3.27; 95% confidence interval: 1.69, 6.30), multimorbidities (odds ratio = 1.593; 95% confidence interval: 1.247, 2.036), fever (odds ratio = 6.66; 95% confidence interval: 1.94, 27.81), CRP above 100 mg/L (odds ratio = 4.76; 95% confidence interval: 1.48, 15.30), and pneumonia (odds ratio = 19.18; 95% confidence interval: 6.47, 56.83). CONCLUSIONS: This national study identified older age, coronary artery disease, heart failure, multimorbidities, fever and pneumonia as risk factors for death in patients with COVID-19 on chronic hemodialysis. The death rate was comparable to other countries and estimated at 23.8%.
BACKGROUND: Hemodialysis patients with COVID-19 have been reported to be at higher risk for death than the general population. Several prognostic factors have been identified in the studies from Asian, European or American countries. This is the first national Lebanese study assessing the factors associated with SARS-CoV-2mortality in hemodialysis patients. METHODS: This is an observational study that included all chronic hemodialysis patients in Lebanon who were tested positive for SARS-CoV-2 from 31st March to 1st November 2020. Data on demographics, comorbidities, admission to hospital and outcome were collected retrospectively from the patients' medical records. A binary logistic regression analysis was performed to assess risk factors for mortality. RESULTS: A total of 231 patients were included. Mean age was 61.46 ± 13.99 years with a sex ratio of 128 males to 103 females. Around half of the patients were diabetics, 79.2% presented with fever. A total of 115 patients were admitted to the hospital, 59% of them within the first day of diagnosis. Hypoxia was the major reason for hospitalization. Death rate was 23.8% after a median duration of 6 (IQR, 2 to 10) days. Adjusted regression analysis showed a higher risk for death among older patients (odds ratio = 1.038; 95% confidence interval: 1.013, 1.065), patients with heart failure (odds ratio = 4.42; 95% confidence interval: 2.06, 9.49), coronary artery disease (odds ratio = 3.27; 95% confidence interval: 1.69, 6.30), multimorbidities (odds ratio = 1.593; 95% confidence interval: 1.247, 2.036), fever (odds ratio = 6.66; 95% confidence interval: 1.94, 27.81), CRP above 100 mg/L (odds ratio = 4.76; 95% confidence interval: 1.48, 15.30), and pneumonia (odds ratio = 19.18; 95% confidence interval: 6.47, 56.83). CONCLUSIONS: This national study identified older age, coronary artery disease, heart failure, multimorbidities, fever and pneumonia as risk factors for death in patients with COVID-19 on chronic hemodialysis. The death rate was comparable to other countries and estimated at 23.8%.
Entities:
Keywords:
COVID-19; Hemodialysis; Mortality; Multimorbidities; National study; SARS-CoV-2
Authors: Carlo Basile; Christian Combe; Francesco Pizzarelli; Adrian Covic; Andrew Davenport; Mehmet Kanbay; Dimitrios Kirmizis; Daniel Schneditz; Frank van der Sande; Sandip Mitra Journal: Nephrol Dial Transplant Date: 2020-05-01 Impact factor: 5.992
Authors: Samira Bell; Jacqueline Campbell; Jackie McDonald; Martin O'Neill; Chrissie Watters; Katharine Buck; Zoe Cousland; Mark Findlay; Nazir I Lone; Wendy Metcalfe; Shona Methven; Robert Peel; Alison Almond; Vinod Sanu; Elaine Spalding; Peter C Thomson; Patrick B Mark; Jamie P Traynor Journal: BMC Nephrol Date: 2020-10-01 Impact factor: 2.388