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. 2021 Feb 17:14:41-51.
doi: 10.2147/IJNRD.S287455. eCollection 2021.

Clinical Characteristics and Short-Term Outcomes of Chronic Dialysis Patients Admitted for COVID-19 in Metro Manila, Philippines

Isabelle Dominique Tomacruz  1 , Paolo Nikolai So  1 , Renz Michael Pasilan  1 , Jameel Kristine Camenforte  1 , Maria Isabel Duavit  1
Affiliations

Clinical Characteristics and Short-Term Outcomes of Chronic Dialysis Patients Admitted for COVID-19 in Metro Manila, Philippines

Isabelle Dominique Tomacruz et al. Int J Nephrol Renovasc Dis. .

Abstract

Aim: Data published on COVID-19 in the Filipino population, particularly those with end stage kidney disease (ESKD) are still lacking.

Methods: We performed a retrospective, observational study of 68 ESKD patients admitted with COVID-19 infection at a tertiary hospital in Metro Manila, Philippines from April 1, 2020 to July 31, 2020. We compared the clinical features, baseline laboratory data, treatment strategies and short-term outcomes between those who survived and those who died. We also determined the risk factors associated with mortality from COVID-19.

Results: Mean age was 54.5 years old, 66% were male. All patients admitted were on maintenance hemodialysis (HD). The most common presenting symptoms were dyspnea (57%), fever (47%) and cough (38%). There was an equal number of patients on high flow nasal cannula (17.7%) and invasive mechanical ventilation (17.7%). ICU admission was required in 17.7% of the cohort. In-hospital death occurred in 25% of the patients. Admission PaO2/FiO2 (PF) ratios (162 ± 134 versus 356 ± 181; p=0.0009) were lower, and procalcitonin (6.07 ± 10.5ng/mL versus 0.73 ± 3.61 ng/mL; p=0.02), lactate dehydrogenase (396 ± 274U/L versus 282 ± 148 U/L; p=0.03), and white blood cell counts (10 ± 7.3 x 109/L versus 6.3 ± 4.2 x 109/L; p= 0.0039) were significantly higher among those who died compared to those who survived. After adjusting for confounders, only low PF ratio (HR 1.01 for every unit decrease, 95% CI 1-1.01) and need for ventilation (HR 6.45, 95% CI 1.16-35.97) conferred a significant risk for in-hospital mortality.

Conclusion: Short-term, in-hospital mortality is high among patients on chronic hemodialysis admitted for COVID-19 infection. They present similarly with the general population. Low PF ratio on admission and need for ventilation are independent risk factors for in-hospital mortality.

Keywords: COVID-19; coronavirus; dialysis; hemodialysis; kidney failure.

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Conflict of interest statement

The authors report no conflicts of interest for this work.

Figures

Figure 1
Figure 1
Differences in (A) PF ratio, (B) procalcitonin (ng/mL), (C) LDH (U/L), and (D) white blood cell counts (x109/L) on admission among those who survived and died; median with interquartile range.
Figure 2
Figure 2
Kaplan–Meier analysis of survival according to type of ventilatory support among ESKD patients on HD admitted for COVID-19.
Figure 3
Figure 3
Kaplan–Meier analysis of survival among end-stage kidney disease patients on hemodialysis admitted for COVID-19.
See this image and copyright information in PMC

References

    1. Naicker S, Yang CW, Hwang SJ, Liu BC, Chen JH, Jha V. The novel coronavirus 2019 epidemic and kidneys. Kidney Int. 2020;1–5. doi:10.1016/j.kint.2020.03.001 - DOI - PMC - PubMed
    1. Coronavirus disease (COVID-19) situation reports. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio.... Accessed August15, 2020.
    1. Cheng Y, Luo R, Wang K, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int. 2020;97(5):829–838. doi:10.1016/j.kint.2020.03.005 - DOI - PMC - PubMed
    1. Li J, Xu G. Lessons from the experience in Wuhan to reduce risk of COVID-19 infection in patients undergoing long-term hemodialysis. Clin J Am Soc Nephrol. 2020;15:717–719. - PMC - PubMed
    1. Clarke C, Prendecki M, Dhutia A, et al. High prevalence of asymptomatic COVID-19 infection in hemodialysis patients detected using serologic screening. J Am Soc Nephrol. 2020;31:1960–1975. - PMC - PubMed

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