Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • LEOSS Study Group - (Author)
  • 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
  • Municipal Hospital Dortmund
  • 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 languageEnglish
Pages (from-to)725-737
Number of pages13
JournalInfection
Volume49
Issue number4
Publication statusPublished - Aug 2021
Peer-reviewedYes

External IDs

PubMed 33851328
ORCID /0000-0001-9473-3018/work/148606197

Keywords

Sustainable Development Goals

Keywords

  • Chronic kidney disease, COVID-19, LEOSS, Predictive factor, SARS-CoV-2