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Article

Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection

1
Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
2
7th Naval Hospital in Gdańsk, 80-305 Gdańsk, Poland
3
Department of Hypertension and Diabetology, Medical University of Gdańsk, 80-210 Gdańsk, Poland
*
Author to whom correspondence should be addressed.
Academic Editor: Jose-Manuel Ramos-Rincon
J. Clin. Med. 2022, 11(2), 285; https://doi.org/10.3390/jcm11020285
Received: 3 November 2021 / Revised: 30 December 2021 / Accepted: 31 December 2021 / Published: 6 January 2022
(This article belongs to the Special Issue COVID-19: Special Populations and Risk Factors)
Introduction: The determinants of COVID-19 mortality are well-characterized in the general population. Less numerous and inconsistent data are among the maintenance hemodialysis (HD) patients, who are the population most at risk of an unfavorable prognosis. Methods: In this retrospective cohort study we included all adult HD patients from the Pomeranian Voivodeship, Poland, with laboratory-confirmed SARS-CoV-2 infection hospitalized between 6 October 2020 and 28 February 2021, both those who survived, and also those who died. Demographic, clinical, treatment, and laboratory data on admission, were extracted from the electronic medical records of the dedicated hospital and patients’ dialysis unit, and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with 3-month all-cause mortality. Results: The 133 patients (53.38% males) aged 73.0 (67–79) years, with a median duration of hemodialysis of 42.0 (17–86) months, were included in this study. At diagnosis, the majority were considered to have a mild course (34 of 133 patients were asymptomatic, another 63 subjects presented mild symptoms), while 36 (27.07%) patients had low blood oxygen saturation and required oxygen supplementation. Three-month mortality was 39.08% including an in-hospital case fatality rate of 33.08%. Multivariable logistic regression showed that the frailty clinical index of 4 or greater (OR 8.36, 95%CI 1.81–38.6; p < 0.01), D-Dimer of 1500 ng/mL or greater (6.00, 1.94–18.53; p < 0.01), and CRP of >118 mg/L at admission (3.77 1.09–13.01; p = 0.04) were found to be predictive of mortality. Conclusion: Very high 3-month all-cause mortality in hospitalized HD patients was determined mainly by frailty. High CRP and D-dimer levels upon admission further confer mortality risk. View Full-Text
Keywords: COVID-19; SARS-CoV-2; hemodialysis; chronic kidney disease; mortality COVID-19; SARS-CoV-2; hemodialysis; chronic kidney disease; mortality
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MDPI and ACS Style

Tylicki, L.; Puchalska-Reglińska, E.; Tylicki, P.; Och, A.; Polewska, K.; Biedunkiewicz, B.; Parczewska, A.; Szabat, K.; Wolf, J.; Dębska-Ślizień, A. Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection. J. Clin. Med. 2022, 11, 285. https://doi.org/10.3390/jcm11020285

AMA Style

Tylicki L, Puchalska-Reglińska E, Tylicki P, Och A, Polewska K, Biedunkiewicz B, Parczewska A, Szabat K, Wolf J, Dębska-Ślizień A. Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection. Journal of Clinical Medicine. 2022; 11(2):285. https://doi.org/10.3390/jcm11020285

Chicago/Turabian Style

Tylicki, Leszek, Ewelina Puchalska-Reglińska, Piotr Tylicki, Aleksander Och, Karolina Polewska, Bogdan Biedunkiewicz, Aleksandra Parczewska, Krzysztof Szabat, Jacek Wolf, and Alicja Dębska-Ślizień. 2022. "Predictors of Mortality in Hemodialyzed Patients after SARS-CoV-2 Infection" Journal of Clinical Medicine 11, no. 2: 285. https://doi.org/10.3390/jcm11020285

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