Universität zu Köln

Pilgram, Lisa, Eberwein, Lukas, Wille, Kai, Koehler, Felix C., Stecher, Melanie, Rieg, Siegbert, Kielstein, Jan T., Jakob, Carolin E. M., Ruthrich, Maria, Burst, Volker, Prasser, Fabian, Borgmann, Stefan, Mueller, Roman-Ulrich, Lanznaster, Julia, Isberner, Nora, Tometten, Lukas ORCID: 0000-0002-5968-8335 and Dolff, Sebastian (2021). Clinical course and predictive risk factors for fatal outcome of SARS-CoV-2 infection in patients with chronic kidney disease. Infection, 49 (4). S. 725 - 738. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1439-0973

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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 x upper limit of normal, aOR 23.21, 95% CI 3.66-147.11, p < 0.001), thrombocytopenia (< 120,000/mu l, 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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pilgram, Lisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Eberwein, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Wille, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED Koehler, Felix C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stecher, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Rieg, Siegbert UNSPECIFIED UNSPECIFIED UNSPECIFIED Kielstein, Jan T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jakob, Carolin E. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruthrich, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Burst, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Prasser, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Borgmann, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Roman-Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Lanznaster, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Isberner, Nora UNSPECIFIED UNSPECIFIED UNSPECIFIED Tometten, Lukas UNSPECIFIED orcid.org/0000-0002-5968-8335 UNSPECIFIED Dolff, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-603251
DOI:	10.1007/s15010-021-01597-7
Journal or Publication Title:	Infection
Volume:	49
Number:	4
Page Range:	S. 725 - 738
Date:	2021
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1439-0973
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60325