Determinants of mortality in a large group of hemodialysis patients hospitalized for COVID-19

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dc.contributor.authorTurgutalp, Kenan
dc.contributor.authorOzturk, Savas
dc.contributor.authorArici, Mustafa
dc.contributor.authorEren, Necmi
dc.contributor.authorGorgulu, Numan
dc.contributor.authorIslam, Mahmut
dc.contributor.authorUzun, Sami
dc.date.accessioned2024-02-23T14:27:17Z
dc.date.available2024-02-23T14:27:17Z
dc.date.issued2021
dc.departmentNEÜen_US
dc.description.abstractBackground: Maintenance hemodialysis (MHD) patients are at increased risk for coronavirus disease 2019 (COVID-19). The aim of this study was to describe clinical, laboratory, and radiologic characteristics and determinants of mortality in a large group of MHD patients hospitalized for COVID-19. Methods: This multicenter, retrospective, observational study collected data from 47 nephrology clinics in Turkey. Baseline clinical, laboratory and radiological characteristics, and COVID-19 treatments during hospitalization, need for intensive care and mechanical ventilation were recorded. The main study outcome was in-hospital mortality and the determinants were analyzed by Cox regression survival analysis. Results: Of 567 MHD patients, 93 (16.3%) patients died, 134 (23.6%) patients admitted to intensive care unit (ICU) and 91 of the ones in ICU (67.9%) needed mechanical ventilation. Patients who died were older (median age, 66 [57-74] vs. 63 [52-71] years, p = 0.019), had more congestive heart failure (34.9% versus 20.7%, p = 0.004) and chronic obstructive pulmonary disease (23.6% versus 12.7%, p = 0.008) compared to the discharged patients. Most patients (89.6%) had radiological manifestations compatible with COVID-19 pulmonary involvement. Median platelet (166 x 10(3) per mm(3) versus 192 x 10(3) per mm(3), p = 0.011) and lymphocyte (800 per mm(3) versus 1000 per mm(3), p < 0.001) counts and albumin levels (median, 3.2 g/dl versus 3.5 g/dl, p = 0.001) on admission were lower in patients who died. Age (HR: 1.022 [95% CI, 1.003-1.041], p = 0.025), severe-critical disease clinical presentation at the time of diagnosis (HR: 6.223 [95% CI, 2.168-17.863], p < 0.001), presence of congestive heart failure (HR: 2.247 [95% CI, 1.228-4.111], p = 0.009), ferritin levels on admission (HR; 1.057 [95% CI, 1.006-1.111], p = 0.028), elevation of aspartate aminotransferase (AST) (HR; 3.909 [95% CI, 2.143-7.132], p < 0.001) and low platelet count (< 150 x 10(3) per mm(3)) during hospitalization (HR; 1.864 [95% CI, 1.025-3.390], p = 0.041) were risk factors for mortality. Conclusion: Hospitalized MHD patients with COVID-19 had a high mortality rate. Older age, presence of heart failure, clinical severity of the disease at presentation, ferritin level on admission, decrease in platelet count and increase in AST level during hospitalization may be used to predict the mortality risk of these patients.en_US
dc.description.sponsorshipTurkish Society of Nephrologyen_US
dc.description.sponsorshipThe study was funded by Turkish Society of Nephrology.en_US
dc.identifier.doi10.1186/s12882-021-02233-0
dc.identifier.issn1471-2369
dc.identifier.issue1en_US
dc.identifier.pmid33446135en_US
dc.identifier.scopus2-s2.0-85099383830en_US
dc.identifier.urihttps://doi.org/10.1186/s12882-021-02233-0
dc.identifier.urihttps://hdl.handle.net/20.500.12452/14532
dc.identifier.volume22en_US
dc.identifier.wosWOS:000607858600001en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherBmcen_US
dc.relation.ispartofBmc Nephrologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectHemodialysisen_US
dc.subjectCovid-19en_US
dc.subjectRadiological Manifestationsen_US
dc.subjectMortalityen_US
dc.subjectClinical Findingsen_US
dc.titleDeterminants of mortality in a large group of hemodialysis patients hospitalized for COVID-19en_US
dc.typeArticleen_US

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