Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
- Department of Internal Medicine III
- Division of Infectious Diseases
- University Hospital Frankfurt
- Leverkusen Hospital
- Ruhr University Bochum
- University of Cologne
- German Center for Infection Research, Partner Site Bonn-Cologne
- University of Freiburg
- Technical University of Braunschweig
- Friedrich Schiller University Jena
- Charité – Universitätsmedizin Berlin
- Hospital Ingolstadt
- Hospital Passau
- University of Würzburg
- Klinikum Ernst von Bergmann gGmbH
- University of Duisburg-Essen
- Jena University Hospital
- Technical University of Munich
- Tropenklinik Paul-Lechler Krankenhaus Tuebingen
- Evangelisches Stadtkrankenhaus Saarbruecken
- University of Regensburg
- Nephrologisches Zentrum Villingen-Schwenningen
- Cellitinnen-Krankenhaus St. Petrus
- University Hospital of Saarland
- Elblandklinikum Riesa
- Oberlausitzkliniken
- Städtischen Klinikum Karlsruhe
- Heinrich Heine University Düsseldorf
- Friedrich-Alexander University Erlangen-Nürnberg
- Klinikum Dortmund gGmbH
- Ludwig Maximilian University of Munich
- Sophien- und Hufeland Klinikum
- University Hospital Carl Gustav Carus Dresden
- Ulm University
- Agaplesion Diakonieklinikum
- Munich Municipal Hospital 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
Original language | English |
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Pages (from-to) | 725-737 |
Number of pages | 13 |
Journal | Infection |
Volume | 49 |
Issue number | 4 |
Publication status | Published - Aug 2021 |
Peer-reviewed | Yes |
External IDs
PubMed | 33851328 |
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ORCID | /0000-0001-9473-3018/work/148606197 |
Keywords
Sustainable Development Goals
ASJC Scopus subject areas
Keywords
- Chronic kidney disease, COVID-19, LEOSS, Predictive factor, SARS-CoV-2