Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease
Publikation: Beitrag in Fachzeitschrift › Forschungsartikel › Beigetragen › Begutachtung
Beitragende
- Medizinische Klinik und Poliklinik III
- Klinische Infektiologie
- Universitätsklinikum Frankfurt
- Klinikum Leverkusen
- Ruhr-Universität Bochum
- Universität zu Köln
- Deutsche Zentrum für Infektionsforschung, Standort Bonn-Köln
- Albert-Ludwigs-Universität Freiburg
- Technische Universität Braunschweig
- Friedrich-Schiller-Universität Jena
- Charité – Universitätsmedizin Berlin
- Klinikum Ingolstadt
- Klinikum Passau
- Julius-Maximilians-Universität Würzburg
- Klinikum Ernst von Bergmann gGmbH
- Universität Duisburg-Essen
- Universitätsklinikum Jena
- Technische Universität München
- Tropenklinik Paul-Lechler Krankenhaus Tuebingen
- Evangelisches Stadtkrankenhaus Saarbruecken
- Universität Regensburg
- Nephrologisches Zentrum Villingen-Schwenningen
- Cellitinnen-Krankenhaus St. Petrus
- Universitätsklinikum des Saarlandes
- Elblandklinikum Riesa
- Oberlausitzkliniken
- Städtisches Klinikum Karlsruhe gGmbH
- Heinrich Heine Universität Düsseldorf
- Friedrich-Alexander-Universität Erlangen-Nürnberg
- Klinikum Dortmund gGmbH
- Ludwig-Maximilians-Universität München (LMU)
- Sophien- und Hufeland Klinikum
- Universitätsklinikum Carl Gustav Carus Dresden
- Universität Ulm
- Agaplesion Diakonieklinikum
- München Klinik Schwabing
- Klinik Preetz
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/µl, 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.
Details
Originalsprache | Englisch |
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Seiten (von - bis) | 725-737 |
Seitenumfang | 13 |
Fachzeitschrift | Infection |
Jahrgang | 49 |
Ausgabenummer | 4 |
Publikationsstatus | Veröffentlicht - Aug. 2021 |
Peer-Review-Status | Ja |
Externe IDs
PubMed | 33851328 |
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ORCID | /0000-0001-9473-3018/work/148606197 |
Schlagworte
Ziele für nachhaltige Entwicklung
ASJC Scopus Sachgebiete
Schlagwörter
- Chronic kidney disease, COVID-19, LEOSS, Predictive factor, SARS-CoV-2