We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease.
- Authors
Pilgram, Lisa; Eberwein, Lukas; Wille, Kai; Koehler, Felix C.; Stecher, Melanie; Rieg, Siegbert; Kielstein, Jan T.; Jakob, Carolin E. M.; Rüthrich, Maria; Burst, Volker; Prasser, Fabian; Borgmann, Stefan; Müller, Roman-Ulrich; Lanznaster, Julia; Isberner, Nora; Tometten, Lukas; Dolff, Sebastian; the LEOSS Study group; Wettstein, Matthias; Ruethrich, Maria
- 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.
- Subjects
MORTALITY risk factors; CHRONIC kidney failure complications; STATISTICS; C-reactive protein; THERAPEUTICS; COVID-19; CONFIDENCE intervals; AGE distribution; RENAL replacement therapy; RISK assessment; CHI-squared test; DESCRIPTIVE statistics; LACTATE dehydrogenase; ANEMIA; LOGISTIC regression analysis; ODDS ratio; THROMBOCYTOPENIA; COMORBIDITY; DISEASE complications
- Publication
Infection, 2021, Vol 49, Issue 4, p725
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-021-01597-7