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BMJ Open . The outcome and related risk factors of unvaccinated patients with end-stage kidney disease during the Omicron pandemic: a multicentre re

tetano

Editor, Senior Moderator
BMJ Open


. 2024 May 15;14(5):e084649.
doi: 10.1136/bmjopen-2024-084649. The outcome and related risk factors of unvaccinated patients with end-stage kidney disease during the Omicron pandemic: a multicentre retrospective study

Quanchao Zhang[SUP] #[/SUP][SUP] 1 [/SUP], Caibao Lu[SUP] 1 [/SUP], Shaofa Wu[SUP] #[/SUP][SUP] 2 [/SUP], Jin He[SUP] 3 [/SUP], Han Wang[SUP] 3 [/SUP], Jie Li[SUP] 4 [/SUP], Zhifen Wu[SUP] 4 [/SUP], Bingshuang Ta[SUP] 5 [/SUP], Bingfeng Yang[SUP] 5 [/SUP], Shengli Liao[SUP] 6 [/SUP], Liao Wang[SUP] 6 [/SUP], Hongwei Chen[SUP] 1 [/SUP], Moqi Li[SUP] 1 [/SUP], Wenchang He[SUP] 1 [/SUP], Yiqin Wang[SUP] 1 [/SUP], Lili Jiang[SUP] 7 [/SUP], Jing-Hong Zhao[SUP] 8 [/SUP], Ling Nie[SUP] 8 [/SUP]



Affiliations
Abstract

Objectives: The study aims to identify the outcome and the related factors of unvaccinated patients with end-stage kidney disease during the Omicron pandemic.
Design: A multicentre retrospective study of patients with end-stage kidney disease undergone maintenance haemodialysis (HD) in China.
Setting: 6 HD centres in China.
Participants: A total of 654 HD patients who tested positive for SARS-CoV-2 were ultimately included in the study.
Outcome measures: The primary outcomes of interest were adverse outcomes, including hospitalisation due to COVID-19 and all-cause mortality.
Results: The average age of the patients was 57 years, with 33.6% of them being over 65 years. Among the patients, 57.5% were male. During the follow-up period, 158 patients (24.2%) experienced adverse outcomes, and 93 patients (14.2%) died. The majority of patients (88/158) developed adverse outcomes within 30 days, and most deaths (77/93) occurred within 1 month. An advanced multivariable Cox regression analysis identified that adverse outcomes were associated with various factors while all-cause mortality was related to advanced age, male gender, high levels of C reactive protein (CRP) and low levels of prealbumin. The Kaplan-Meier curves demonstrated significantly higher all-cause mortality rates in the older, male, high CRP and low prealbumin subgroups.
Conclusions: Among unvaccinated HD patients with confirmed Omicron infections, various factors were found to be linked to adverse outcomes. Notably, age, sex, CRP and prealbumin had a substantial impact on the risk of all-cause mortality.

Keywords: Dialysis; Mortality; Vaccination.

 
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