Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania
Background There is limited information about the clinical characteristics, treatment and outcome of maintenance hemodialysis patients with COVID-19. Moreover, regional differences are also conceivable since the extend and severity of outbreaks varied among countries. Methods In this retrospective,...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-01-01
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| Series: | Renal Failure |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/0886022X.2020.1853571 |
| _version_ | 1798024853529296896 |
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| author | Gabriel Stefan Ana Maria Mehedinti Iuliana Andreiana Adrian Dorin Zugravu Simona Cinca Ruxandra Busuioc Ioana Miler Simona Stancu Ligia Petrescu Ioana Dimitriu Elena Moldovanu Diana Elena Crasnaru Georgeta Gugonea Valentin Georgescu Victor Dan Strambu Cristina Capusa |
| author_facet | Gabriel Stefan Ana Maria Mehedinti Iuliana Andreiana Adrian Dorin Zugravu Simona Cinca Ruxandra Busuioc Ioana Miler Simona Stancu Ligia Petrescu Ioana Dimitriu Elena Moldovanu Diana Elena Crasnaru Georgeta Gugonea Valentin Georgescu Victor Dan Strambu Cristina Capusa |
| author_sort | Gabriel Stefan |
| collection | DOAJ |
| description | Background There is limited information about the clinical characteristics, treatment and outcome of maintenance hemodialysis patients with COVID-19. Moreover, regional differences are also conceivable since the extend and severity of outbreaks varied among countries. Methods In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of 37 maintenance hemodialysis patients (median age 64 years, 51% men) hospitalized with COVID-19 from 24 March to 22 May 2020 as confirmed by real-time PCR. Results The most common symptoms at admission were fatigue (51%), fever (43%), dyspnea (38%) and cough (35%). There were 59% mild/moderate patients and 41% severe/critical patients. Patients in the severe/critical group had a significantly higher atherosclerotic burden since diabetic kidney disease and vascular nephropathies were the most common primary kidney diseases and eighty percent of them had coronary heart disease. Also, Charlson comorbidity score was higher in this group. At admission chest X-ray, 46% had ground-glass abnormalities. Overall, 60% patients received hydroxychloroquine, 22% lopinavir–ritonavir, 11% tocilizumab, 24% systemic glucocorticoids, and 54% received prophylactic anticoagulation. Seven (19%) patients died during hospitalization and 30 were discharged. The main causes of death were cardiovascular (5 patients) and respiratory distress syndrome (2 patients). In Cox regression analysis, lower oxygen saturation, anemia and hypoalbuminemia at admission were associated with increased mortality. Conclusions In conclusion, we observed a high mortality rate among maintenance hemodialysis patients hospitalized for COVID-19. Anemia, lower serum albumin and lower basal oxygen saturation at admission were factors associated with poor prognosis. |
| first_indexed | 2024-04-11T18:09:22Z |
| format | Article |
| id | doaj.art-0c10cfc563674261b363b82db7612bc7 |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-04-11T18:09:22Z |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-0c10cfc563674261b363b82db7612bc72022-12-22T04:10:11ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492021-01-01431495710.1080/0886022X.2020.18535711853571Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in RomaniaGabriel Stefan0Ana Maria Mehedinti1Iuliana Andreiana2Adrian Dorin Zugravu3Simona Cinca4Ruxandra Busuioc5Ioana Miler6Simona Stancu7Ligia Petrescu8Ioana Dimitriu9Elena Moldovanu10Diana Elena Crasnaru11Georgeta Gugonea12Valentin Georgescu13Victor Dan Strambu14Cristina Capusa15“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of Nephrology“Dr. Carol Davila” Teaching Hospital of NephrologyBackground There is limited information about the clinical characteristics, treatment and outcome of maintenance hemodialysis patients with COVID-19. Moreover, regional differences are also conceivable since the extend and severity of outbreaks varied among countries. Methods In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of 37 maintenance hemodialysis patients (median age 64 years, 51% men) hospitalized with COVID-19 from 24 March to 22 May 2020 as confirmed by real-time PCR. Results The most common symptoms at admission were fatigue (51%), fever (43%), dyspnea (38%) and cough (35%). There were 59% mild/moderate patients and 41% severe/critical patients. Patients in the severe/critical group had a significantly higher atherosclerotic burden since diabetic kidney disease and vascular nephropathies were the most common primary kidney diseases and eighty percent of them had coronary heart disease. Also, Charlson comorbidity score was higher in this group. At admission chest X-ray, 46% had ground-glass abnormalities. Overall, 60% patients received hydroxychloroquine, 22% lopinavir–ritonavir, 11% tocilizumab, 24% systemic glucocorticoids, and 54% received prophylactic anticoagulation. Seven (19%) patients died during hospitalization and 30 were discharged. The main causes of death were cardiovascular (5 patients) and respiratory distress syndrome (2 patients). In Cox regression analysis, lower oxygen saturation, anemia and hypoalbuminemia at admission were associated with increased mortality. Conclusions In conclusion, we observed a high mortality rate among maintenance hemodialysis patients hospitalized for COVID-19. Anemia, lower serum albumin and lower basal oxygen saturation at admission were factors associated with poor prognosis.http://dx.doi.org/10.1080/0886022X.2020.1853571covid-19chronic hemodialysisclinical featuresmortality |
| spellingShingle | Gabriel Stefan Ana Maria Mehedinti Iuliana Andreiana Adrian Dorin Zugravu Simona Cinca Ruxandra Busuioc Ioana Miler Simona Stancu Ligia Petrescu Ioana Dimitriu Elena Moldovanu Diana Elena Crasnaru Georgeta Gugonea Valentin Georgescu Victor Dan Strambu Cristina Capusa Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania Renal Failure covid-19 chronic hemodialysis clinical features mortality |
| title | Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania |
| title_full | Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania |
| title_fullStr | Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania |
| title_full_unstemmed | Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania |
| title_short | Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania |
| title_sort | clinical features and outcome of maintenance hemodialysis patients with covid 19 from a tertiary nephrology care center in romania |
| topic | covid-19 chronic hemodialysis clinical features mortality |
| url | http://dx.doi.org/10.1080/0886022X.2020.1853571 |
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