COVID-19 infection in Libyan chronic hemodialysis patients: Prevalence, risk factors, severity and predictors of mortality
DOI:
https://doi.org/10.54361/ljmr.17-02Keywords:
COVID-19, hemodialysis, prevalence, outcome, LibyaAbstract
Background: Chronic kidney disease (CKD) is associated with the increased risk of both outpatient and inpatient pneumonia. This association is independent of comorbid diabetes, cardio-vascular disease (CVD), asthma, and chronic obstructive airway disease. Dialysis patients are considered at risk groups for SARS-CoV-2 infection; Short-term mortality in patients on chronic hemodialysis who were hospitalized with COVID-19 was high. Outcomes in those requiring intensive care unit (ICU) and mechanical ventilation management were poor. Aim: This study mainly aimed to identify the prevalence, risk factors, severity and predictors of mortality in Libyan hemodialysis patients infected with COVID- 19. Methods: In this retrospective cohort study, data of CKD patients on maintenance hemodialysis diagnosed with COVID-19 infection from two large dialysis centers in Libya were collected and analyzed using SPSS version 22 for .demographic, clinical and laboratory profiles. Results: The data of 810 patients from two hemodialysis centers in Libya showed infection rate was 10.2 %, and the overall mortality was 26.5% (39/83) 47% of patients needed admission to ICU for supportive mechanical ventilation (SPO2 ranged from 76-92%). The biochemical and laboratory data showed a decreased mean absolute lymphocyte counts. A high neutrophil-lymphocyte ratio (NLR), and a mild decrease in platelet counts. C-reactive protein (CRP), fibrinogen, ferritin, and D-dimer were also high at admission. (22/83, 26.5%) of total patients, and (17/39) 43.6% of ICU patients died in less than 28 days after COVID-19 diagnosis. Conclusions: In CKD patients on maintenance hemodialysis diagnosed with COVID-19 infection; severity of disease at presentation, need for invasive supportive mechanical ventilation, older age, raised serum glutamic oxaloacetic transaminase, and lower level of albumin may have been valuable predictors of mortality and poor outcomes.
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References
Chou CY, Wang SM, Liang CC, Chang CT, Liu JH, Wang IK, Hsiao LC, Muo CH, Huang CC, Wang RY. Risk of pneumonia among patients with chronic kidney disease in outpatient and inpatient settings: a nationwide population-based study. Medicine (Baltimore). 2014 Dec; 93(27):e174. PMID: 25501062; PMCID: PMC4602797.
Fisher M, Yunes M, Mokrzycki MH, Golestaneh L, Alahiri E, Coco M. Chronic Hemodialysis Patients Hospitalized with COVID-19: Short-term Outcomes in the Bronx, New York. Kidney360. 2020 Jun 18;1(8):755-762
Jager KJ, Kramer A, Chesnaye NC, et al. Results from the ERA-EDTA Registry indicate a high mortality due to COVID-19 in dialysis patients and kidney transplant recipients across Europe. Kidney Int. 2020; 98(6):1540–8
Cianciolo G, Donati G, La Manna G, et al. The cardiovascular burden of end-stage renal disease patients. Minerva Urol Nefrol. 2010;62(1):51–66
Lamarche C, Iliuta IA, Kitzler T. Infectious disease risk in dialysis patients: a transdisciplinary approach. Can J Kidney Health Dis. 2019; 6
http://covid19.who.int/region/emro/country/ly
Sarnak MJ, Jaber BL. Mortality caused by sepsis in patients with end-stage renal disease compared withthe general population.KidneyInt.2000 Oct;58(4):1758-64. PMID: 11012910.
Asghar MS, Haider Kazmi SJ, Khan NA, Akram M, Hassan M, Rasheed U, Ahmed Khan S. Poor Prognostic Biochemical Markers Predicting Fatalities Caused by COVID-19: A Retrospective Observational Study from a Developing Country. Cureus. 2020 Aug 5;12(8):e9575. PMID: 32913691; PMCID: PMC7474562.
Wang L. C-reactive protein levels in the early stage of COVID-19. Med Mal Infect. 2020 Jun;50(4):332-334. Epub 2020 Mar 31. PMID: 32243911; PMCID: PMC7146693.
Omore I, Brimah I, Tijani S, Fadairo-Azinge A, Gazi M, Malik IO, Sajja P, Ali AM, Ayinla R, Assallum H. Predictors of Poor Outcomes for COVID-19-Associated Pneumonia in a Minority Population. Cureus. 2021 Jan 2;13(1): e12431.
Freitas GRR, da Luz Fernandes M, Agena F, Jaluul O, Silva SC, Lemos FBC, Coelho V, Elias DN, Galante NZ. Aging and End Stage Renal Disease Cause A Decrease in Absolute Circulating Lymphocyte Counts with A Shift to A Memory Profile and Diverge in Treg Population. Aging Dis. 2019 Feb 1;10(1):49-61. PMID: 30705767; PMCID: PMC6345336.
Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, Liu S, Zhao P, Liu H, Zhu L, Tai Y, Bai C, Gao T, Song J, Xia P, Dong J, Zhao J, Wang FS. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020 Apr;8(4):420- 422. Epub 2020 Feb 18. Erratum in: Lancet Respir Med. 2020 Feb 25;: PMID: 32085846; PMCID: PMC7164771.
Meisner M, Lohs T, Huettemann E, Schmidt J, Hueller M, Reinhart K. The plasma elimination rate and urinary secretion of procalcitonin in patients with normal and impaired renal function. Eur J Anaesthesiol. 2001 Feb;18(2):79-87. PMID: 11270029.
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