tetano
Editor, Senior Moderator
Infection
. 2021 Apr 13.
doi: 10.1007/s15010-021-01597-7. Online ahead of print.
Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease
Lisa Pilgram[SUP] #[/SUP][SUP] 1 [/SUP], Lukas Eberwein[SUP] #[/SUP][SUP] 2 [/SUP], Kai Wille[SUP] 3 [/SUP], Felix C Koehler[SUP] 4 5 6 [/SUP], Melanie Stecher[SUP] 7 8 [/SUP], Siegbert Rieg[SUP] 9 [/SUP], Jan T Kielstein[SUP] 10 [/SUP], Carolin E M Jakob[SUP] 7 8 [/SUP], Maria R?thrich[SUP] 11 [/SUP], Volker Burst[SUP] 4 6 [/SUP], Fabian Prasser[SUP] 12 13 [/SUP], Stefan Borgmann[SUP] 14 [/SUP], Roman-Ulrich M?ller[SUP] 4 5 15 [/SUP], Julia Lanznaster[SUP] 16 [/SUP], Nora Isberner[SUP] 17 [/SUP], Lukas Tometten[SUP] #[/SUP][SUP] 18 [/SUP], Sebastian Dolff[SUP] #[/SUP][SUP] 19 [/SUP], LEOSS Study group
Collaborators, Affiliations
Abstract
Purpose: The ongoing pandemic caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2) has stressed health systems worldwide. Patients with chronic kidney disease (CKD) seem to be more prone to a severe course of coronavirus disease (COVID-19) due to comorbidities and an altered immune system. The study's aim was to identify factors predicting mortality among SARS-CoV-2-infected patients with CKD.
Methods: We analyzed 2817 SARS-CoV-2-infected patients enrolled in the Lean European Open Survey on SARS-CoV-2-infected patients and identified 426 patients with pre-existing CKD. Group comparisons were performed via Chi-squared test. Using univariate and multivariable logistic regression, predictive factors for mortality were identified.
Results: Comparative analyses to patients without CKD revealed a higher mortality (140/426, 32.9% versus 354/2391, 14.8%). Higher age could be confirmed as a demographic predictor for mortality in CKD patients (> 85 years compared to 15-65 years, adjusted odds ratio (aOR) 6.49, 95% CI 1.27-33.20, p = 0.025). We further identified markedly elevated lactate dehydrogenase (> 2 ? upper limit of normal, aOR 23.21, 95% CI 3.66-147.11, p < 0.001), thrombocytopenia (< 120,000/?l, aOR 11.66, 95% CI 2.49-54.70, p = 0.002), anemia (Hb < 10 g/dl, aOR 3.21, 95% CI 1.17-8.82, p = 0.024), and C-reactive protein (? 30 mg/l, aOR 3.44, 95% CI 1.13-10.45, p = 0.029) as predictors, while renal replacement therapy was not related to mortality (aOR 1.15, 95% CI 0.68-1.93, p = 0.611).
Conclusion: The identified predictors include routinely measured and universally available parameters. Their assessment might facilitate risk stratification in this highly vulnerable cohort as early as at initial medical evaluation for SARS-CoV-2.
Keywords: COVID-19; Chronic kidney disease; LEOSS; Predictive factor; SARS-CoV-2.
. 2021 Apr 13.
doi: 10.1007/s15010-021-01597-7. Online ahead of print.
Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease
Lisa Pilgram[SUP] #[/SUP][SUP] 1 [/SUP], Lukas Eberwein[SUP] #[/SUP][SUP] 2 [/SUP], Kai Wille[SUP] 3 [/SUP], Felix C Koehler[SUP] 4 5 6 [/SUP], Melanie Stecher[SUP] 7 8 [/SUP], Siegbert Rieg[SUP] 9 [/SUP], Jan T Kielstein[SUP] 10 [/SUP], Carolin E M Jakob[SUP] 7 8 [/SUP], Maria R?thrich[SUP] 11 [/SUP], Volker Burst[SUP] 4 6 [/SUP], Fabian Prasser[SUP] 12 13 [/SUP], Stefan Borgmann[SUP] 14 [/SUP], Roman-Ulrich M?ller[SUP] 4 5 15 [/SUP], Julia Lanznaster[SUP] 16 [/SUP], Nora Isberner[SUP] 17 [/SUP], Lukas Tometten[SUP] #[/SUP][SUP] 18 [/SUP], Sebastian Dolff[SUP] #[/SUP][SUP] 19 [/SUP], LEOSS Study group
Collaborators, Affiliations
- PMID: 33851328
- DOI: 10.1007/s15010-021-01597-7
Abstract
Purpose: The ongoing pandemic caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2) has stressed health systems worldwide. Patients with chronic kidney disease (CKD) seem to be more prone to a severe course of coronavirus disease (COVID-19) due to comorbidities and an altered immune system. The study's aim was to identify factors predicting mortality among SARS-CoV-2-infected patients with CKD.
Methods: We analyzed 2817 SARS-CoV-2-infected patients enrolled in the Lean European Open Survey on SARS-CoV-2-infected patients and identified 426 patients with pre-existing CKD. Group comparisons were performed via Chi-squared test. Using univariate and multivariable logistic regression, predictive factors for mortality were identified.
Results: Comparative analyses to patients without CKD revealed a higher mortality (140/426, 32.9% versus 354/2391, 14.8%). Higher age could be confirmed as a demographic predictor for mortality in CKD patients (> 85 years compared to 15-65 years, adjusted odds ratio (aOR) 6.49, 95% CI 1.27-33.20, p = 0.025). We further identified markedly elevated lactate dehydrogenase (> 2 ? upper limit of normal, aOR 23.21, 95% CI 3.66-147.11, p < 0.001), thrombocytopenia (< 120,000/?l, aOR 11.66, 95% CI 2.49-54.70, p = 0.002), anemia (Hb < 10 g/dl, aOR 3.21, 95% CI 1.17-8.82, p = 0.024), and C-reactive protein (? 30 mg/l, aOR 3.44, 95% CI 1.13-10.45, p = 0.029) as predictors, while renal replacement therapy was not related to mortality (aOR 1.15, 95% CI 0.68-1.93, p = 0.611).
Conclusion: The identified predictors include routinely measured and universally available parameters. Their assessment might facilitate risk stratification in this highly vulnerable cohort as early as at initial medical evaluation for SARS-CoV-2.
Keywords: COVID-19; Chronic kidney disease; LEOSS; Predictive factor; SARS-CoV-2.